What Is Whooping Cough? Causes, Symptoms, and Treatments to Know

Pertussis is a respiratory illness that affects your lungs and causes a notable cough. Its unique sounding and persistent cough has led to different names over the years, including “whooping cough” and the “100-day cough.” The common name came about because the coughing fits can be so bad that people gasp for air while making a “whooping” sound. 

Whooping cough cases are on the rise, and the illness can be serious, especially for babies. Here’s what you can do to keep yourself and your infant safe. 

What is whooping cough, and what causes it?

Whooping cough is a contagious illness caused by Bordetella pertussis bacteria. The bacteria enters your body through respiratory droplets from someone who is infected. This is the same way other respiratory illnesses, like the flu (influenza) and COVID-19, enter your body. 

Once the bacteria enters your lungs, they attach to the lining of your lung and release toxins. This causes your airways to swell, making it hard for air to pass in and out, which makes breathing difficult.

Anyone can get whooping cough, but it’s especially a problem for infants and children. A vaccine against whooping cough has helped lower the threat of this potentially life-threatening illness. But not everyone gets vaccinated, and outbreaks still occur (more on this below).

What are the symptoms of whooping cough?

It’s probably not surprising that coughing is the most common symptom of whooping cough. But it’s not the only symptom. In fact, whooping cough has three stages. 

Early stage

The early stage lasts a couple of weeks. During this time, whooping cough can be hard to distinguish from the flu or a common cold. 

Symptoms include:

• Runny nose

• Slight cough

• Fever

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• What can your cough tell you? There are many different types of coughs, and they can give you important clues about your health (and illness).

In the early stage, babies can have moments of apnea — when they stop breathing and turn blue. Apnea is dangerous and requires immediate medical attention.

Paroxysmal stage

During the paroxysmal stage, people have severe coughing fits (paroxysms) that can be debilitating and even dangerous. Coughing fits during this stage:

• Are worse at night

• Usually have the “whooping” sound

• Can last so long that people vomit or turn blue

• Are so strong that they can cause people to break a rib or rupture a blood vessel from coughing

• Occur every hour, making it hard to sleep

This phase can last up to 10 weeks, which is how whooping cough got its nickname as the “100-day cough.”

Recovery stage 

The recovery stage can last several weeks or even months. During this time, coughing fits happen less often and are less severe. But because the lungs are still weakened from the whooping cough infection, people can get other respiratory illnesses during this stage. Having another illness can further weaken your lungs and make it harder to recover. 

Is whooping cough contagious?

Yes, whooping cough is very contagious. If you’ve been in close contact with someone who has whooping cough, there’s an 80% chance you’ll get it too — unless you’re fully vaccinated.

People with whooping cough are most contagious up to about 2 weeks after their cough starts. Adults with whooping cough might not realize they have a serious illness — and some don’t have any symptoms. This can be dangerous because they can spread the illness to babies who are too young to be vaccinated. These very young infants are at the greatest risk of serious illness if they catch whooping cough. 

Are there whooping cough outbreaks?

Unlike polio, whooping cough was never eradicated in the U.S. This means there are always some active cases of whooping cough, which puts everyone at risk for outbreaks. There are regular outbreaks every few years, and these outbreaks are growing in size. 

For example, before a vaccine became available in the 1940s, whooping cough was a deadly childhood illness — about 200,000 children in the U.S. got whooping cough each year. 

Once the vaccine became widely available, the number of cases dropped. From 1968 to 1992, there were fewer than 5,000 cases of whooping cough in the U.S. each year. But cases have been going up since the mid-1990s. In 2012, a peak year, the U.S. had almost 50,000 cases. While numbers dropped during the COVID pandemic, cases are on the rise again.

So, this is happening for many reasons, including:

• The effectiveness of the whooping cough vaccine fades over time, so booster doses are needed.

• Improved testing, tracking, and reporting methods for infectious diseases means more cases are getting reported.

• Vaccine fears and misinformation that spread during the COVID-19 pandemic have led to fewer people getting the vaccines they need.

Common whooping cough treatments

Whooping cough can be treated with antibiotics. There are also home remedies to help manage symptoms. 

