Whooping Cough: Signs and Symptoms

Whooping Cough: Signs and Symptoms

Whooping cough, medically known as pertussis, is a bacterial infection that can lead to extreme coughing fits. Caused by Bordetella pertussis bacteria, whooping cough infections are very contagious. They can spread through respiratory droplets or when you touch your nose or mouth after touching an infected surface. Whooping cough most commonly affects children, but adults can get it too—especially if they are not fully vaccinated against the infection.

After exposure to whooping cough, symptoms may not appear for several days or weeks. The condition often resembles a common cold in the beginning stage. Within a week or two, however, symptoms progress to severe coughing fits. Inhaling after this type of coughing can sound like a “whoop,” hence the name of the condition. The coughing fits can lead to other symptoms like vomiting, fatigue, and disrupted sleep. 

Knowing the symptoms of whooping cough in infants, children, and adults can help you get the timely care you may need to prevent complications and further spread.

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Whooping cough symptoms usually begin 7-10 days after you are exposed to the pertussis bacteria. However, symptoms may take as little as five days or as many as three weeks to develop. 

Most adults and children have cold-like symptoms in the beginning, which then progress to coughing fits. The cough may linger for weeks or months, even after treatment with antibiotics.

The coughing gets less severe and less frequent over time until it goes away. However, coughing fits may return with future respiratory infections, even several months after the original bout of whooping cough resolves.

Most children and adults experience three stages, or phases, of whooping cough: catarrhal, paroxysmal, and convalescent. Each phase brings different symptoms or symptom severity.

Catarrhal Phase

In this first stage of whooping cough, symptoms resemble those of a cold or other minor respiratory infection. These symptoms typically last for one to two weeks and may include:

  • Runny nose
  • Nasal congestion
  • Low-grade fever
  • Watery or bloodshot eyes
  • Tiredness

If treatment with antibiotics is started during or soon after this phase, the next two phases may be milder and shorter. With early treatment, you will also be contagious for a shorter time. Without treatment, you will be contagious for about three weeks, during which you should isolate.

Paroxysmal Phase

In the next phase of whooping cough, the initial cold-like symptoms may go away. In their place, severe coughing fits develop (also known as paroxysms). These fits may be so severe that you gasp for air during or afterward, creating a “whoop” sound as you inhale. This phase typically lasts about one to six weeks but can last longer.

People with whooping cough experience an average of 15 coughing fits per day in this phase. Several things can trigger these coughing fits. For instance, anything that requires a sudden intake of air, like yawning, laughing, or exercising, can bring on an attack. Cold air or irritants in the air, like smoke, also can trigger a coughing fit.

Coughing violently can lead to other symptoms as well, such as:

Serious complications are also possible in this stage. People at particularly high risk for serious complications include infants, adults with lung conditions like asthma or chronic obstructive pulmonary disease (COPD), and people who have never received a pertussis vaccine. Severe complications of whooping cough can include:

  • Pneumonia, a lung infection
  • Brief periods of time in which breathing stops (apnea)
  • Brain dysfunction (encephalopathy) stemming from a lack of oxygen or the toxin released by the pertussis bacteria
  • Collapsed lung
  • Seizures
  • Blood collecting between the brain and the skull (subdural hematoma)
  • Death

Convalescent Phase

During the final phase of whooping cough, the coughing fits gradually become less severe and happen less often until they go away. This phase will likely last a few weeks, but the characteristic cough can suddenly come back even months later.

Coughing fits often occur with future respiratory infections. However, eventually, most people make a full recovery from whooping cough.

While older children experience similar symptoms to those of adults, whooping cough may present differently in infants. Infants may not develop a cough at all. The main symptom in infants is trouble breathing, which may appear as:

  • Labored, fast, or shallow breathing
  • Apnea
  • A change in lip or skin color, such as lighter tones turning blue, due to a lack of oxygen

Infants are also at much higher risk for life-threatening complications from whooping cough. This is especially true for those who have not received a full course of the diphtheria, tetanus, and pertussis (DTaP) vaccine, and those whose birthing parents did not receive the tetanus, diphtheria, and pertussis (Tdap) vaccine during pregnancy.

Serious complications in infants can include:

  • Pneumonia
  • Heart failure
  • Collapsed lung
  • Bleeding or dysfunction in the brain
  • Convulsions
  • Abnormally slow heart rate (bradycardia)
  • Dangerously high blood pressure in the lungs that is hard to treat (refractory pulmonary hypertension)
  • Dangerously low overall blood pressure (systemic hypotension)

Up to half of infants under age 1 with whooping cough need to be hospitalized for treatment. The younger an infant is, the more likely they will need to be treated in a hospital.

Bordetella pertussis will clear out of your system on its own in about three weeks. Most people can recover from whooping cough without treatment. However, it is important to get treated with antibiotics as soon as possible to protect the people around you from contracting the infection and protect both of you from complications. Although whooping cough itself is not particularly dangerous, its complications can be.

If you or your child has cold-like symptoms along with any trouble breathing, contact your healthcare provider right away.

Whooping cough, or pertussis, is a very contagious bacterial infection. It usually causes multiple coughing fits a day, during which you make a distinctive “whoop” sound when inhaling. However, the early symptoms of whooping cough in adults resemble those of a cold, and infants may never develop a cough. If you suspect you or a loved one has symptoms of whooping cough, consider reaching out to a healthcare provider. Early diagnosis and treatment can help keep your symptoms mild and shorter-lasting.

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