Whooping Cough: Beyond the “Whoop” – A Guide to Prevention and Treatment

Whooping cough (pertussis) is a highly contagious respiratory tract infection. In many people, it’s marked by a severe hacking cough followed by a high-pitched intake of breath that sounds like “whoop.” Before the vaccine was developed, it was considered a childhood disease.

Pertussis may begin like a common cold, but unlike a cold, the coughing can last for weeks or months.

Symptoms of pertussis usually develop within 5 to 10 days after you come into contact with the bacteria that cause it. Sometimes symptoms do not develop for as long as 3 weeks.

Early symptoms: Stage 1

Early symptoms can last for 1 to 2 weeks and usually include:

In its early stages, whooping cough appears to be nothing more than the common cold. Therefore, doctors often do not suspect or diagnose it until the more severe symptoms appear.

Runny or stuffed-up nose.
Low-grade fever (less than 100.4°F)
Mild, occasional cough (babies do not do this)
Apnea (life-threatening pauses in breathing) and cyanosis (turning blue or purple) in babies and young children.

Later symptoms: Stage 2

One to 2 weeks after the first symptoms start, people with whooping cough may develop paroxysms—rapid, violent, and uncontrolled coughing fits. These coughing fits usually last 1 to 6 weeks but can last for up to 10 weeks. Coughing fits generally get worse and become more common as the illness continues.

Coughing fits can cause people to:

Make a high-pitched “whoop” sound when they are finally able to inhale at the end of a coughing fit
Vomit during or after coughing fits.
Feel very tired after the fit, but usually seem well in-between fits.
Struggle to breathe.

Babies may struggle to breathe, while teens and adults usually have mild symptoms.

Many babies with whooping cough don’t cough at all. Instead, it may cause them to turn blue or struggle to breathe. It may seem like a common cold for the entire illness, not just the beginning.

The infection is generally milder in teens and adults than in babies and children, especially those who have gotten vaccinated against whooping cough. It may seem like a common cold. The “whoop” is often not there for people who have a milder illness.

However, teens and adults can have serious cases of whooping cough. Teens and adults, especially those who did not get whooping cough vaccines, may have lengthy coughing fits that keep them up at night. Those who get these coughing fits say it’s the worst cough of their lives. It can also cause major disruptions to daily life and serious complications.

Vaccinated people may not get as sick. Vaccines are effective, but not perfect. The infection is usually not as bad for people who have gotten vaccinated against whooping cough but still get sick.

In vaccinated people who get whooping cough:

The cough usually won’t last as many days.
Coughing fits, whooping, and vomiting after coughing fits are less common.
Apnea and cyanosis are less common (in vaccinated babies and children)

CDC recommends whooping cough vaccines for people of all ages.

Recovery: Stage 3

Recovery from whooping cough can be slow. The cough becomes milder and less common as you get better.

Coughing fits may stop for a while but can return if you get other respiratory infections. Coughing fits can return many months after the whooping cough illness started.

Causes

Whooping cough, also known as pertussis, is a very contagious respiratory illness caused by a type of bacteria called Bordetella pertussis. The disease is only found in humans.

Whooping cough bacteria attach to the cilia (tiny, hair-like extensions) that line part of the upper respiratory system. The bacteria release toxins (poisons), which damage the cilia and cause airways to swell.

The bacteria that cause whooping cough spread easily from person to person through the air. When a person who has pertussis sneezes or coughs, they can release small particles with the bacteria in them. Other people then breathe in the bacteria. It also spreads when people spend a lot of time together or share breathing space, like when you hold a newborn on your chest.

People can spread the bacteria from the start of the very first symptoms and for at least 2 weeks after coughing begins. Taking antibiotics early in the illness may shorten the amount of time someone is contagious. Some people have mild symptoms and don’t know they have whooping cough, but they can still spread the bacteria to others. Some people have mild symptoms and don’t know they have whooping cough, but they can still spread the bacteria to others.

Diagnosis and Treatment

Treating whooping cough (pertussis) early with antibiotics may make the infection less serious and help prevent spreading the bacteria that cause it to others.

See a doctor if you think you or your child may have whooping cough.

Diagnosis

Doctors diagnose whooping cough by considering if you have been in contact with someone who has whooping cough and by doing a

History of typical signs and symptoms.
Physical exam
Laboratory test of a mucus sample from the back of the throat
Blood test

Treatment

Doctors generally treat whooping cough with antibiotics. There are several antibiotics available to treat whooping cough. It’s very important to treat whooping cough early, before coughing fits begin.

Treating whooping cough early can:

Make the illness less serious
Help prevent spreading the bacteria that cause it to others

Starting treatment after three weeks of illness is unlikely to help even though most people will still have symptoms. By then, your body has gotten rid of the bacteria, but the symptoms are still there due to the damage already done to your body.

