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Whooping Cough (Pertussis) in Adults

What is whooping cough (pertussis)?

Whooping cough, or pertussis, is very contagious and mainly affects infants and young children. Whooping cough is caused by a bacterium called Bordetella pertussis. The illness is characterized by coughing spells that end with a characteristic "whoop" as air is inhaled. Whooping cough caused thousands of deaths in the 1930s and 1940s. With the advent of a vaccine, the death rate has declined dramatically. Pertussis vaccines are very effective. However, if pertussis is circulating in the community, there is a possibility that even a fully vaccinated person could catch the disease. Babies who are too young to receive the vaccine are also at very high risk of catching pertussis. The illness can be very serious, even sometimes fatal, in young infants. Many babies infected with pertussis have caught it from an adult.

What are the symptoms of whooping cough?

The disease starts like the common cold, with a runny nose or congestion, sneezing, and sometimes a mild cough or fever. Usually, after a week or two, severe coughing begins. The following are the most common symptoms of whooping cough. However, each person may experience symptoms differently. Infants younger than age 6 months may not have a classic whooping cough, or it may be difficult to hear. Instead of coughing, infants may have a pause in their breathing, called apnea, which is very serious. You should talk with your healthcare provider or call 911 immediately if you observe pauses in breathing. Symptoms of whooping cough may include:

  • Coughing, violently and rapidly, until all the air has left the lungs and a person is forced to inhale, causing a "whooping" sound

  • Persistent sneezing

  • Nasal discharge

  • Fever

  • Sore, watery eyes

  • Lips, tongue, and nailbeds may turn blue during coughing spells

Whooping cough can last up to 10 weeks and can lead to pneumonia and other complications.

The symptoms of whooping cough may look like other medical conditions. Always talk with your healthcare provider for a diagnosis.

How is whooping cough diagnosed?

In addition to a complete medical history and physical exam, diagnosis of whooping cough is often confirmed with a culture taken from the nose.

What is the treatment for whooping cough?

Your healthcare provider will figure out the best treatment for you based on: 

  • How old you are

  • Your overall health and past health

  • How sick you are

  • How well you can handle specific medicines, procedures, or therapies

  • How long the condition is expected to last

  • Your opinion or preference

Antibiotics are typically given within 3 weeks of the onset of cough in babies over age 1 year, and within 6 weeks of the onset of cough in infants younger than 1 year. Antibiotics are also given to pregnant women within 6 weeks of the onset of cough. Antibiotics help to prevent the spread of infection after 5 days of treatment, but don't affect the duration or severity of the illness.Other treatment may include:

  • Keeping warm

  • Eating small, frequent meals

  • Drinking plenty of fluids

  • Reducing stimuli that may provoke coughing

Hospitalization may be needed in severe cases.

Can whooping cough be prevented?

Although a vaccine has been developed against whooping cough, which is routinely given to children in their first year of life, cases of the disease still happen, especially in infants younger than age 6 months.

Since the 1980s, a dramatic increase in the number of cases of pertussis has happened, especially in children and teenagers, ages 10 to 19, and in babies younger than age 6 months. This is because of the decline in vaccination in some communities. Also, the current (acellular) vaccine is safer and better tolerated but does not last as long as the older cellular vaccine. Therefore, more adults are now susceptible to whooping cough after the protection of the vaccine has worn off. The CDC recommends that children get 5 DTaP shots for maximum protection against pertussis. A DTaP shot is a combination vaccine that protects against 3 diseases: diphtheria, tetanus, and pertussis. The first 3 shots are given at ages 2, 4, and 6 months. The fourth shot is given between ages 15 and 18 months; the fifth shot is given when a child enters school at ages 4 to 6 years. At their regular checkups, preteens ages 11 or 12  years should get a dose of Tdap. The Tdap booster contains tetanus, diphtheria, and pertussis. If an adult did not get a Tdap as a preteen or teen, he or she should get a dose of Tdap instead of the Td booster. All adults should get a Td booster every 10 years, but it can be given before the 10-year mark.

The CDC recommends that pregnant women should have a whooping cough vaccine in the third trimester of every pregnancy so protective antibodies can be transferred to the fetus before birth. Always talk with your healthcare provider for advice. 

Medical Reviewers:

  • Lentnek, Arnold, MD
  • Sather, Rita, RN