Antibiotics for whooping cough

Antibiotics aren’t helpful for all respiratory illnesses. They can help fight bacterial infections but are not effective against viral infections, like the flu. But whooping cough is caused by a bacteria, so early antibiotic treatment can help. 

The most common antibiotics for pertussis are:

• Azithromycin

• Clarithromycin

• Erythromycin

• Trimethoprim / sulfamethoxazole

Starting antibiotics during the early phase can:

• Make symptoms less severe, especially in infants 

• Prevent someone from passing whooping cough to others

• Shorten the period when people are contagious (health experts recommend continuing to isolate 5 days after starting antibiotic treatment)

By the time the coughing fits start during the paroxysmal phase, the toxins have already damaged the lining of your lungs, and antibiotics won’t help symptoms. For this reason, healthcare professionals may not wait for test results and start antibiotics immediately if they think you could have whooping cough.

Home remedies for whooping cough

Beyond antibiotic treatment, there are some things you can do at home to help with your symptoms and prevent spreading the illness: 

• Minimize whooping cough triggers, like smoke and dust.

• Use a vaporizer to help loosen lung mucus and soothe coughing.

• Drink enough fluids to prevent dehydration.

• Eat smaller but more frequent meals to decrease the risk of vomiting during coughing fits.

• Keep surfaces around your home clean and wash your hands often to prevent spreading the infection.

Who gets whooping cough?

Anyone can get whooping cough. But young children are much more likely to get it than adults:

• Infants younger than 1 year old are 30 times more likely than adults to get whooping cough.

• Children and young adults between the ages of 1 and 20 are 8 times more likely than adults to get whooping cough.

Children — especially infants less than 1 year old — are also more likely to get seriously sick. Very young newborns are at the highest risk of life-threatening complications. Most babies under 6 months of age need to be hospitalized if they get whooping cough. Babies can have serious complications from whooping cough, including pneumonia, dehydration, and seizures.

How can you prevent getting sick from whooping cough?

Getting the pertussis vaccine is the best way to prevent getting sick from whooping cough. All pertussis vaccines also include protection against tetanus and diphtheria. There are two main types of pertussis vaccines:

• DTaP: Babies and children get DTaP in a series of five shots. 

• Tdap: The Tdap vaccine is for older children and adults. The CDC recommends that teens and adults get a Tdap booster every 10 years. There are two FDA-approved Tdap vaccines to choose from — Adacel and Boostrix.

How effective are whooping cough vaccines?

Pertussis vaccines are safe and effective. People who get vaccinated are much less likely to get sick. But the protection isn’t perfect, and it fades over time. Even so, vaccination not only lowers your chance of getting infected, it also reduces the risk of serious illness if you do get sick. 

Should you get vaccinated while pregnant?

Yes, healthcare experts recommend getting vaccinated against whooping cough between 27 and 36 weeks of pregnancy. This allows time for your body to make protective antibodies that you can pass along to your growing baby. These antibodies help protect your baby until they can get their own vaccine at 2 months old. 

Plus, getting vaccinated during pregnancy will make you less likely to get whooping cough yourself. And that means you’re less likely to pass whooping cough to your baby. A Tdap vaccine is recommended for each pregnancy — regardless of how many times you’ve received the vaccine.

Other adults who will spend time around your newborn should consider getting a whooping cough vaccine too.

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Written by:

Ronald W. Dworkin, MD, PhD

Ronald W. Dworkin, MD, is a board-certified anesthesiologist who has been practicing anesthesiology in a community hospital for 30 years. He has taught in the honors program at George Washington University for over 10 years and works as a senior fellow at the Hudson Institute.

Edited by:

Alex Eastman, PhD, RN

Alex Eastman, PhD, RN, is a California-based registered nurse and staff medical editor at GoodRx, where he focuses on clinical updates and Latino health.

Reviewed by:

Kerry R. McGee, MD, FAAP

Kerry McGee, MD, FAAP, has over a decade of experience caring for babies, children, and teenagers as a primary care pediatrician. She has a special interest in adolescent health, particularly in adolescent mental health.

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