Whooping Cough (Pertussis): Symptoms, Causes, Diagnosis, and Treatment
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Whooping cough (pertussis) is a highly contagious bacterial respiratory illness known for weeks-long coughing spells that may end in a high-pitched "whoop." Today it mainly strikes infants too young to be fully vaccinated and teens or adults whose childhood vaccine protection has faded. Deaths are rare and mostly occur in infants [1]. Early antibiotics, the DTaP/Tdap vaccine series, and simple home care make most cases manageable, but babies under 6 months can develop life-threatening complications and usually need hospital care.
Quick Answer
Whooping cough is an infection caused by the Bordetella pertussis bacterium, spread through cough and sneeze droplets. It starts like a cold and progresses to severe coughing fits that can last weeks or months, and infants may stop breathing. Antibiotics work best when started early, and vaccination is the strongest prevention. Contact a professional if someone turns blue or whoops.
What the research says
Antibiotics clear the bacteria but do not change the course of the illness. A Cochrane review of 12 trials (1,720 participants) found that antibiotics eliminate Bordetella pertussis from patients, making them non-infectious, but do not alter the subsequent clinical course; short courses (3 days of azithromycin, 7 days of clarithromycin, or 7 days of erythromycin estolate) cleared the bacteria as well as 14-day courses of erythromycin (RR 1.02, 95% CI 0.98-1.05) with fewer side effects (RR 0.66, 95% CI 0.52-0.83) (Altunaiji et al., Cochrane Database Syst Rev, 2005) [3].
Older children and adults are now a main source of infection for babies. An expert consensus built on a literature review reports that the burden of pertussis has shifted from infants to school-age children and adults, who have become the main source of infection for vulnerable infants, and lists waning immunity after vaccination among possible reasons for the resurgence (Mi et al., World J Pediatr, 2024) [4].
What Is Whooping Cough?
Whooping cough, also called pertussis, is an illness that spreads easily. It is caused by a bacterial infection, and many people who catch it develop a serious hacking cough. Breathing in after coughing often produces a high-pitched noise that sounds like a "whoop," which gives the disease its common name [1].
Before the pertussis vaccine existed, whooping cough was thought of as a childhood disease. Today the pattern has shifted. The illness mainly affects two groups: children who are too young to have received all their vaccine doses, and teenagers and adults whose protection from the childhood vaccine has faded over time [1].
Deaths linked to whooping cough are rare, and they most often occur in infants [1]. Pregnant people can help protect their babies by receiving a booster shot during pregnancy, and vaccination is also recommended for anyone who will have close contact with an infant.
Who gets whooping cough today? Infants too young to be fully vaccinated, plus teens and adults whose childhood vaccine protection has worn off.
Fact | What the evidence shows |
Cause | Bordetella pertussis bacteria |
Most affected | Infants under 12 months, and teens/adults with faded vaccine protection |
Death risk | Rare; most deaths occur in infants |
Contagious period | Until at least 5 days of antibiotics are completed; about 3 weeks without treatment |
Prevention | DTaP childhood series plus Tdap boosters |
What are the symptoms of whooping cough by stage?
Symptoms usually do not appear right away. After becoming infected, it takes about 5 to 10 days for symptoms to start, and sometimes up to three weeks [1]. The illness begins mildly and often looks like a common cold.
Early stage (first week or two). Initial symptoms can include a runny or stuffy nose, red and watery eyes, fever, and a cough [1]. Because these signs resemble an ordinary cold or the flu, whooping cough is frequently missed at this stage.
Later stage. After a week or two, symptoms become worse. Thick mucus builds up inside the airways, causing rapid coughing that cannot be controlled. This cough can last for weeks or months and may be worse at night. Intense coughing attacks may cause vomiting, a red or blue face, extreme tiredness, and a high-pitched "whoop" sound during the next breath of air [1].
People with mild illnesses often do not make the whooping sound. In teens and adults, an ongoing hacking cough is sometimes the only symptom of whooping cough [1].
Stage | Typical symptoms |
Early (days 5–10 after exposure, up to 3 weeks) | Runny or stuffy nose, red watery eyes, fever, mild cough — mimics a common cold |
Later (after 1–2 weeks) | Uncontrollable rapid coughing, coughing for weeks or months, worse at night, coughing fits causing vomiting, red or blue face, extreme tiredness, high-pitched "whoop" on inhale |
Infants and young children | May not cough at all; may gag or struggle to breathe, skin/lips/nails turn blue or purple, life-threatening pauses in breathing (apnea) |
When should you see a doctor about whooping cough?
Contact a healthcare professional if ongoing coughing spells cause you or your child to vomit, turn red, purple, or blue, breathe in with a whooping sound, or fail to drink enough fluid [1].
