The Dangers of Whooping Cough (Pertussis)

Whooping cough might sound like a disease from another era. But the illness, also called pertussis, is alive and well in the U.S.

Known as a childhood illness, whooping cough is actually most common in adolescents and adults. They pass whooping cough to other family members without realizing that their cold-like symptoms are really pertussis.

For siblings and spouses, catching pertussis might mean a nagging cough and missed work days. But when the recipient is an unvaccinated infant, whooping cough can spell serious trouble.

“Most of the severe disease and complications from pertussis occur in very young children, who either haven’t been vaccinated or haven’t completed their vaccinations yet,” says Harry Keyserling, MD, professor of pediatric infectious disease at Atlanta’s Emory University and a spokesman for the American Academy of Pediatrics. “There have been about 30 deaths per year from pertussis [in the U.S.] recently -- almost all in children less than 3 months old.”

Most of these vulnerable children catch whooping cough from a family member at home. Although pertussis symptoms are mild in vaccinated people, it’s still highly infectious. And, mild pertussis in an adult easily becomes severe illness in an infant.

Classic Symptoms of Whooping Cough

Bordetella pertussis is a bacteria that can live in the human respiratory tract. Pertussis is passed through secretions, so sneezes and coughs spread the bug around. Symptoms generally start a week or so after B. pertussis lands in the nose or mouth.

The classic course of whooping cough is rarely seen today, except in incompletely vaccinated children. In its initial phase, pertussis looks just like any of the many common colds children experience in their early years. Runny nose, sneezing, and low-grade fevers are typical.

Unlike a cold, though, pertussis infection doesn’t clear up in a week or so. The nasal congestion resolves, but is replaced by periods of intense coughing. In this second phase of pertussis, coughing fits occur once every one to two hours and are worse at night.

In older infants and toddlers, a gasp for air after a coughing fit can sometimes produce a loud “whoop.” Many infants younger than 6 months of age don’t have the whoop, but they may develop gagging or shortness of breath. Teens and adults also usually do not have the ‘whooping’ sound in their coughs. The intense coughing phase can last from one to 10 weeks.

Symptoms start to ease in the third stage of whooping cough, called the convalescent phase. Coughing fits become less frequent and eventually subside over a few weeks.

To a parent, a child’s coughing fits from pertussis can be disturbing to see. Children often cough themselves beet-red in the face. They may vomit after a spasm of coughing. Exhausted by coughing, small children can stop breathing for a few moments after a fit. Infants may stop feeding, resulting in weight loss or malnutrition. Hospitalization is often necessary in young children with pertussis.