Whooping cough (pertussis)

Whooping cough (pertussis)

Whooping cough (pertussis): symptoms, treatment, and prevention


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

Consult your doctor if your child:

  • 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

Call 911 or go to the emergency room immediately if your child:

  • 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.

Age: Whooping cough can occur at any age, but the disease is more severe in children under 12 months, especially babies under 6 months.
Duration: Whooping cough lasts 1 to 3 months. It progresses through 3 phases.
  • Phase 1: The child has common cold symptoms that last 1 to 2 weeks.
  • Phase 2: Over the next 2 to 4 weeks, their cold symptoms ease, but they have long bouts of wet coughing, followed by the distinctive “whooping” sound when they inhale. Coughing fits may cause bluish skin (cyanosis), slower heart rate, and apnea. These coughing fits leave the child exhausted and short of breath. The coughing may be followed by vomiting. Between coughing fits, the child has no difficulty breathing and may feel relatively well.
  • Phase 3: Generally, the child feels less sick, but the coughing fits may continue for 1 to 2 weeks. Sometimes the illness can last up to 3 months. If the child gets another upper respiratory tract infection in the year that follows, they may occasionally have a cough similar to whooping cough.
Infectious period: If the child hasn’t been treated with antibiotics, the disease is most contagious during the first phase and remains contagious until the cough resolves. Antibiotic treatment will reduce the infectious period; however, the child will remain contagious up to 5 days after starting antibiotics.
Isolation period: The child should stay home. If they feel well enough, they may return to daycare or school after 5 days of antibiotic treatment, or after 3 weeks without antibiotic treatment. Some children may need extra rest and a longer period with fewer activities.
How it spreads: Whooping cough is transmitted through airborne droplets when an infected person sneezes, coughs, or spits while speaking. It can also spread through direct or indirect contact with saliva from an infected person (toys, kitchen utensils, glasses, water bottles, hands, etc.)
Incubation period: Usually 1 to 2 weeks, but can be up to 21 days.

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.
Are humidifiers a good idea?
Many health experts now advise against using humidifiers, including the Canadian Paediatric Society and the guide From Tiny Tot to Toddler: A practical guide for parents from pregnancy to age two. If not cleaned properly, these devices can become breeding grounds for bacteria and mould, since the water inside stays at room temperature for long periods. What’s more, very few users follow the maintenance routine recommended by manufacturers. See our article on humidifiers for more information.

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.

Whooping cough and pregnancy
Pregnant women are advised to get vaccinated against whooping cough. The vaccine is given between the 26th and 32nd week of each pregnancy. This helps protect the baby during the first few months of life. If you’ve been in contact with someone who has whooping cough during your pregnancy, consult a doctor. They may prescribe an antibiotic after evaluating you.
Naître et grandir

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

Photo: GettyImages/FatCamera

Resources and references

Note: The links to other websites are not updated regularly, and some URLs may have changed since publication. If a link is no longer valid, please use search engines to find the relevant information.

  • AboutKidsHealth. “Pertussis (whooping cough).” AboutKidsHealth. 2024. aboutkidshealth.ca
  • Collective. Red Book 2024: Report of the Committee on Infectious Diseases. 33rd ed., Itasca, American Academy Of Pediatrics, 2024, 1261 pp.
  • Guadreault, Pierre, and Marc Lebel. “Coqueluche.” Dictionnaire de pédiatrie Weber, 3rd ed. Montreal, Chenelière Éducation, 2015, pp. 264–266.
  • Gouvernement du Québec. “Whooping cough.” 2024. quebec.ca
  • Gouvernement du Québec. “Québec Immunization Program.” 2024. quebec.ca
  • Institut national de santé publique du Québec. “Vaccination” in From Tiny Tot to Toddler: A practical guide for parents from pregnancy to age two. 2024. inspq.qc.ca
  • Nemours KidsHealth. “Whooping Cough (Pertussis).” KidsHealth. 2023. kidshealth.org
  • Kliegman, Robert, and Joseph W. St. Geme III. Nelson Textbook of Pediatrics. 21st ed., Amsterdam, Elsevier, 2020, p. 4264.
  • Mandell, Gerald D., et al. Principles and practice of infectious diseases. 7th ed., Montreal, Elsevier Canada, 2014, p. 4320.
  • Mayo Clinic. “Whooping cough.” Mayo Clinic. 2022. mayoclinic.org
  • Ministère de la Famille du Québec. Les infections en milieu de garde. 2019. cdn-contenu.quebec.ca
  • Health Canada. “Pertussis (whooping cough).” 2020. canada.ca
  • Canadian Paediatric Society. “Pertussis (Whooping cough).” Caring for Kids. 2021. caringforkids.cps.ca

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