Call 911 or your local emergency number immediately if you or your child seems to struggle to breathe. Also seek emergency care if you notice pauses in breathing [1].
Situation | Action |
Coughing spells causing vomiting, color change, whooping sound, or poor fluid intake | Call your healthcare professional |
Struggling to breathe, pauses in breathing | Call 911 or local emergency number right away |
What Causes Whooping Cough?
A type of bacteria called Bordetella pertussis causes whooping cough. When an infected person coughs or sneezes, tiny germ-filled droplets spray into the air, and anyone nearby can breathe them in [1].
The bacteria can also spread when people spend a long time together, or when people share breathing space — such as while holding a newborn on your chest [1]. This is why close household contact is one of the main ways the infection travels through families.
What are the risk factors for whooping cough?
The whooping cough vaccine received in childhood wears off over time. This leaves many teenagers and adults prone to infection during an outbreak [1], and regular outbreaks still happen.
Certain infants face the highest risk of serious health problems and death. These are babies younger than 12 months old who are not vaccinated or who have not received all of their vaccine doses [1].
Risk factor | Why it matters |
Childhood vaccine wearing off | Protection fades by around age 11, leaving teens and adults vulnerable during outbreaks |
Being under 12 months old | Infants without full vaccination face the most serious complications and highest death risk |
Regular community outbreaks | Whooping cough outbreaks still occur on a recurring basis |
Close contact with infected people | Household members, caregivers, and those sharing breathing space are easily exposed |
What complications can whooping cough cause?
Teens and adults often recover from whooping cough with no problems. When health conditions do occur in this group, they tend to be side effects of intense coughing [1].
These can include bruised or cracked ribs, an abdominal hernia (tissue bulging through a weak spot in the muscles of the stomach area), and broken blood vessels in the skin or the whites of the eyes. Teens and adults can also experience loss of bladder control, weight loss, and fainting [1].
Complications are far more serious in infants, especially those under 6 months of age. They can include pneumonia (a lung infection), ear infection, slowed or stopped breathing, dehydration or weight loss due to trouble feeding, seizures, and brain damage. Infants and toddlers have the highest risk of complications, are more likely to need hospital treatment, and the illness can be life-threatening for infants younger than 6 months [1].
Group | Possible complications |
Teens and adults | Bruised or cracked ribs, abdominal hernia, broken blood vessels in skin or eyes, loss of bladder control, weight loss, fainting |
Infants (especially under 6 months) | Pneumonia, ear infection, slowed or stopped breathing, dehydration or weight loss, seizures, brain damage; highest risk of life-threatening illness and hospitalization |
How can you prevent whooping cough?
The best way to prevent whooping cough is the pertussis vaccine, which is often given together with vaccines against two other serious diseases: diphtheria and tetanus [1]. Healthcare professionals recommend starting vaccination during infancy.
The DTaP series. The childhood vaccine is a series of five shots, most often given at 2 months, 4 months, 6 months, 15 to 18 months, and 4 to 6 years. Vaccine side effects are most often mild and may include fever, crankiness, headache, fatigue, or soreness at the injection site [1].
Booster shots (Tdap). Booster shots strengthen the body's defenses against whooping cough, diphtheria, and tetanus, and are recommended for pre-teens (age 11 or 12, since protection fades by age 11), pregnant women (between 27 and 36 weeks of each pregnancy, which may also protect the infant in the first months of life), and adults — including adults who never received Tdap before, who can get it at any time and should be up to date at least two weeks before close contact with a baby [1]. The tetanus and diphtheria booster is recommended for adults every 10 years, and Tdap may be given instead of that booster.
Preventive medications. If you or your infant has been exposed to someone with whooping cough, talk with your healthcare professional. Antibiotics may be recommended to protect against infection if you are a healthcare professional, pregnant, younger than 12 months, have a condition that raises the risk of serious illness (such as a weakened immune system or asthma), live with someone who has whooping cough, or live with someone at high risk of serious complications, such as babies and pregnant women [1].
Prevention measure | Who it's for | Key details |
DTaP childhood series | Infants and children | Five shots at 2 months, 4 months, 6 months, 15–18 months, and 4–6 years |
Tdap booster | Pre-teens | One shot at age 11 or 12, as protection fades by age 11 |
Tdap during pregnancy | Pregnant women | Between 27 and 36 weeks of each pregnancy; may protect the infant early on |
Tdap for adults | Adults | Anytime if never received; recommended at least 2 weeks before close infant contact; may replace the 10-year tetanus/diphtheria booster |
Preventive antibiotics | Exposed high-risk people | Healthcare workers, pregnant people, infants under 12 months, people with conditions like weakened immunity or asthma, and household contacts of infected or high-risk people |
How is whooping cough (pertussis) diagnosed?