Manage whooping cough symptoms and reduce the risk of spreading the bacteria to others.

Take antibiotics exactly as prescribed by the doctor.
Keep your home free from irritants – as much as possible – that can trigger coughing, such as smoke, dust, and chemical fumes.
Use a clean, cool mist humidifier to help loosen mucus and soothe the cough.
Wash hands often with soap and water for at least 20 seconds.
Eat small meals every few hours to help prevent vomiting.
Get plenty of fluids, including water, juices, and soups, and fruits to prevent dehydration (lack of fluids).
Do not take cough medicine unless your doctor recommends them. Giving cough medicine probably will not help and is often not recommended for children younger than 4 years old.

Signs of dehydration include:

Getting treatment in a hospital
Dry, sticky mouth
Sleepiness or tiredness
Thirst
Decreased urination or fewer wet diapers
Few or no tears when crying
Muscle weakness
Headache
Dizziness or lightheadedness

Pertussis can sometimes be very serious and can cause complications, especially for babies. People with serious illness or complications need care in the hospital. About a third of babies younger than 1 year old who get whooping cough need care in the hospital.

Hospital treatment of whooping cough usually focuses on:

Keeping breathing passages clear. This may require suctioning (drawing out) mucus.
Monitoring breathing and giving oxygen, if needed.
Preventing or treating dehydration. People might need intravenous (IV, through the vein) fluids if they show signs of dehydration or have difficulty eating.

Complications

Pertussis can cause serious and sometimes deadly complications in babies and young children. Babies and children who have not had all recommended whooping cough vaccines are more likely to get serious complications.

About one third of babies younger than 1 year old who get whooping cough need care in the hospital. The younger the baby, the more likely they will need treatment in the hospital.

Of those babies younger than 1 year old who are treated in the hospital with whooping cough about:

2 in 3 (68%) will have apnea (life-threatening pauses in breathing)
1 in 5 (22%) get pneumonia (lung infection)
1 in 50 (2%) will have convulsions (violent, uncontrolled shaking)
1 in 150 (0.6%) will have encephalopathy (disease of the brain)
1 in 100 (1%) will die

Teens and adults

Teens and adults can also get complications, like pneumonia, from whooping cough.

If they have a severe cough, teens and adults can:

Pass out
Fracture (break) a rib
Lose bladder control
Lose weight

Complications are usually less serious in this older age group, especially in those who have been vaccinated against whooping cough. However, if complications are serious, some people may need care in the hospital.

Prevention

The best way to prevent pertussis is to get vaccinated. CDC recommends whooping cough vaccination for everyone.

Preventive antibiotics

Preventive antibiotics, also known as postexposure antimicrobial prophylaxis (PEP), are medicines given to someone that has been exposed to a harmful bacterium in order to help prevent them from getting sick.

Doctors and local health departments generally determine who should get preventive antibiotics. For people exposed to whooping cough, CDC recommends preventive antibiotics only if they:

Live with the person who has been diagnosed with whooping cough.
Are at increased risk for serious disease (e.g., babies, people with certain medical conditions) or will have close contact with someone who is at increased risk for serious disease (e.g., women in their third trimester of pregnancy, people who work with or care for high-risk individuals).

If you’ve been exposed to the bacteria that cause pertussis, talk to your doctor about whether you need preventive antibiotics. This is especially important if there is a baby or pregnant woman in your household or you plan to have contact with a baby or pregnant woman.

Good hygiene

CDC recommends practicing good hygiene to prevent the spread of the bacteria that cause whooping cough and other respiratory illnesses.

Cover your mouth and nose with a tissue when you cough or sneeze.
Throw away used tissues in the waste basket right away.
Cough or sneeze into your upper sleeve or elbow if you don’t have a tissue. Never cough into your hands because you can spread germs this way.
Wash your hands often with soap and water for at least 20 seconds.
Use an alcohol-based hand sanitizer if soap and water are not available.
Temporary immunity after getting sick

People who have had whooping cough have some natural immunity (protection) to future whooping cough infections. Getting sick with whooping cough doesn’t provide lifelong protection.

CDC recommends pertussis vaccination even if you have had the disease before, since natural immunity fades and does not offer lifelong protection.

5 Things to Know About Whooping Cough

Keeping up to date with whooping cough vaccines is the best way to protect you and your loved ones.

Whooping cough can be very serious, especially for babies.

Pertussis can cause serious illness in people of all ages and can even be life threatening, especially in babies.
About one third of babies younger than 1 year old who get whooping cough need care in the hospital, and 1 out of 100 babies who get treatment in the hospital die.

