Whooping cough

What is whooping cough? 

Whooping cough (a.k.a. pertussis) is a highly contagious respiratory disease. Caused by the bacteria Bordetella pertussis, its most obvious symptoms are uncontrollable, violent coughing and trouble breathing. After coughing fits, people with pertussis often struggle to take deep breaths and in the process make a “whooping” sound. 

Thousands of cases of pertussis have been identified in recent years, although the full extent of illness is unknown. Although health care providers are mandated to report cases of whooping cough to state health departments, many cases are untreated and therefore uncounted, leading to underreporting

What are the symptoms? 

Initially whopping cough may be mistaken for the common cold. Children will often have a runny nose, a mild cough, and a low-grade fever. As the condition worsens, mucus thickens and causes persistent and severe coughing attacks. The telltale sign of whooping cough is the sound of a “whoop” as your child tries to catch his breath in-between fits of uncontrollable coughing. 

How do children get whooping cough? 

Whooping cough spreads very easily when an infected person coughs or sneezes. Those most susceptible to pertussis and its complications are infants. About half of infants younger than age 1 who contract whooping cough are hospitalized, and 1–2 of every 100 infants hospitalized with the disease die, according to the U.S. Centers for Disease Control and Prevention. Pertussis is rarely fatal for adults. 

How is it treated? 

Since pertussis is a bacterial infection, it can be treated with antibiotics. In older children and adults, treatment is often given at home. However, infants and young children are likely to be treated in a hospital due to a greater risk of developing pneumonia. In the hospital, a child will be given oxygen and intravenous (IV) fluids as needed. This will help to open airways and alleviate dehydration, a result of vomiting due to excessive coughing. (It should be noted that cough medicines are not recommended for children under age 6. Read more here.) 

How can it be prevented? 

Immunization continues to be the first strategy for protecting young children from pertussis, and there are two whooping cough vaccines: DTaP, for children under 7 years old, and Tdap, for older children and adults. (The formulation of these vaccines is different, as the CDC explains.) Neither vaccine provides lifelong protection; experts have found that protection from pertussis wanes over time.

Early protection is critical. Babies cannot receive their first whooping cough vaccine until 2 months of age, and their immunization status remains well below 80 percent until the third pertussis vaccination at 6 months of age. The CDC’s Advisory Committee on Immunization Practices recommends that pregnant women get a booster shot with each pregnancy to ensure that their infants passively acquire pertussis antibodies via the placenta. The AAP and the Global Pertussis Initiative recommend cocooning—vaccinating parents, caregivers, and other close contacts—as a second strategy for protecting infants. 

Whether children should receive an additional dose is unclear, with at least one study finding increased risk of pertussis in infants with a sibling whose most recent immunization was more than two years prior. The AAP, therefore, recommends a dose be given to siblings 11 years and older.

The CDC recommends

  • Pregnant women receive the Tdap vaccine during each pregnancy, regardless of prior vaccinations. Ideally, Tdap should be administered between 27 and 36 weeks gestation, to maximize the maternal antibody response and passive antibody transfer to the infant. However, it may be given at any time during pregnancy. 
  • Health care providers administer Tdap immediately postpartum, if it is not administered during pregnancy. 
  • Mothers breastfeed their infants. In addition to other health benefits for both mothers and babies, breast milk will convey antibodies to the baby. 
  • Doctors vaccinate children with DTaP at 2 months, 4 months, 6 months, between 15–18 months, and between 4–6 years old; and that parents follow this recommended immunization schedule. 
  • Adolescents and adults (parents, siblings, grandparents, and childcare providers) who will have close contact with an infant under 12 months old receive a single dose of Tdap to protect against pertussis, even if they have received the vaccine previously. Vaccine protection for whooping cough fades over time, so experts recommend adults receive a tetanus and diphtheria booster (Td) every 10 years and substitute a Tdap vaccine for one of the boosters. The dose of Tdap can be given earlier than the 10-year mark, but you should talk to your doctor about what schedule is best based on individual circumstances. Children ages 7–10 years who did not complete their Tdap vaccination round should receive a single Tdap dose, as should adolescents ages 11–18 years who did complete their childhood vaccinations, according to the CDC

When should I call a doctor? 

Call the doctor immediately if you suspect your child may be developing whooping cough, even if your child is up to date with her vaccinations. Whopping cough can be fatal in young infants, so it is critical that babies be seen by a health care professional immediately if the child vomits after coughing, is having trouble breathing, or if you hear a “whoop” sound after a cough.

Last updated December 11, 2017

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