Whooping cough can take time to confirm because it looks like a cold or the flu, and providers sometimes diagnose it from symptoms and an exam alone. Sometimes healthcare professionals can confirm the diagnosis just by asking about your symptoms and performing a physical exam [2].
When more information is needed, medical tests may include the following. A nose or throat culture takes a mucus sample from the back of the throat, where the nose and throat meet, and checks it for signs of whooping cough bacteria. Blood tests look for antibodies, the proteins your body makes to fight infections, but this is a general test and not specific to whooping cough. A chest X-ray may be recommended to check for signs of pneumonia caused by whooping cough [2].
Test | What it does |
Nose or throat culture | Mucus sample from the back of the throat checked for whooping cough bacteria |
Blood test | Checks for infection-fighting antibodies; general test, not specific to whooping cough |
Chest X-ray | Looks for signs of pneumonia due to whooping cough |
Symptom review + physical exam | Sometimes enough for diagnosis on its own |
What are the treatment options for whooping cough?
Hospital care for infants. Most often, infants need treatment in the hospital for whooping cough because the illness is more dangerous for babies. If a child cannot keep down liquids or food, fluids given through a vein may be needed. The child is cared for away from others to prevent the infection from spreading [2].
Home treatment for older children and adults. Treatment for older children and adults can often be given at home, since the illness tends to be milder [2].
Antibiotics. Antibiotics kill the bacteria that causes whooping cough. When taken early, they may make the illness less serious and may shorten the time a person is at risk of spreading it. If you live with other people, they may be given antibiotics to help prevent them from getting sick [2].
What does not help. Not much is available to relieve the cough itself. Cough medicines sold without a prescription do not help treat whooping cough — do not take them unless your healthcare professional tells you to [2].
Treatment approach | Details |
Hospital care (infants) | Most infants need hospital treatment; IV fluids if unable to keep down liquids or food; isolated from others to prevent spread |
Antibiotics | Kill the bacteria; most effective early; may shorten contagious period; housemates may also receive them |
Home treatment (older children/adults) | Often sufficient since illness tends to be milder |
Over-the-counter cough medicines | Do not help treat whooping cough; avoid unless your healthcare professional advises |
How can you care for yourself and prevent spreading whooping cough at home?
At home, whooping cough can be managed with rest, plenty of fluids, smaller meals and an irritant-free home, while covering coughs helps prevent spread.
Get plenty of rest — a cool, quiet, and dark bedroom may help you relax and rest better. Drink plenty of fluids such as water, juice, and soups, and watch for dehydration symptoms in children: dry lips, crying without tears, and urinating much less often. Eat smaller, more-frequent meals rather than large ones to help prevent vomiting after coughing. Keep your home free of irritants that trigger coughing spells, such as dust, tobacco smoke, and fumes from fireplaces [2].
To prevent spreading whooping cough, cover your cough or sneeze with a tissue or the inside of your elbow, throw away used tissues right away [2], wash your hands often for at least 20 seconds, and wear a mask if you must be around others.
Stay home from work or school until you have completed at least five days of treatment. If a young child is sick, keep them home from daycare until they finish five days of treatment. If you do not receive treatment, it is safest to stay away from others for three weeks after symptoms start — your body gets rid of the bacteria by then, even though you may still have symptoms [2].
How can people cope with whooping cough?
Whooping cough is manageable for most people, but the weeks-long cough can be exhausting for both the sick person and the household. Rest, hydration, and smaller meals make the recovery period more tolerable, and antibiotics shorten the contagious window. Keeping infants away from unvaccinated or sick contacts, ensuring pregnant caregivers receive their Tdap shot, and making sure everyone around a newborn is up to date on boosters are the most practical ways families can protect the most vulnerable members.
How should you prepare for a whooping cough appointment?
If you think you or your child has whooping cough, make an appointment with a healthcare professional, and seek emergency care for serious symptoms such as trouble breathing.
What you can do. Write a list that includes your symptoms described in detail, information about past medical problems, dates of vaccinations, information about the medical conditions of parents or siblings, and the questions you want to ask your healthcare professional [2].
What to expect from your doctor. Your healthcare professional will perform a physical exam and listen to your lungs. Questions may include when the cough started, how long a coughing spell tends to last, whether anything triggers the cough, whether the cough ever causes gagging or vomiting, whether the cough has ever caused your face to change color, and whether you have been exposed to anyone with whooping cough [2].
