Whooping cough (pertussis)

Symptoms

• Cold symptoms (dry cough, runny nose, etc.) that last 1 or 2 weeks
• Intense coughing fits that appear as cold symptoms start to improve
• Choking or struggling to breathe after a coughing fit (face turns red, eyes become watery)
• High-pitched wheeze when inhaling
• Nausea (in some cases)
• Vomiting or pauses in breathing (apnea) after a coughing fit
• Little or no fever

• Might have contracted whooping cough
• Has been exposed to someone with whooping cough (even if your child has been vaccinated)
• Is under 6 months old

• Is having severe difficulty breathing (shallow breaths, stops breathing, has grayish skin tone or bluish lips or nails)
• Struggles to catch their breath after a coughing fit
• Is having a hard time drinking or eating
• Has seizures (rolled-back eyes, uncontrolled limb movements, loss of consciousness)

What is whooping cough?

Whooping cough, or pertussis, is a highly contagious infection of the upper respiratory tract caused by a bacterium (Bordetella pertussis).

This infection causes intense coughing fits, followed by a distinctive wheezing sound on inhalation. This sound is the reason for the name “whooping” cough.

A child with whooping cough may have intense coughing fits and difficulty clearing mucus, and may feel like they’re choking. Their face may turn red and their eyes may water. The coughing may be followed by gagging as if they are about to vomit, or by apnea (a temporary pause in breathing).

Whooping cough is a notifiable disease, which means doctors are required to report cases to public health authorities.

Complications

In some cases, whooping cough can lead to serious complications (e.g., pneumonia, ear infections, respiratory distress, dehydration, seizures, brain damage, burst blood vessels in the eye, persistent vomiting, apnea). These complications are most common in young children or children who have not been vaccinated.

In older children, violent coughing fits may cause cracked or fractured ribs, hernia, or collapsed lung (pneumothorax).

Infants under 3 months old are usually hospitalized with whooping cough to monitor for choking and apnea. They are at higher risk of respiratory or heart failure and may need oxygen therapy.

Infants aged 3 to 6 months may also be hospitalized, depending on the severity of their symptoms. Children of any age should be hospitalized if they have serious complications.

Treatment

An antibiotic can reduce the duration of the illness and the severity of symptoms if it is prescribed early (when the signs of a bad cold first appear). In most cases, antibiotic treatment lasts 5 to 7 days.

However, because the symptoms look a lot like a common cold, whooping cough is usually missed at first. The main benefit of antibiotic treatment is to reduce the high risk of spreading the infection. It’s also recommended that all family members take antibiotics.

It’s important to take antibiotics for the full prescribed period. This helps avoid relapse and prevents the bacteria from developing antibiotic resistance.

Care and practical advice

• Encourage quiet activities. Your child doesn’t need to stay in bed all day, but they should get plenty of rest.
• To help calm a coughing fit, take them to the bathroom, close the door and run hot water in the shower for a few minutes. Stay with them in the bathroom for about 20 minutes. Read a story, rock them, or distract them while you wait for the cough to ease.
• Give them fluids often (water, milk, soup, etc.).
• If they don’t have much appetite, give them nutritious, high-protein foods (eggs, fish, Greek yogurt, etc.) in small quantities 5 or 6 times a day.
• If they have a fever, give them acetaminophen (e.g., Tylenol^® or Tempra^®) or ibuprofen (e.g., Advil^®, Motrin^®) as indicated and in the doses recommended for your child’s weight. Don’t give ibuprofen to babies under 6 months, and never give Aspirin^® (acetylsalicylic acid) to a child or teenager.
• Avoid giving them syrups or cough medicines.
• Keep your child away from secondhand smoke such as wood-burning stoves or fireplaces.

Prevention

Vaccination is still the best way to prevent whooping cough. In Canada, the whooping cough vaccine is usually given in combination with other vaccines.

To prevent whooping cough, the DTaP/IPV/Hib/HepB vaccine is given at 2 months and 4 months, and the DTaP/IPV/Hib vaccine at 12 months. Between ages 4 and 6, children receive another vaccine (dTaP-IPV) that also protects against the disease. For more details on these vaccines, consult the vaccination schedule.

The effectiveness of the whooping cough vaccine ranges from 80% to 93%, depending on the vaccine strain. A vaccinated child can still catch whooping cough, but the symptoms will be milder.

Scientific review: Dr. Anne-Claude Bernard-Bonnin, pediatrician Research and copywriting:The Naître et grandir team Updated: November 2024

Photo: GettyImages/FatCamera