Spot whooping cough and whooping cough in children early before it’s too late

Whooping cough, commonly known as whooping cough, has reemerged in recent years, with cases in the United States increasing significantly in 2024 and 2025. This highly contagious bacterial infection triggers serious whooping cough symptoms, especially coughing fits in children, which can lead to serious complications like pneumonia or hospitalization in infants. Recognize warning signs, such as whooping cough symptomsproves crucial for rapid intervention and limiting the spread.​

Health authorities are reporting more than 11,000 cases nationwide by mid-2024, a sharp increase from previous years, driven by waning vaccine immunity and falling vaccination rates. Parents and caregivers should remain vigilant for indicators of pertussis, especially in unvaccinated children under 1 year of age, who are at highest risk.​

What is whooping cough?

Whooping cough comes from the bacteria Bordetella pertussis, which attacks the respiratory tract and is spread through airborne droplets from coughing or sneezing. Infected people remain contagious for up to three weeks without treatment, making pertussis a public health problem during epidemics.​

The disease historically caused thousands of deaths before widespread vaccination, and modern epidemics highlight its persistence despite vaccines. Coughing fits in children are a characteristic of whooping coughoften degenerating into uncontrollable spasms that leave victims gasping for air. Immunity from childhood vaccines fades over time, allowing adolescents and adults to unknowingly pass it on to vulnerable groups.​

Early Warning Signs

Whooping cough symptoms begin subtly, mimicking a cold with a runny nose, sneezing, and mild, intermittent coughing over one to two weeks. A mild fever may accompany these early signs, leading many people to overlook whooping cough until progression occurs.​

As the infection progresses, the child’s coughing fits intensify and develop into paroxysms, rapid, harsh bursts of coughing ending in a high-pitched “scream” on inhalation as the child struggles to breathe. Victims may turn blue, vomit after coughing, or suffer from apnea, especially infants who lack the strength to hear the cry. These warning signs require special attention, as delays increase the risk of complications such as rib fractures or seizures in severe cases.​

What are the stages of whooping cough?

Whooping cough occurs in three distinct stages, each with unique pertussis symptoms that guide diagnosis and care.

• Stage 1 (catarrhal, 1-2 weeks): Looks like a typical upper respiratory infection with mild cough, congestion, and mild fever; this phase turns out to be the most contagious.​
• Stage 2 (paroxysmal, 1 to 6 weeks): Dominated by the violent child coughingup to 15 per day, triggered by minimal stimuli, accompanied by whooping cough, exhaustion and possible vomiting or pauses in breathing.​
• Stage 3 (convalescence, weeks to months): The cough gradually subsides but persists, with full recovery taking up to three months due to fatigue.​

Understanding these stages helps differentiate whooping cough from bronchitis or allergies, prompting prompt medical evaluation.​

Who is at risk for whooping cough?

Infants under six months of age are most affected by whooping cough, with more than half requiring hospitalization due to respiratory distress or secondary infections. Unvaccinated or partially vaccinated children are at eight times greater risk of infection than their fully vaccinated peers.​

Pregnant women, the elderly and immunocompromised people are also at high risk, often contracting it from asymptomatic carriers like vaccinated adults. Outbreaks are increasing in communities with low vaccination coverage, highlighting the need for booster shots in adolescents and adults, according to the World Health Organization.​

How do you know if someone has whooping cough?

Health care providers diagnose whooping cough based on clinical history, physical exams, and laboratory tests when pertussis symptoms persist beyond two weeks. The main indicators include prolonged coughing accompanied by screaming, post-tussive vomiting or inspiratory stridor, especially in children who cough.​

Confirmation involves nasal swabs for PCR testing, throat cultures or blood antibody tests, with chest x-rays ruling out pneumonia. Initial suspicion arises from a history of exposure or symptoms unresponsive to standard cough remedies.​

Prevention and treatment

Vaccination remains the cornerstone of pertussis prevention, with DTaP for children and Tdap boosters recommended for preteens, adults, and pregnant women to protect newborns. Administering Tdap during each pregnancy provides passive immunity to infants, significantly reducing severe cases.​

Antibiotics like azithromycin shorten the duration of illness and contagiousness if started early, ideally in the catarrhal stage, although they offer less benefit later. Supportive measures include hydration, small frequent meals to prevent vomiting, humidified air, and isolation for at least five days after antibiotic administration, according to the Centers for Disease Control and Prevention. Avoid over-the-counter cough suppressants, as they are ineffective against whooping cough spasms.​

Seek immediate care for infants with difficulty breathing, cyanosis, or signs of dehydration such as dry lips or decreased urine output. Hospitalization may involve oxygen, IV fluids, or monitoring for complications. Public health strategies emphasize hand washing, wearing masks during outbreaks, and excluding sick children from school until the outbreak is over.

Frequently Asked Questions

1. Can adults get whooping cough and what are the symptoms?

Adults can get whooping cough and often have milder whooping cough symptoms than children, such as prolonged coughing lasting weeks without the classic whooping cough. Complications can include rib fractures, fainting, or incontinence due to severe coughing fits.​

2. How long does whooping cough last in children?

Whooping cough typically lasts 6 to 10 weeks in children, with the convalescence phase resulting in a persistent cough that can persist for months, increasing vulnerability to other respiratory infections. Full recovery varies but often exceeds three months total.​

3. Is whooping cough contagious after starting antibiotic treatment?

People with whooping cough remain contagious for up to three weeks without antibiotics, but treatment reduces that period to about five days after onset, emphasizing early intervention to curb the spread. Isolation protocols help protect vulnerable contacts during this window.​

4. Does previous pertussis infection confer lifelong immunity?

Natural pertussis infection provides temporary immunity lasting 4 to 20 years, but reinfection remains possible as protection wanes, similar to vaccine-induced immunity. Boosters prove essential for lasting defense against future exposure.