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The Permanente Medical Group

Symptoms

Whooping cough symptoms begin 7 to 21 days after a person is infected.

The illness occurs in 2 stages.

Stage 1:

• Includes cold-like symptoms, such as runny nose and mild cough without fever.
• Lasts 1 to 2 weeks, possibly less in young babies.

Infected people are highly contagious during this stage. They are unlikely to know that they have whooping cough.

Stage 2 is when most cases are diagnosed. This stage can include:

• Strong coughing.
• Coughing fits (paroxysms), especially in babies and young children. Gasping for air during paroxysms may cause a “whooping” sound.

Whooping cough can last 4 to 6 weeks in teens and adults, and 14 weeks or longer in young children or smokers.

Some patients feel nauseated or vomit after coughing (posttussive nausea or vomiting).

Children remain contagious during this stage.

Complications

Young babies and older adults are most vulnerable to complications from whooping cough.

In babies and unvaccinated toddlers, complications can include:

• Pneumonia
• Seizures
• Death

Older adults may fracture ribs during severe coughing fits.

Teens and adults who are otherwise healthy usually recover from whooping cough without problems.

When to Call Us

Call us immediately:

• If you, your child, or your baby has symptoms of whooping cough. We may ask you to wear a mask to your appointment to prevent spreading the illness.

If you or your baby or child has already been diagnosed with whooping cough, immediately call 911 and seek emergency medical help if any of these symptoms are occurring:

• Breathing difficulties, or no breathing
• Breathing more quickly than usual
• Seizures
• Bluish-colored skin
• Exhaustion

You or your baby or child may also need emergency care if you have ongoing vomiting or signs of dehydration, such as:

• Less urination or fewer wet diapers
• Few or no tears
• Dry mouth
• Headache
• Dizziness
• Muscle weakness
  

Diagnosis

We usually use the polymerase chain reaction (PCR) test, which detects pertussis bacteria. We swab the back of your nose to get a sample for the test.

The PCR test:

• Is accurate within 3 weeks of when a person is infected, when symptoms may still be mild.
• Can show a positive result even during antibiotic treatment for whooping cough.

For babies, we may use a complete blood count (CBC) test to check for whooping cough.

When a person’s test results are positive (pertussis infection is detected in his or her body), the person is treated with an antibiotic.

Family members and others who’ve been in close contact with a sick person may also be treated with an antibiotic.

Treatment can be lifesaving for a newborn baby and may keep family members from getting sick. It also helps prevent spreading the disease to others.

Risk Factors

If there’s any possibility that you could give whooping cough to a baby or older adult, or another person who’s at higher risk, make sure you are fully vaccinated.

Getting vaccinated is especially important for:

Parents or caretakers (for example, grandparents) of babies who are:

• Newborn
• Younger than 6 months

Pregnant women. Each time you are pregnant, get a Tdap (tetanus, diphtheria, and pertussis) vaccine. This gives your unborn baby extra protection.

Keep in mind that:

• The best time to get a Tdap is in the 27th to 36th week of your pregnancy.
• It’s safe for you to get a Tdap vaccine anytime during your pregnancy or while you are breastfeeding. 

Also, women who’ve just given birth and never had Tdap can get vaccinated before they go home from the hospital.

Young adolescents should receive Tdap at age 11. California state law requires teens to have Tdap before entering 7th grade.

Health care workers, particularly those who work with babies, children, or pregnant women, should be vaccinated.

Prevention

Vaccination is the best protection against whooping cough. If you’ve already had whooping cough, you are not fully protected from getting it again.

Two types of vaccines can be given. The type you get depends on your age:

• The childhood vaccine is DTaP (diphtheria, tetanus, and acellular pertussis).
• The teen/adult vaccine is Tdap (tetanus, diphtheria, and acellular pertussis).

DTaP vaccine

Children must have DTaP before entering school in California.

DTaP isn’t recommended for babies younger than 6 weeks because their immune response isn’t strong enough.

The usual ages for DTaP doses are:

• 2 months
• 4 months
• 6 months
• 12 to 18 months (at least 6 months after the third dose)
• 4 to 6 years

Side effects may include 1 to 2 days of:

• Redness and mild swelling where the shot was given
• Fever

DTaP can cause high fevers or swelling in children over age 7 and should not be given.

Tdap vaccine

Tdap is given as a single dose to adults and teens (age 11 and older). It’s also given to children over age 7 who weren’t fully vaccinated when they were younger.

Tdap contains less pertussis antigen than DTaP. Tdap is safe for teens and adults but provides less protection.

Why Treatment Is Important

Remember, whooping cough can be serious or life-threatening for babies and older adults.

Treatment can help people who have or have been exposed to whooping cough.

By getting treatment, you or your child are less likely to be harmed by whooping cough. And, you help prevent the disease from spreading to others.

If you’ve been diagnosed with whooping cough:

• Don’t go to work or school until you’ve taken at least 5 days of antibiotics as prescribed by your doctor or Public Health Department.
• Take all your prescribed medications, even if you don’t feel sick.

If you’ve been exposed to whooping cough but don’t have an active infection:

• Take preventive antibiotics to protect yourself, your family, and your community.
• Be assured that these antibiotics are safe and have minor or no side effects.

U.S. law requires us to report all whooping cough cases to local Public Health Departments. This helps officials detect outbreaks and prevent future cases.

Treatments

We usually treat whooping cough with an antibiotic medication.

• Taking your medication exactly as instructed is important.
• Being treated within 3 weeks of being infected with pertussis may make your symptoms milder.

If you think your child may have whooping cough, don’t use over-the-counter cough medicines (suppressants or expectorants). These medicines:

• Won’t control the strong coughing caused by pertussis.
• May be dangerous, especially for children younger than age 4.

If complications develop, we’ll treat them as needed.

Hospitalization

In babies, whooping cough can cause:

• Serious breathing problems, including loss of breathing in very young babies.
• Seizures due to low oxygen levels in the brain.

Often, the hospital is the safest place for babies with whooping cough to get care. We will monitor your child’s breathing and may need to:

• Give extra oxygen through a mask.
• Suction mucus from the nose.

If your child can’t eat or drink due to uncontrollable coughing, we may give intravenous (IV) fluids.

Home Treatment

Don’t let your child go to school, or return to work yourself, until your doctor tells you it’s safe to do so.

Make sure you or your child:

• Take antibiotics and other medications exactly as prescribed.
• Get enough rest.
• Drink plenty of fluids. Use a straw if it’s hard to drink due to coughing.
• Eat small meals, if coughing or vomiting make eating difficult.

Be sure to call us if the sick person:

• Vomits repeatedly.
• Has signs of dehydration, such as dry mouth or reduced urination.

Wash your hands frequently. Throw used tissues in a trash can and empty it often.

Moistening the air by using a humidifier may help the sick person feel better. No one should smoke near the sick person.