Whooping cough, also known as pertussis, is a highly contagious illness caused by a bacterial infection. It leads to severe, persistent coughing fits, and when a person breathes in after coughing, it often produces a sharp “whooping” sound.
Before the pertussis vaccine was introduced, whooping cough was considered mainly a childhood disease. Today, it still mostly affects young children who have not yet completed their vaccination schedule, as well as teenagers and adults whose immunity has decreased over time.
Although deaths from whooping cough are uncommon, they occur most often in infants. Pregnant individuals can help protect their babies by receiving a booster vaccine during pregnancy, and vaccination is also advised for anyone who will be in close contact with a newborn.
Signs and Symptoms of Whooping Cough (Pertussis):
After exposure to the bacteria that cause whooping cough, symptoms usually appear within 5 to 10 days, though in some cases they may take up to three weeks to develop. Early symptoms are often mild and can easily be mistaken for a common cold. These may include:
- Runny or blocked nose
- Red, watery eyes
- Mild fever
- Occasional cough
As the infection progresses over the next one to two weeks, the condition becomes more severe. Thick mucus begins to accumulate in the airways, triggering intense, uncontrollable coughing spells. These coughing fits can last for several weeks or even months and are often worse at night, disrupting sleep and daily activities.
Severe coughing episodes may lead to:
- Vomiting after coughing
- A flushed, red, or bluish face
- Extreme fatigue
- A sharp, high-pitched “whoop” sound when breathing in after a cough
In teenagers and adults, the illness may be milder, and the classic “whoop” sound is often absent. In these cases, a persistent, dry, hacking cough may be the only noticeable symptom, which can delay diagnosis.
In infants and very young children, symptoms can be more dangerous. Some babies may not cough at all but instead may:
- Gag or struggle to breathe
- Show bluish or purplish discoloration of the lips, skin, or nails
- Experience life-threatening pauses in breathing, known as apnea
Because symptoms can vary by age and severity, early recognition and medical care are essential. Prompt treatment not only reduces complications but also helps prevent the spread of infection to others, especially vulnerable infants and young children.
The Three Phases of Whooping Cough (Pertussis)
Whooping cough develops in three distinct phases, each with its own pattern of symptoms. Understanding these stages can help with early recognition and proper care.
Phase 1: Early Cold-Like Phase:
This initial phase usually lasts one to two weeks. During this time, the infection spreads easily to others, but it often goes unnoticed because the symptoms resemble a common cold. Typical signs include:
- Blocked or runny nose
- Sore throat
- Watery eyes
- Mild cough that slowly becomes more frequent
- Slight fever or normal body temperature
- General tiredness or feeling unwell
In infants, breathing problems may be more noticeable. Parents may observe that the baby:
- Appears to work harder to breathe
- Has inward movement of the chest or belly while breathing
- Develops a bluish or gray color around the lips or skin due to low oxygen levels
Phase 2: Severe Coughing Phase.
This phase can last from one to six weeks and sometimes even longer. Thick mucus collects in the airways, leading to intense coughing attacks. Common features include:
- Repeated coughing spells that continue for several minutes
- A loud “whooping” sound when breathing in after coughing
- Vomiting or extreme tiredness following coughing episodes
- Coughing triggered by laughing, crying, or eating
- Frequent coughing during both day and night, often worse at night
Over time, these coughing attacks become more frequent, then slowly begin to decrease.
Phase 3: Recovery Phase.
The final phase may continue for several weeks. During this period, coughing becomes milder and less frequent. Although the person starts to feel better, the respiratory system is still healing.
- Occasional cough may persist
- Energy levels gradually improve
- The body remains more sensitive to other respiratory infections
If another illness occurs during recovery, severe coughing may return. Rest, proper care, and avoiding exposure to infections are important to support full healing.
Causes and Spread of Whooping Cough:
Whooping cough is caused by a bacterium called Bordetella pertussis. Once it enters the body, it attacks the lining of the airways, leading to irritation and swelling. This irritation causes thick mucus to form, which triggers the intense and persistent coughing that characterizes the illness.
The infection spreads through tiny droplets released into the air when an infected person coughs, sneezes, or talks. After exposure, symptoms usually appear within five to ten days, although in some cases they may take up to three weeks to develop.
Is Whooping Cough Easily Transmitted?
Yes, whooping cough is highly contagious. It commonly spreads among family members, and children often catch it at school or in group settings.
An infected person can pass the bacteria to others from the early, cold-like stage of the illness until about three weeks after severe coughing episodes begin. This means a person may unknowingly spread the infection for several weeks, even before realizing they have whooping cough.
How Whooping Cough Is Diagnosed?
To confirm whooping cough, a healthcare provider uses a combination of clinical evaluation and medical tests. The process usually begins with a detailed review of your symptoms, including how long the cough has lasted, whether coughing fits occur, and if a “whooping” sound is present. Your recent exposure to others with similar symptoms may also be discussed.
A physical examination is then performed to assess breathing, lung sounds, and overall respiratory health.
To identify the bacteria directly, a laboratory test is often done. This involves collecting a mucus sample from the back of the nose or throat using a soft swab or a saline-filled syringe. The sample is analyzed to detect Bordetella pertussis, the bacterium responsible for whooping cough.
Additional tests may include:
- Blood tests to look for signs of infection or immune response.
- Chest X-rays to check for complications such as pneumonia or other lung involvement.
- PCR testing (polymerase chain reaction), which is a fast and highly accurate method for detecting pertussis bacteria in respiratory samples.
Early diagnosis is important because treatment is most effective in the early stages and helps reduce the risk of spreading the infection to others.
Management and Care for Whooping Cough:
Whooping cough is most commonly treated with antibiotics. Starting treatment as early as possible is essential because it can reduce the severity of symptoms and lower the risk of passing the infection to others. When antibiotics are given in the later stages usually after three weeks of illness they may no longer improve symptoms, since the bacteria have already left the body and the remaining cough is due to airway damage.
In some cases, especially in infants, older adults, or people with weakened immune systems, whooping cough can become severe and may require hospital care. Hospital treatment may include oxygen support, fluids, and close monitoring of breathing.
Prevention and Protection Against Whooping Cough
Vaccination is the most effective way to protect against whooping cough. Two main vaccines are used: DTaP for infants and children, and Tdap for adolescents, adults, and pregnant individuals. These vaccines also protect against tetanus and diphtheria.
To reduce the risk of serious illness, babies and other vulnerable individuals should be kept away from anyone who is infected. In some situations, healthcare providers may prescribe preventive antibiotics to close contacts of an infected person to stop the disease from developing.
You can further limit the spread of whooping cough and other respiratory infections by practicing good hygiene, including:
- Washing hands regularly with soap and water or using hand sanitizer
- Avoiding touching the face with unclean hands
- Disinfecting frequently touched surfaces such as doorknobs and toys
- Covering coughs and sneezes with a tissue or elbow
- Staying home when feeling unwell
- Keeping distance from people who show signs of illness
These simple steps, along with vaccination, play a key role in controlling the spread of whooping cough and protecting community health.
