Whooping cough was once considered a common and dangerous childhood disease, but widespread use of its vaccine beginning in the 1940s helped to almost completely eliminate it.

However, cases of whooping cough have been on the rise in recent years. We don’t know the exact reason why, but research has shown the bacteria that causes whooping cough has changed, causing past vaccination protections to wane – which is why it’s so important to stay up-to-date with your vaccinations.

Below, we’ll go over what whooping cough is, what causes it and how it’s transmitted. We’ll also cover treatment options and how to protect yourself from getting it.

What is whooping cough and how serious is it?

Whooping cough (also known as pertussis) is a highly contagious bacterial infection in your upper respiratory tract, namely your lungs and airways. It can produce a variety of symptoms, most notably a severe cough that sounds like a “whoop.” And for some, it can be a potentially life-threatening infection.

Whooping cough is caused by the Bordetella pertussis bacteria. People of any age can get whooping cough, but babies under 1 year old and people who have a chronic respiratory illness, like asthma, are at greatest risk of more severe symptoms.

How whooping cough spreads

Whooping cough affects your respiratory tract, so it’s easily spread from person to person through infected drops of saliva. This can happen by:

  • Coughing or sneezing
  • Sharing breathing space with someone, like when holding a baby on your chest
  • Touching infected surfaces, then touching your nose or mouth

While the pertussis bacteria can live for 3-5 days on a surface or an object, it’s unlikely to spread that way. As a precaution, if you think you’ve been exposed to whooping cough or you have whooping cough, thoroughly disinfect anything you may have come in contact with while you were contagious.

Serious whooping cough complications in infants and children

Infants and children who aren’t vaccinated against whooping cough or haven’t received the full schedule of vaccinations are most susceptible, and they’re more likely to develop serious complications – some of which can be life-threatening. Complications can include:

  • Bacterial pneumonia, which is the most common complication and the most common cause of death in infants
  • Apnea, which are dangerous pauses in breathing
  • Cyanosis, which is a bluish discoloration of the skin due to inadequate oxygen intake
  • Seizures from violent coughing fits (more common in infants)
  • Encephalopathy, which is a decrease in blood flow or oxygen to the brain

Complications of whooping cough in adults

Complications for teens and adults are usually less severe than with infants and children, especially for those who’ve been vaccinated, but they can still happen. Complications in adults can include:

  • Vomiting during or after a coughing fit
  • Difficulty breathing
  • Bruised or cracked ribs from prolonged coughing
  • Weight loss
  • Urinary incontinence
  • Fainting or passing out
  • Ear infections
  • Dehydration
  • Hernia
  • Nosebleed
  • Anorexia

More serious but rare complications can include:

  • Encephalopathy, due to coughing fits
  • Lung collapse
  • Brain bleed
  • Seizure
  • Rectal prolapse

Whooping cough stages and symptoms to look for

When a pertussis infection begins, you may initially mistake it for the common cold. Symptoms of whooping cough can take up to three weeks to develop, but they most commonly begin 5-10 days after you come in contact with the bacteria. If you do have it, you’re considered highly contagious for 2-3 weeks after you start coughing.

Stage 1 of whooping cough: Cold-like symptoms

Early symptoms of whooping cough can present like mild cold symptoms, so unless you know for certain you’ve been in contact with someone who has it, your doctor likely won’t test you. Early symptoms usually last for 1-2 weeks and can include:

  • Stuffed up or runny nose
  • Low-grade fever (less than 100.4°F/38°C)
  • Occasional mild cough (though this symptom doesn’t occur in babies)

Stage 2 of whooping cough: An uncontrollable cough that may have a whooping sound

After 1-2 weeks of the early symptoms, you may start having uncontrollable, rapid and violent coughing fits, known as paroxysms. You may also make a high-pitched whoop sound when you inhale after a coughing fit. These sudden attacks of coughing may also cause gagging and vomiting.

These fits usually last for 1-6 weeks, but they can continue for up to 10 weeks. Coughing fits can become more common and get worse as long as your illness continues.

Stage 3 of whooping cough: Recovery

Since stage two of whooping cough can continue for up to 10 weeks, recovery from whooping cough can be very slow. In this stage, it’s likely that you’ll have fewer coughing fits, but they can still occur, and your cough will become milder and less common as you heal.

During this stage and for a few months after, it’s important to avoid exposure to other respiratory infections (as best you can) because you’re more susceptible to them – even the common cold could cause your coughing fits to return.

How whooping cough is diagnosed

Unless you know you’ve been exposed to whooping cough, your doctor likely won’t think to test you until you have the symptoms of stage 2. If you think you or your child has whooping cough, it’s important to get tested as soon as possible. As it’s so highly contagious, don’t go to a clinic without advanced warning – let them know you’re coming to give them time to prepare.

Whooping cough is typically diagnosed with a blood sample or a swab from the back of your throat. Your doctor will also likely ask about your signs, symptoms and exposure to whooping cough before giving you an official diagnosis.

Whooping cough vs. croup

Croup is an illness that usually affects young children, and it causes swelling of the airways and trouble breathing. While croup and whooping cough both affect breathing, they’re two very different infections:

  • While whooping cough is caused by bacteria, croup is usually caused by a virus
  • The cough caused by croup is more of a barking sound, while the cough with whooping cough is more of a whoop
  • Croup usually lasts just a few days, but whooping cough can last for a few months
  • Croup doesn’t often have complications, and whooping cough can often cause severe complications

Whooping cough treatments for children and adults

Since whooping cough is a bacterial infection, doctors usually prescribe an antibiotic. It’s important to start treatment as soon as possible to avoid more serious symptoms and complications, and to protect those around you from whooping cough.

It’s also important to start on an antibiotic right away because treatment after you’ve been sick for several weeks is unlikely to help. At that point, your body will have gotten rid of the bacteria that caused whooping cough, but you’ll likely still be experiencing symptoms.

You’re still contagious for up to five days after starting an antibiotic, so take precautions to not spread it to others until the antibiotic starts to work.

Manage whooping cough symptoms at home

Beginning an antibiotic is a good first step to feeling better, and you should make sure you take your full course of antibiotics, exactly as prescribed by your doctor. As for managing the symptoms, there are at-home remedies you can try for relief. Contact your doctor about approved remedies, which may include:

  • Using a cool-mist humidifier to help soothe your cough
  • Keeping your home free of irritants that might trigger your cough, like smoke and dust
  • Getting plenty of liquids to avoid dehydration

Unless your doctor recommends it, don’t take cough medicine – it’s not likely to help a cough caused by pertussis.

There are two vaccinations that include the pertussis vaccine, the DTaP and Tdap vaccines, both of which protect against pertussis, diphtheria and tetanus. The vaccine you receive is dependent on your age and vaccination history.

It’s important to get vaccinated if you’re able, and to make sure your child follows the recommended vaccination schedule for whooping cough. While you can still get whooping cough even if you’ve been vaccinated, it’s likely your symptoms will be mild and you won’t experience complications.

If you think you or your child has been exposed to whooping cough, or if you’re unsure of your pertussis vaccination status, HealthPartners primary care doctors can help diagnose and treat whooping cough. And if your child isn’t up to date with their vaccines, make an appointment to get them back on track.