Whooping Cough (Pertussis) in Children

What is whooping cough in children?

Whooping cough (pertussis) is a contagious illness. It causes intense fits (paroxysms) of coughing. It mainly affects babies and young children.

Whooping cough used to be called the 100-day cough because it can last for weeks or months. The illness often starts like the common cold, with a runny nose, sneezing, and a mild cough or fever. After 1 to 2 weeks, severe coughing starts. The cough often ends with a whooping sound as air is inhaled. During coughing spells, it's hard for babies and children to eat, drink, or breathe. These spells can last for weeks. In babies, it may cause periods of not breathing (apnea). Whooping cough is worse for children younger than age 1. It's fatal in some cases.

The pertussis vaccine can help prevent the illness. But the vaccine is not 100% effective. Epidemics have occurred, especially in areas where vaccine rates have fallen. If pertussis is spreading in an area, there is a chance that a person who has had the vaccine can still catch the disease. The vaccine's protection also wears off over time. Teens and adults who haven't had a booster may spread the disease during an outbreak.

What causes whooping cough in a child?

Whooping cough is caused by Bordetella pertussis bacteria. It's very contagious. It’s spread from child to child through coughing and sneezing. Once the bacteria are in a child's airways, it causes swelling of the airways and mucus.

Which children are at risk for whooping cough?

A child is more at risk for whooping cough if they are around someone with the illness and:

• The child has not had the vaccine

• The child had the vaccine but its protection is wearing off

What are the symptoms of whooping cough in a child?

Symptoms start about 1 to 3 weeks after contact with the bacteria. They occur in 3 stages.

The first stage can last 1 to 2 weeks. Symptoms include:

• Mild cough

• Low fever

• Runny nose

• For babies, a pause in breathing (apnea)

The second stage may last for 1 to 6 weeks, but it can last up to 10 weeks. Symptoms include:

• Cough that gets worse and comes in severe fits

• Cough that can be started by many factors, including feeding, crying, or playing

• Cough that is dry and harsh

• Cough that ends with a whoop sound when breathing in

• Being very tired (exhausted) after coughing fits

The child may also vomit with the coughing and seem to be choking on the vomit.

The third stage (recovery) lasts weeks to months:

• Vomiting and the whooping cough stop first.

• The cough often decreases around week 6, but it may continue now and then for the next 1 to 2 months.

Symptoms can be a bit different for each child. In babies, the cough may be very hard to hear. Infants may have a pause in breathing (apnea) instead of a cough. If you notice this, call your child's healthcare provider or take your child to the hospital right away. 

These symptoms can be caused by other health conditions. Make sure your child sees a healthcare provider for a diagnosis.

How is whooping cough diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. Your child will also have a physical exam. A sample of fluid from the nose or mucus from a cough may be tested for the bacteria. This is often done to confirm the diagnosis.

How is whooping cough treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

In some cases, your child may need to go to the hospital for treatment. This is for supportive care and monitoring. Sometimes, your child may need oxygen and IV (intravenous) fluids until they start to recover.

Your child may also take antibiotic medicine. Antibiotics work best if given early in the disease. If given later, they may not make your child get better faster. Antibiotics do help to prevent the spread of infection to others. Anyone who has been in close contact with a child with whooping cough is often given antibiotic medicine. This is the case even if someone has had the pertussis vaccine.

Home treatment may include:

• Keeping your child comfortably warm

• Feeding your child small meals often

• Giving your child plenty of fluids

• Preventing things that cause coughing, such as smoke

Talk with your child’s healthcare provider about the risks, benefits, and possible side effects of all medicines.

What are possible complications of whooping cough in a child?

Whooping cough can lead to lung infection (pneumonia).

How can I help prevent whooping cough in my child?

The whooping cough vaccine is routinely given to children in the first year of life. But cases of the illness still occur, especially in babies younger than 6 months old.

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 months, 4 months, and 6 months. The fourth shot is given between ages 15 months and 18 months. The fifth shot is given at 4 to 6 years old.

At regular checkups, kids ages 11 or 12 should get a dose of Tdap. The Tdap booster protects against tetanus, diphtheria, and pertussis.

Immunity from the vaccine only lasts about 10 to 20 years. A Tdap booster is recommended for all adults who haven't been vaccinated before, and then a Tdap or Td booster every 10 years. Older adults who have been in close contact with a child with whooping cough, such as a grandparent, are at extra risk if they haven't had a Tdap booster vaccine. All pregnant people should get the vaccine during every pregnancy, even if they have had the Tdap before. Talk with your healthcare provider about getting the vaccine.

When should I call my child’s healthcare provider?

Call the healthcare provider if:

• Your child has symptoms that don’t get better, or get worse

• Your child has new symptoms

• Your baby has pauses in breathing (apnea) instead of a cough  

Key points about whooping cough in children

• Whooping cough (pertussis) is a contagious illness caused by bacteria. It mainly affects babies and young children.

• The illness often starts like the common cold, with a runny nose, sneezing, and a mild cough or fever. After 1 to 2 weeks, intense fits (paroxysms) of coughing start. The cough often ends with a whooping sound as air is inhaled.

• The pertussis vaccine can help prevent the illness. But the vaccine isn't 100% effective. Epidemics have occurred in areas where vaccine rates have fallen.

• The cough often decreases around week 6, but it may continue now and then for the next 1 to 2 months.

• In some cases, a child may need to go to the hospital for treatment. This is for supportive care and monitoring. Your child may also take antibiotic medicine.

• The CDC recommends that children get 5 DTaP shots for maximum protection against pertussis.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.