Pertussis is contagious.

The bacteria that cause whooping cough spread easily from person to person through coughing and sneezing.
Some people have mild symptoms and don’t know they have whooping cough, but they can still spread the bacteria that cause it to others, including babies.

Severe coughing fits can last for weeks.

Pertussis can cause rapid, violent, and uncontrolled coughing fits until all air is gone from the lungs. These coughing fits can go on for up to 10 weeks or more.

Babies may not cough at all.

Babies may not cough at all. Instead, they may have apnea (life-threatening pauses in breathing) or struggle to breathe.
Any time someone is struggling to breathe, it is important to get them to a doctor right away.

Vaccines are the best protection against pertussis.

The best way to protect you and your loved ones is to stay up to date with recommended whooping cough vaccines.
Two vaccines in the United States help prevent whooping cough: DTaP and Tdap. Children younger than 7 years old get DTaP, while older children, teens, and adults get Tdap.
Women should get a Tdap vaccine during the third trimester of each pregnancy to help protect their baby early in life.

Vaccination: The Best Defense

The good news is that whooping cough is preventable through vaccination. The DTaP vaccine protects against diphtheria, tetanus, and pertussis. Children typically receive a series of DTaP shots throughout their infancy and childhood, with booster shots, known as Tdap, recommended for adolescents and adults. Pregnant women are also advised to get the Tdap vaccine to help protect their newborns from whooping cough in the first few vulnerable months of life.

If you suspect whooping cough in yourself or your child, seek immediate medical attention. Early diagnosis and treatment with antibiotics can shorten the illness and prevent the spread of the bacteria. Supportive care, including plenty of rest, fluids, and pain relievers, can help ease symptoms while the body fights off the infection.

Working Together for Prevention

Maintaining high vaccination rates is crucial for controlling whooping cough outbreaks. By getting vaccinated and encouraging others to do the same, we can create a community shield that protects those most vulnerable – our infants.

Pertussis may elicit a chuckle when depicted in cartoons, but it’s a serious illness that demands awareness and preventive action. By understanding the risks and the power of vaccination, we can keep ourselves, our loved ones, and our communities safe from whooping cough.

“I’m Emily, a 28-year-old yoga instructor, and whooping cough, or pertussis as the doctors call it, took my breath away in more ways than one.

It started innocently enough. A tickle in my throat, a runny nose – nothing I wouldn’t get over with some rest and fluids. A week later, the cough was still there, but it had morphed into something monstrous. Each cough felt like a mini explosion in my chest, leaving me gasping for air. Sleep became a distant memory as the coughing fits raged through the night, each one ending with that awful, high-pitched “whoop” that gave the illness its name.

I finally dragged myself to the doctor, convinced I had bronchitis. But the diagnosis hit me like a punch to the gut: whooping cough. Apparently, adults can get it too, and my lack of a recent booster shot left me wide open.

The next few weeks were a blur of exhaustion and fear. The cough became relentless, leaving me with cracked ribs and a bruised ego. Simple tasks like walking to the mailbox became monumental efforts. The worst part, though, was the fear. Every cough sent shivers down my spine, the worry for those around me gnawing at me. I couldn’t see my niece, a precious newborn, for fear of passing this horrible illness on to her.

The antibiotics helped, slowly pushing the illness back. But the recovery was slow. It took weeks before the coughing subsided, and my lungs felt like their own again. Even now, months later, there’s a lingering echo of that experience, a constant reminder of how easily a seemingly harmless illness can turn your life upside down.

My story is a cautionary tale. Don’t underestimate whooping cough. Get vaccinated and encourage those around you to do the same. It’s not just about protecting yourself; it’s about protecting the most vulnerable among us – our babies and young children. Whooping cough may have stolen my breath, but it won’t steal my voice. I’m sharing my story so others can learn from my experience and take steps to protect themselves and their loved ones”.

“I’m Emily, a 28-year-old yoga instructor, and whooping cough, or pertussis as the doctors call it, took my breath away in more ways than one.

It started innocently enough. A tickle in my throat, a runny nose – nothing I wouldn’t get over with some rest and fluids. A week later, the cough was still there, but it had morphed into something monstrous. Each cough felt like a mini-explosion in my chest, leaving me gasping for air. Sleep became a distant memory as the coughing fits raged through the night, each one ending with that awful, high-pitched “whoop” that gave the illness its name.

The antibiotics helped, slowly pushing the illness back. But the recovery was slow. It took weeks before the coughing subsided and my lungs felt like their own again. Even now, months later, there’s a lingering echo of that experience, a constant reminder of how easily a seemingly harmless illness can turn your life upside down.”

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