Pertussis (Whooping cough)

Also called whooping cough, pertussis is caused by germs that get into the throat and lungs and makes it difficult to clear mucous from the airways. Children may cough so long and so hard that they can’t breathe. Young infants may not be able to cough forcefully and may stop breathing.

Babies with whooping cough may have fits (seizures) and in serious cases, go into a coma.  About 1 in 400 infants with pertussis dies because of pneumonia or brain damage.

Older children, adolescents and adults who get whooping cough will have 1 to 2 weeks of frequent severe coughing spells. In total, coughing can last from 6 to 12 weeks.

How does pertussis spread?

Pertussis is a very contagious disease.

• It spreads when an infected person coughs or sneezes and the germs land in the nose or mouth of someone who is close by.
• It usually spreads among family members and in other situations where there is close contact between people.

Pertussis is most contagious during the first 2 weeks, when symptoms are similar to a common cold.

Anyone who has not been vaccinated against pertussis can become ill with whooping cough. The pertussis vaccine does not work as well as other vaccines, and protection wears off after a few years, so even people who have had the vaccine can sometimes get pertussis. However, it is still important to get the vaccine because those who have been vaccinated and still get pertussis will have a much milder disease  than those who have not been vaccinated.

What are the symptoms of pertussis?

• Pertussis is also known as “whooping cough” because the main symptom is severe coughing. Coughing may be followed by a “whoop” sound before the next breath.
• It usually starts like a cold, with a very runny nose. After a few days, the typical coughing begins. Your child is already contagious when the cold-like symptoms start.
• The coughing can be so aggressive that children vomit or have trouble breathing. Many children keep themselves and their families awake because they cough so much in the night.
• The cough is usually severe for 2 to 3 weeks and then starts to get better.
• Some children will continue to have some coughing for several months after having pertussis, especially if they get a cold before they fully recover.

Whooping cough is becoming more common among teens because the protection from their vaccines has worn off. Older children and teens usually only have a prolonged cough without the “whoop” sound. They can also have trouble breathing, vomit, or experience weight loss.

Can pertussis cause bigger problems?

Yes. Babies with whooping cough may have spells where they don’t breathe or have seizures. In serious cases, they can go into a coma. Infants under 1 year old often have to be hospitalized. Almost all deaths from pertussis happen in children who are under 6 months old.

Older children, teenagers and adults may cough so hard that they break a rib, lose control of their urine, get a hernia or collapse a lung.

How is pertussis treated?

• If the illness is discovered early enough, before the coughing spells start, antibiotics may help.
• If treatment is started later, antibiotics won’t help. This is because the bacteria have already done their damage. But antibiotics may still be given to prevent the bacteria spreading to someone else.

How can I protect my child?

You can protect your child by making sure they are vaccinated.

Your child will be vaccinated at 2, 4, 6 and 18 months, at age 4 to 6 years, and usually again in adolescence (between 14 and 16 years of age). 

Adults should have one dose in their adult years, especially parents or grandparents of young children and people who work with young children. In most jurisdictions the adolescent and adult doses are provided free of charge.

Because this disease is so severe in very young babies, vaccination of all pregnant women is now recommended. Antibodies produced by the mother are passed to the fetus before birth, protecting the baby for the first few months of life. Young babies can also be protected if everyone around them, including adults, has been appropriately vaccinated, but that does not seem to protect them as well as vaccinating the pregnant mother.

When should I call the doctor?

Take your child to the doctor if you think that they might have whooping cough even if they have already received all scheduled vaccines.

If your child has been exposed to pertussis, they should receive pertussis vaccine as soon as possible if their vaccines are not up to date. Some children exposed to pertussis are given antibiotics. Your doctor or your local public health unit can tell you if your exposed child needs antibiotics.

See your doctor if your child has coughing that:

• is followed by vomiting, or
• is followed by a whooping sound when your child breathes in after coughing, or
• causes breathing problems, or
• makes your child’s skin or lips turn red, purple, or blue.