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Whooping cough, also known as pertussis, is a highly contagious bacterial infection that inflames the lungs and airways. The pertussis bacteria also infect the windpipe, where they bring on a persistent, violent cough.
The name whooping cough comes from the weird, birdlike "whooping" sounds that children typically make when they have the illness and try to take a deep breath between coughs. (Babies may not be strong enough to make this characteristic whooping sound.)
Whooping cough is especially dangerous, even deadly, for babies under a year old, so it's important to seek treatment immediately if your baby shows signs of infection.
What are whooping cough symptoms?
Whooping cough often starts with cold or flulike symptoms that last 1 or 2 weeks, but sometimes continue for as long as 3 weeks. These symptoms can include:
- Runny nose
- Mild or occasional cough
- A low fever
After a week or two, a child with whooping cough will typically develop more telltale symptoms of the disease such as:
- Rapid fits of coughing for 20 or 30 seconds nonstop, followed by a "whoop" sound as they struggle to breathe before the next coughing spell starts. The coughing is often worse at night.
- Coughing up or vomiting mucus
- Exhaustion after coughing fits
- Lips and nails that turn bluish from lack of oxygen during coughing episodes.
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Special dangers and symptoms to look out for in babies
Whooping cough can be very dangerous for babies under a year old, who are especially susceptible to complications such as pneumonia, convulsions, brain damage, and even death. If you think your baby may have whooping cough, seek medical attention right away.
Some babies don't cough or whoop at all when they have whooping cough. Instead, your baby may show other symptoms, including:
- Gasping for air
- Going red in the face
- Stopping breathing for a few seconds.
It's important to watch babies with pertussis closely in case they stop breathing. If your baby has any trouble breathing, call 911 or take her to the nearest emergency room. Also take her to the ER if she has persistent vomiting, seizures, or signs of dehydration.
How long does whooping cough last?
Whooping cough can last up to 10 weeks, or even longer, although the coughing fits will usually start to ease within six weeks, if not before.
The typical progression of the disease is:
- Stage one: Cold symptoms for 1 to 2 weeks
- Stage two: Coughing fits for another 1 to 6 weeks
- Stage three: Gradual recovery with occasional coughing fits for 2 to 3 weeks
Note that the disease is usually less severe, and goes away more quickly, in people who've had the pertussis vaccine.
How do children catch whooping cough?
Whooping cough is very contagious. Your child could have gotten it from direct contact with someone infected with the bacteria or by simply breathing air infected with the germs. The bacteria usually enter the nose or throat.
Young babies are especially susceptible to catching whooping cough because they don't start getting DTaP vaccines until they're 2 months old. They can catch the disease from older siblings, parents or caregivers who don't even know they have it.
People with whooping cough are most contagious during the early stages of the disease, up until about 2 weeks after the coughing fits start.
Can you get whooping cough if you've been vaccinated?
Yes, because the whooping cough vaccine isn't 100 percent effective. However, you're much less likely to get whooping cough if you've been vaccinated, and if you do catch it the symptoms are normally milder.
Most children receive several vaccinations against whooping cough (pertussis) as part of the DTaP series, which also protects against diphtheria and tetanus. The shots start at 2 months of age and continue until the child is 4 to 6 years old. Later, at age 11 or 12, your child will get an additional dose of whooping cough protection as part of the TdaP vaccine.
Your child's protection against the disease increases with each shot, so her risk of getting it will be at its lowest after she receives the fifth shot of the series, between 4 and 6 years of age.
Whooping cough cases declined dramatically following the introduction of pertussis vaccines in the 1940s, although the number has rebounded slightly over the last few decades. In 2018, there were more than 15,000 reported cases of whooping cough in the United States. Most of these infections were in children under 1 year old.
How is whooping cough diagnosed?
To find out if your child has whooping cough, the doctor may:
- listen to your child's cough
- swab her nose to test the cells for the pertussis bacteria
How is whooping cough treated?
If the doctor suspects that your child has whooping cough, he'll give your child an antibiotic to fight the infection right away. He won't wait for test results, as these can take some time and it's important to treat whooping cough as soon as possible.
Antibiotics can help relieve symptoms if given very early on. If given later, they may not shorten the course of the illness, but they can still remove the bacteria from your child's secretions, preventing her from spreading the infection to others.
Beyond that, you can't do much other than wait for the cough to subside.
Of course, if the cough gets worse even with antibiotics, call your doctor immediately.
About half of babies under one year old who get whooping cough require treatment in the hospital. Most of these babies suffer from slowed or stopped breathing, or pneumonia. Hospitalized children may need to be put on oxygen, and given intravenous fluids to avoid dehydration.
Caring for whooping cough at home
If your child is diagnosed with whooping cough, there are a few things you can do to help her heal and stay comfortable:
- Follow the antibiotic schedule exactly as your child's doctor prescribed.
- Use a cool-mist humidifier to keep the air in your child's room moist.
- Keep your home free of irritants such as smoke and dust.
- Ensure your child stays well hydrated (keep in mind that if your baby is under 6 months old, she should only drink breast milk or formula). Immediately report any signs of dehydration to your child's doctor.
- If your child is eating solids, encourage small meals every few hours to prevent vomiting.
DON'T give your child a cough suppressant unless your doctor recommends it. Cough medicine is usually not recommended for children under 6 years old. Coughing is what the body naturally does when it needs to clear the lungs of mucus. If you suppress that reaction, you may be hindering your child's ability to heal.
Preventing whooping cough
Vaccination is the best way to protect against whooping cough. Below are vaccine recommendations for each age group.
- For children: Get the DTaP vaccine on schedule.
- For teens and adults: Get a booster Tdap vaccine. The Tdap can prevent those who receive it from contracting whooping cough and transmitting it to babies.
- For pregnant women: Get a Tdap vaccine during each pregnancy, preferably between 27 and 36 weeks' gestation.
Other ways to prevent whooping cough include:
- Antibiotics. If your child is diagnosed with whooping cough, all of her close contacts will need to be treated with antibiotics as well.
- Proper hand washing. Scrub hands with soap and water for at least 20 seconds, or use hand sanitizer.
- Covering your mouth and nose with a tissue when you cough or sneeze. If you don't have a tissue, use your upper sleeve or elbow, not your hand.
After having whooping cough, does my child still need to be vaccinated?
Yes. Unfortunately, it's possible for someone who's had whooping cough to get it again. Because your child is still susceptible to the illness – and because the DTaP shot contains important protection against diphtheria and tetanus as well – make sure she finishes the series.