Prepare to list | Be ready to answer |
Symptoms in detail | When did the cough start? |
Past medical problems | How long does a coughing spell last? |
Vaccination dates | Does anything trigger the cough? |
Medical conditions of parents/siblings | Does the cough cause gagging or vomiting? |
Questions for your doctor | Has your face changed color? Any whooping cough exposure? |
Conclusion
Whooping cough remains a real threat even in the vaccine era — it hides behind common-cold symptoms, wrecks nights with weeks-long coughing spells, and can be genuinely dangerous for infants under 6 months. The good news is that the disease is well understood and highly preventable: the five-dose DTaP childhood series, Tdap boosters for pre-teens, pregnant women, and adults, preventive antibiotics after exposure, and early antibiotic treatment all work together to keep pertussis from doing serious harm. If a persistent cough is followed by vomiting, a whooping sound, or color changes — or if an infant seems to struggle to breathe — do not wait. See a healthcare professional promptly, and protect the babies around you by keeping your own vaccinations up to date.
Talk to your doctor about whether you, your household, and your newborn's caregivers are up to date on pertussis vaccination — and ask about preventive antibiotics if you have been exposed to whooping cough.
Frequently Asked Questions
What is whooping cough (pertussis)?
Whooping cough is a highly contagious respiratory illness caused by the bacterium Bordetella pertussis. It produces severe, uncontrollable coughing spells that can last for weeks or months, often followed by a high-pitched "whoop" sound when breathing in.
How long does whooping cough last?
After an incubation period of about 5 to 10 days (sometimes up to three weeks), the coughing phase can last for weeks or months and is often worse at night. Without treatment, a person remains contagious for about three weeks after symptoms start.
Why do people make a "whoop" sound?
The whoop is a high-pitched noise made during the breath of air drawn in after an intense coughing attack. People with mild illness often do not make this sound, and teens and adults may only have an ongoing hacking cough.
Do babies always cough with whooping cough?
No. Many babies with whooping cough do not cough at all. Instead, they may gag or struggle to breathe, have skin, lips, or nails that turn blue or purple, or experience apnea — life-threatening pauses in breathing.
How does whooping cough spread?
When an infected person coughs or sneezes, germ-filled droplets spray into the air and nearby people breathe them in. It also spreads during prolonged time together or by sharing breathing space, such as holding a newborn on your chest.
Is whooping cough dangerous for adults?
Teens and adults often recover with no problems, though intense coughing can cause bruised or cracked ribs, hernias, broken blood vessels in the eyes, weight loss, fainting, and loss of bladder control. The serious, life-threatening cases occur mainly in infants under 6 months.
How is whooping cough diagnosed?
Diagnosis may be based on symptoms and a physical exam alone, or confirmed with a nose or throat culture, a blood test for antibodies (a general test, not specific to pertussis), or a chest X-ray to check for pneumonia.
How is whooping cough treated?
Antibiotics kill the bacteria and work best when started early — they may make the illness less serious and shorten the contagious period. Infants often need hospital care with IV fluids, while older children and adults can usually be treated at home.
Do over-the-counter cough medicines help?
No. Not much relieves the cough itself, and non-prescription cough medicines do not help treat whooping cough. Only take them if your healthcare professional tells you to.
How can I prevent whooping cough?
Vaccination is the best prevention: five DTaP shots in childhood (2, 4, 6, 15–18 months, and 4–6 years), Tdap boosters for pre-teens, pregnant women (27–36 weeks of each pregnancy), and adults, plus being up to date at least two weeks before close contact with a baby. Exposed high-risk people may also receive preventive antibiotics.
How long should I stay home after whooping cough starts?
Stay home from work or school until at least five days of antibiotics are completed; keep a sick young child home from daycare for the same period. Without treatment, stay away from others for three weeks after symptoms start.
Related Resources
Related Reading
Nasopharyngeal Swab: Testing for COVID-19, Flu, RSV and More explains the deep nose swab used to test for respiratory infections.
References
Mayo Clinic Staff. Whooping cough: Symptoms & causes. Mayo Clinic. March 15, 2025. https://www.mayoclinic.org/diseases-conditions/whooping-cough/symptoms-causes/syc-20378973
Mayo Clinic Staff. Whooping cough: Diagnosis & treatment. Mayo Clinic. March 15, 2025. https://www.mayoclinic.org/diseases-conditions/whooping-cough/diagnosis-treatment/drc-20378978
Altunaiji S, Kukuruzovic R, Curtis N, et al. Antibiotics for whooping cough (pertussis). Cochrane Database Syst Rev. 2005;(1):CD004404. PMID 15674946. https://doi.org/10.1002/14651858.CD004404.pub2
Mi YM, Deng JK, Zhang T, et al. Expert consensus for pertussis in children: new concepts in diagnosis and treatment. World J Pediatr. 2024;20(12):1209-1222. PMID 39537933. https://doi.org/10.1007/s12519-024-00848-5
Medical disclaimer
The information provided in this article is for educational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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