Pediatrician explains whooping cough

by Shreya Doshi, MD, MBBS

coughing child Credit: Pixabay/CC0 Public Domain

Whooping cough, or pertussis, is a highly contagious respiratory infection caused by bacteria called Bordetella pertussis. The infection attacks the lining of the breathing passages. People can get whooping cough any time of year, but generally infections are seen in late summer and fall.

Symptoms of whooping cough vary based on age, medical conditions and whether the child is vaccinated against the disease. The main sign is strong coughing. Between coughs, children take deep, fast breaths. This can create the high-pitched “whooping” sound that gives the illness its name. The cough of pertussis has also been called the “100-day cough” because it may last for months. Sometimes, the cough returns with future respiratory infections.

Here’s what else to know about whooping cough, including why it’s surging in the United States, how it is treated and when children and adults should get the vaccine.

Why whooping cough infections are on the rise

Many years ago, there were a lot of cases of whooping cough each year in the U.S. However, after a vaccine for pertussis was developed, that number dropped.

During the COVID pandemic, most of us were taking steps to lower the spread of infections. For example, we stayed home, wore masks and washed our hands often. This is one reason why the number of pertussis cases went down. Since then, the number of cases has risen again.

In 2024, the number of whooping cough cases in the U.S. has been at least five times higher than in 2023. Outbreaks among adolescents have been reported in schools in several states.

Experts think there are a few reasons for the increase:

The pertussis vaccine’s protection may have faded over time. This means that people who had the vaccine a long time ago can get infected and spread it.
The vaccine protects against severe disease, but not always against infection. So, people who are vaccinated can still spread the disease.
Research suggests that the Bordetella pertussis bacteria might be slowly changing, making it harder for the vaccine to work as well.
Many young children fell behind on vaccinations during the pandemic because of fewer doctor visits. Vaccination rates still have not returned to pre-pandemic levels. Because of this, it is especially important now for children, teens and adults to get their whooping cough vaccine.

Symptoms of whooping cough in children

Whooping cough usually starts like a common cold and then gets worse after a week or two. Older children might make the “whoop” sound when they cough. This stage can last for two weeks or more. Your child might be short of breath and may have bluish or gray skin around their mouth. They may also tear, drool or vomit.

Symptoms in young infants may be different. For example, they may not cough at all. Instead, they may struggle to breathe or just stop breathing. Some experience vomiting after a long bout of coughs.

Is whooping cough dangerous?

Infants under a year of age have the most risk of infection and serious problems from whooping cough. About a third of infants with this infection are hospitalized. The infection can cause babies to become tired and run-down. It can also make them more at risk for other infections, including pneumonia (lung infection) and other complications like seizures.

Whooping cough can be very serious in some infants, but typically they start to recover after two to four more weeks. Older children and adults with whooping cough may have milder symptoms.

When to call the pediatrician

Contact your pediatrician if you have concerns, such as:

Your infant or child has not been fully immunized, and/or has been exposed to someone with whooping cough or who has a chronic cough.
Their cough becomes more severe and frequent, they are struggling to breathe, or their lips and fingertips become blue or gray.
They become exhausted after coughing episodes, eat poorly, vomit after coughing and look sick.

Antibiotics for whooping cough

Whooping cough is treated with an antibiotic. The medicine works best when it is taken early in the illness, before the coughing spells begin. The antibiotic can stop the spread of the whooping cough infection, but it does not prevent or treat the cough itself.

Cough medicines do not relieve coughing spells, either. Your pediatrician can suggest other forms of home treatment to help manage your child’s cough. Antibiotics should be used judiciously to prevent further resistance and side effects. Please consult your pediatrician prior to use.

When can my child return to school or child care?

Whooping cough is very contagious, which means that it spreads easily to others. Your child should stay home from child care or school at least until they have finished five days of antibiotics. Others in your household may also need to take antibiotics to prevent them from getting sick or spreading the disease even if they are vaccinated.

How to protect your child against whooping cough

The best way to protect your child from severe symptoms caused by whooping cough is with the vaccine and booster shot.

Younger children should get the vaccine at 2 months, 4 months and 6 months of age, and at 12 to 18 months and 4 or 5 years of age before the start of school. Older children should get the vaccine when they are 11 or 12 years old to boost their immunity to whooping cough.

Parents, family members and caregivers who will be in close contact with babies younger than 1 year old should get a booster shot. This lowers the risk of passing the infection to the infant.

According to pediatricians, if you are pregnant, you should get the vaccine during the third trimester. Getting the vaccine during each pregnancy provides antibodies to protect you, and short-term protection is passed to your baby.

2024 Tribune Content Agency, LLC.

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