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Understanding Whooping Cough (Pertussis)

Whooping cough (pertussis) is a bacterial infection of the respiratory tract. It is highly contagious and spreads easily from person to person through droplets when an infected person coughs, sneezes, or talks. With whooping cough, thick mucus forms deep inside the airways. This leads to severe coughing spells that make a “whooping” sound (sharp intake of breath). Most infants and children in the U.S. get a series of vaccines to prevent whooping cough. But infants too young to be fully immunized are vulnerable to infection. Sometimes, whooping cough can occur in children who have had the full series of vaccines. Protection from the vaccine or the disease will also wear off over time. This can leaveolder children, teens, and adults at risk.

Boy coughing into hand.

What are the symptoms?

  • At first, whooping cough seems like a common cold. Symptoms include a runny nose, sneezing, mild fever, and a slight cough.

  • One to 2 weeks later, the cough becomes severe. It often comes in spells that last a minute or more and end with a high-pitched whoop. The intense coughing can cause a child to break a rib, vomit, turn blue, or even pass out. This stage can last 1 to 6 weeks or longer.

  • In time, the cough improves. But it may linger in a less severe form for months. A child can spread the infection as long as the cough lasts.  

What are the complications of whooping cough?

Whooping cough can cause other problems including:

  • Ear infections

  • Pneumonia

  • Slowed or stopped breathing

  • Fluid loss (dehydration)

  • Seizures

Babies and children younger than 2 years old are more at risk for serious problems and even death.

Who is at risk?

Children who have all of the vaccines are often protected from whooping cough. But others are at risk, including:

  • Babies 6 months and younger who haven’t had at least 3 doses of whooping cough vaccine

  • Children and teens age 11 to 18 who haven’t had a booster shot of the vaccine

  • Anyone who hasn’t been vaccinated or who hasn’t had a booster shot of the vaccine

How is whooping cough diagnosed?

Your child’s healthcare provider will ask about your child’s health history and do a physical exam. A small sample of material may be taken from your child’s nose or throat. The sample is sent to a lab and tested for the bacteria that cause whooping cough. Your child may also have blood tests or chest X-rays.

How is whooping cough treated?

Older children and teens are often treated at home with self-care to keep them comfortable until the symptoms pass. Infants and toddlers are more likely to have complications. So they are often treated in the hospital. During a hospital stay, children with whooping cough:

  • May be given medicines to ease inflamed airways

  • Have their breathing carefully watched

  • May have their airways suctioned to remove mucus

  • Are given antibiotics through an IV (intravenous) line into a vein in the arm

If antibiotics are prescribed

Antibiotics can shorten the illness, but only if given early. They won’t cure whooping cough in most cases. But they may still be prescribed to help make your child less contagious. In that case:

  • Make sure your child takes all the medicine, even if he or she feels better. If not, the infection may come back.

  • Be sure your child takes the medicine as directed. For example, some antibiotics should be taken with food.

  • Ask your child’s healthcare provider or pharmacist what side effects the medicine may cause and what to do about them.

Your child should stay home from school until he or she has completed at least 5 days of antibiotic treatment. If appropriate antibiotic treatment is not used, he or she should wait 3 weeks or 21 days after the start of the cough.

Caring for your child at home

To help your child recover fully from whooping cough:

  • Give plenty of fluids, such as water, juice, or warm soup. Fluids help loosen mucus, so your child can breathe more easily. They also help prevent dehydration.

  • Offer smaller meals. Small amounts of food are easier to eat when coughing is severe.

  • Make sure your child gets enough rest. Ask your child’s healthcare provider about the best sleeping position to improve breathing.

  • Run a humidifier in your child’s bedroom to ease coughing and loosen mucus in the airways. Be sure to clean the humidifier regularly to prevent growth of mold and bacteria.

  • Keep your house free of irritants that can trigger coughing spells. These include tobacco smoke and fumes from fireplaces.

  • Don't give your child over-the-counter cough syrups. They won’t ease your child’s cough and may be harmful.

  • Don’t take your child with whooping cough to school or daycare until the provider says it’s OK.

  • Ask your child’s provider if others in your home should get a booster shot to help keep them from getting sick.

Call 911

Call 911 if your child:

  • Has trouble breathing

  • Stops breathing even for an instant

  • Has skin or lips that look blue, purple, or gray

  • Has a seizure

  • Shows a sudden lack of energy or can't move

  • Is unconscious or does not respond

  • Has a fever (see "Fever and children" below)

  • Has signs of dehydration such as sunken eyes, dry mouth, dark or strong-smelling urine, or no urine output in 6 to 8 hours

When to call the healthcare provider

Call your child’s healthcare provider right away if your child:

  • Exhaustion after coughing spells

  • Loss of appetite and eating poorly

  • Vomiting after coughing spells

  • Weak and looking sick

  • Has signs of dehydration such as sunken eyes, dry mouth, dark or strong-smelling urine, or no urine output in 6 to 8 hours

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer. For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead temperature of 100.4°F (38°C) or higher, or as directed by the provider.

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider.

Child age 3 to 36 months:

  • Rectal, forehead, or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider.

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider.

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider.

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

Preventing whooping cough

Most children get a vaccine against whooping cough starting at 2 months old. It’s often combined with vaccines for 2 other diseases, diphtheria and tetanus. The combination vaccine (called DTaP) is given in a series of 5 shots at these ages:

  • 2 months

  • 4 months

  • 6 months

  • 15 to 18 months

  • 4 to 6 years, just before starting school

Make sure your child has the full series of whooping cough vaccines. If your child misses a shot, talk with your child’s healthcare provider about a makeup schedule. The vaccine's effects may start to fade by age 11. For that reason, healthcare providersadvise a booster shot for most children at 11 to 12 years of age. Booster shots are also advised for some adults. And make sure to stay away fromadults or children with whooping cough.

The American Academy of Pediatrics advises that teens, pregnant teens, and pregnant women be vaccinated. A single dose is also advised for adults (even those older than 65) who have contact with babies. Talk with your child’s provider to learn more.

Online Medical Reviewer: Barry Zingman MD
Online Medical Reviewer: Marianne Fraser MSN RN
Online Medical Reviewer: Raymond Kent Turley BSN MSN RN
Date Last Reviewed: 6/1/2019
© 2000-2019 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.