Whooping cough, commonly known as whooping cough, has made a resurgence in recent years, with cases increasing significantly in the United States in 2024 and into 2025. This highly contagious bacterial infection triggers severe whooping cough symptoms, particularly childhood coughing fits that can lead to serious complications such as pneumonia or hospitalization in infants. Recognize early warning signs, such as whooping cough symptomsIt is crucial for rapid intervention and limiting the spread.
Health authorities report more than 11,000 cases nationwide by mid-2024, a sharp increase from previous years, driven by waning immunity to vaccines and declining vaccination rates. Parents and caregivers should remain vigilant for indicators of whooping cough, especially in unvaccinated children under one year of age, who face the greatest risks.
What is whooping cough?
Whooping cough comes from the bacteria Bordetella pertussis, which attacks the respiratory tract and spreads through airborne droplets when coughing or sneezing. Infected people remain contagious for up to three weeks without treatment, making whooping cough a public health problem during outbreaks.
Historically, the disease caused thousands of deaths before widespread vaccination, and modern epidemics highlight its persistence despite vaccines. Infantile coughing spells represent a hallmark of whooping coughwhich often escalates into uncontrollable spasms that leave victims breathless. Immunity from childhood vaccines fades over time, allowing teenagers and adults to unknowingly transmit it to vulnerable groups.
Early warning signs
Whooping cough symptoms begin subtly, mimicking a common cold with a runny nose, sneezing, and a mild, intermittent cough for one to two weeks. These initial signs may be accompanied by a low-grade fever, leading many to overlook whooping cough until progression occurs.
As the infection progresses, infant cough attacks intensify into paroxysms, rapid, harsh bursts that end in a high-pitched “scream” during inhalation as the child struggles to breathe. Victims may turn blue, vomit after coughing, or experience apnea, especially babies who lack the strength to cry out. These early warning signs demand attention, as delays increase the risks of complications, such as rib fractures or seizures in severe cases.
What are the stages of whooping cough?
Whooping cough develops in three distinct stages, each presenting unique whooping cough symptoms that guide diagnosis and care.
Stage 1 (catarrhal, 1 to 2 weeks): Resembles a typical upper respiratory infection with mild cough, congestion, and mild fever; This phase is more contagious. Stage 2 (paroxysmal, 1-6 weeks): dominated by violent childhood cough attacksup to 15 daily, caused by minimal stimuli, accompanied by whooping screams, exhaustion and possible vomiting or breathing pauses. Stage 3 (convalescent, weeks to months): Cough gradually subsides but persists, and full recovery takes up to three months amid fatigue.
Understanding these stages helps differentiate whooping cough from bronchitis or allergies, which requires timely medical evaluation.
Who is at risk for whooping cough?
Infants younger than six months bear the greatest burden of whooping cough, with more than half requiring hospitalization due to respiratory distress or secondary infections. Unvaccinated or partially vaccinated children face eight times the odds of infection than their fully immunized peers.
Pregnant women, older people, and immunocompromised people also face elevated risks, often contracting it from asymptomatic carriers, such as vaccinated adults. Outbreaks are increasing in communities with low vaccination coverage, underscoring the need for boosters in adolescents and adults, according to the World Health Organization.
How do you know if someone has whooping cough?
Health care providers diagnose pertussis through medical history, physical examinations, and laboratory tests when pertussis symptoms persist for more than two weeks. Key indicators include prolonged coughing with screaming, post-cough vomiting, or inspiratory stridor, particularly in childhood cough attacks.
Confirmation involves nasal swabs for PCR testing, throat cultures or blood antibody tests, and chest x-rays rule out pneumonia. Early suspicion arises from a history of exposure or symptoms that do not respond to standard cough remedies.
Prevention and Treatment
Vaccination remains the cornerstone of pertussis prevention, and boosters of DTaP for children and Tdap for preteens, adults, and pregnant women are recommended to protect newborns. Administration of Tdap during each pregnancy confers passive immunity to babies, dramatically reducing severe cases.
Antibiotics such as azithromycin shorten the duration of illness and contagion if started early, ideally within 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 babies who have breathing difficulties, cyanosis, or signs of dehydration, such as dry lips or reduced urine output. Hospitalization may involve oxygen, intravenous fluids, or monitoring for complications. Public health strategies emphasize handwashing, wearing masks during outbreaks, and excluding sick children from school until given permission.
Frequently asked questions
1. Can adults get whooping cough and what are the symptoms?
Adults can get whooping cough and often experience milder whooping cough symptoms than children, such as a prolonged cough that lasts for weeks without the classic scream. Complications may include rib fractures, fainting, or incontinence from severe coughing spells.
2. How long does whooping cough last in children?
Whooping cough generally lasts 6 to 10 weeks in all stages in children, and the convalescent phase features a persistent cough that can persist for months, increasing vulnerability to other respiratory infections. Total recovery varies, but often exceeds three months in total.
3. Is whooping cough contagious after starting antibiotics?
People with whooping cough remain contagious for up to three weeks without antibiotics, but treatment reduces this period to about five days after onset, emphasizing early intervention to slow the spread. Isolation protocols help protect vulnerable contacts during this period.
4. Does prior pertussis infection provide lifelong immunity?
Natural pertussis infection provides temporary immunity that lasts 4 to 20 years, but reinfection remains possible as protection wanes, similar to vaccine-induced immunity. Reinforcements are essential for sustained defense against future exposures.