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See a health care provider if you or your child are coughing violently. Get immediate care for breathing difficulties.

Whooping cough, also known as pertussis, is a very contagious respiratory disease caused. It is caused by the bacterium Bordetella pertussis. 

Whooping cough is known for uncontrollable, violent coughing which often makes it hard to breathe. After fits of many coughs, someone with whooping cough often needs to take deep breaths which result in a "whooping" sound. Whooping cough can affect people of all ages, but can be very serious, even deadly, for babies less than a year old. Other people at high risk of severe illness include those with immunocompromised conditions and moderate to severe asthma. 

Symptoms

Symptoms of whooping cough can vary for people based on their age and if they've been vaccinated or not. Whooping cough vaccines work well, but protection can fade overtime. People who are vaccinated can still get whooping cough, but their illness is generally milder.

Early Symptoms

It usually takes five to 10 days for symptoms to appear after exposure to the bacteria that cause whooping cough. Sometimes it can take as long as three weeks to develop symptoms. Whooping cough appears similar to a common cold early on:

  • Runny or stuffed up nose
  • Low-grade fever (less than 100.4°F)
  • Mild, occasional cough
Babies may struggle to breathe.

Many babies with whooping cough don't cough at all. Instead, they may have apnea (life-threatening pauses in breathing). The apnea may cause cyanosis (to turn blue) or they may struggle to breathe. For some babies, whooping cough may seem like a common cold for the entire illness, not just at the beginning. Unvaccinated or not fully vaccinated babies less than one year old have the highest risk for severe complication and death.

Later Symptoms

Rapid, violent and uncontrolled coughing fits

One to two weeks after the first symptoms start, people may develop paroxysms, known as coughing fits. These coughing fits usually last one to six weeks but can last for up to 10 weeks. The cough generally gets worse and becomes more common as the illness continues.

Coughing fits can cause people to

  • Make a high-pitched "whoop" when they inhale after a coughing fit
  • Vomit during or after coughing fits
  • Feel very tired after the fit, but usually seem well in-between fits
  • Have difficulty sleeping at night
  • Struggle to breathe
  • Fracture (break) a rib

Those who get these coughing fits say it's the worst cough of their lives.

Listen to an example of whooping cough 

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Whooping cough can be very serious for babies.

About one in three babies younger than one year old who get whooping cough need care in the hospital. The younger the baby, the more likely they'll need hospital treatment. Babies younger than one year old who are treated in the hospital can have:

  • Life-threatening pauses in breathing: 2 in 3 (68%)
  • Lung infection: 1 in 5 (22%
  • Violent, uncontrolled shaking: 1 in 50 (2%)
  • Encephalopathy (disease of the brain): 1 in 150 (0.6%)
  • One in 100 (1%) will die from their complications. 
The best protection against whooping cough is vaccination. Make sure you and your family are up to date on whooping cough vaccinations. 

How It Spreads

Whooping cough is very contagious. The bacteria spreads easily from person-to-person through the air in respiratory droplets when someone who is infected coughs or sneezes. People can be contagious for weeks, and can unknowingly spread the bacteria. 

Without appropriate treatment, someone with whooping cough is considered contagious for 21 days after the start of their cough. After just five days of appropriate antibiotic treatment, they are no longer considered contagious.

Read more.

Prevention

Vaccination

The best way to prevent whooping cough is to get vaccinated with the DTaP or Tdap vaccine. CDC recommends whooping cough vaccination for everyone. Pregnant people are recommended to get whooping cough vaccine during the third trimester of every pregnancy to provide protection to their baby before birth.

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Antibiotics 

Some people should receive antibiotics to prevent them from getting sick if they have been in close contact with someone with whooping cough. Preventive antibiotics are also known as postexposure antimicrobial prophylaxis (PEP). These are medicines given to someone who has been exposed to harmful bacteria to help prevent them from getting sick. If you've been exposed to someone with whooping cough, talk to a health care provider about preventive antibiotics.

Treatment

It's very important to treat whooping cough early, before coughing fits begin. If taken in the early stages of illness, antibiotics can help make symptoms less severe and shorted the length of illness. If taken after coughing fits have started, antibiotics may not change the severity or duration of symptoms, but will decrease the amount of time the infected person can spread the bacteria. Take antibiotics exactly as prescribed. 

Many people can manage symptoms at home. However, whooping cough can be very serious and cause complications, especially for babies. Seek emergency care if you or your child is having trouble breathing.

People who are sick with whooping cough should stay home and away from others until finishing five days of antibiotics, or until 21 days have passed since the start of the cough. They should also make sure to cover coughs and sneezes and practice good handwashing.

Read more.

Information for Health Care Providers

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An outbreak of whooping cough (pertussis) has been identified in the Brattleboro area in Windham County. Providers are encouraged to consider whooping cough when assessing people with cough illness.

Read the Health Advisory (August 14, 2024)

Report all suspected and confirmed cases to the Vermont Department of Health Infectious Disease Epidemiology program at 802-863-7240, option 2.

Clinical Overview and Features

During the COVID-19 pandemic, cases of pertussis decreased nationally. However, CDC now reports that pertussis cases are beginning to return to pre-pandemic patterns. 

Testing

Culture was previously the gold standard for laboratory diagnosis of pertussis, but now PCR testing is more common for a variety of reasons. The culture is most sensitive if collected during the first two weeks of illness after onset of cough. The PCR is most sensitive in the 3-4 weeks after onset of cough. If people are tested outside of these time ranges, it increases the chance of false negative results. Serology testing may sometimes be indicated. Each type of testing has advantages and disadvantages. Learn more about laboratory testing. 

Both pertussis PCR and culture can be performed at the Vermont Department of Health Laboratory. The PCR and culture can be performed on the same sample. 

Providers interested in sending samples to the Laboratory should contact the Vermont Department of Health Infectious Disease Epidemiology program at 802-863-7240, option 2 to discuss testing and arrange transport. 

Treatment

Vaccination

Topics:
Vaccine-preventable Diseases
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