7 Key Whooping Cough Symptoms You Should Never Ignore

Whooping cough, medically known as pertussis, is a highly contagious respiratory infection caused by the bacterium Bordetella pertussis. This condition gets its name from the distinctive “whoop” sound patients make when gasping for air after severe coughing fits. While whooping cough can affect people of all ages, it poses the greatest danger to infants and young children who haven’t completed their vaccination series.

Understanding the symptoms of whooping cough is crucial for early detection and preventing the spread of this potentially serious infection. The disease typically progresses through three stages, each presenting different symptoms that can last for weeks or even months. Early recognition allows for prompt medical attention and helps protect vulnerable individuals in your community.

1. Persistent Dry Cough

The hallmark symptom of whooping cough is a persistent, uncontrollable cough that can last for weeks. In the early stages, this cough may seem like a common cold, starting as a mild, occasional cough. However, within one to two weeks, it intensifies dramatically.

The cough associated with pertussis is distinctly different from typical coughs:

• It occurs in rapid, violent bursts with multiple coughs in a single breath
• Episodes can last for several minutes without pause
• The force of coughing can cause facial redness or a bluish tint due to oxygen deprivation
• It often produces thick mucus that may be difficult to expel
• Coughing fits can occur 10-20 times per day or more

This relentless cough can be exhausting and may interfere with eating, drinking, and sleeping. The severity often worsens at night, disrupting rest for both the patient and family members.

2. The Characteristic “Whooping” Sound

The most recognizable symptom that gives whooping cough its name is the distinctive high-pitched “whoop” sound made when inhaling after a coughing fit. This sound occurs because the airways have become so irritated and narrowed that breathing in rapidly creates a sharp, whooping noise.

Important characteristics of this symptom include:

• The whoop typically occurs after a series of rapid coughs when the person desperately gasps for air
• Not all patients develop this classic whoop sound, particularly older children and adults
• Infants younger than 6 months often don’t whoop at all; instead, they may struggle to breathe or temporarily stop breathing
• The intensity of the whoop can vary from mild to severe

If you hear this distinctive sound, it’s a strong indicator that whooping cough may be present, and immediate medical evaluation is warranted.

3. Vomiting After Coughing Episodes

Many people with pertussis experience vomiting immediately following intense coughing fits. This symptom is particularly common in children and can lead to additional complications if not properly managed.

The vomiting associated with whooping cough has several notable features:

• It’s triggered directly by the violent coughing rather than nausea
• The force and intensity of coughing stimulates the gag reflex
• Thick mucus accumulation in the throat can also trigger vomiting
• Repeated vomiting can lead to dehydration and weight loss, especially in infants
• Some patients become afraid to eat due to fear of vomiting, leading to nutritional concerns

Parents and caregivers should monitor fluid intake carefully when vomiting occurs frequently, as young children and infants can become dehydrated quickly.

4. Extreme Fatigue and Exhaustion

The relentless nature of whooping cough takes a tremendous toll on the body, resulting in profound exhaustion. This fatigue goes beyond normal tiredness and can significantly impact daily functioning.

Patients with pertussis experience exhaustion due to multiple factors:

• Frequent coughing fits deprive the body of adequate oxygen
• Sleep disruption from nighttime coughing prevents restorative rest
• The physical exertion of violent coughing drains energy reserves
• Fighting the infection requires significant immune system resources
• Reduced food intake due to coughing and vomiting limits energy availability

This exhaustion can persist throughout the illness and even continue into the recovery phase, which is sometimes called the “convalescent stage.” Patients may feel weak and tired for weeks after other symptoms begin to improve.

5. Breathing Difficulties and Apnea

Whooping cough can cause significant breathing problems, ranging from shortness of breath to complete pauses in breathing. This symptom is particularly dangerous in infants and requires immediate medical attention.

Breathing difficulties manifest in several concerning ways:

• Apnea: Complete pauses in breathing that last several seconds, most common in infants under 6 months
• Cyanosis: A bluish or purple tint to the lips, face, or fingertips indicating insufficient oxygen
• Rapid breathing: Abnormally fast breathing between coughing episodes
• Chest retractions: The skin pulling in around the ribs and neck during breathing efforts
• Labored breathing: Visible struggle and increased effort to breathe

Infants with whooping cough may not cough or whoop at all but instead experience apnea episodes. Any breathing difficulty, especially in young infants, requires emergency medical evaluation as it can be life-threatening.

6. Cold-Like Symptoms in Early Stage

Whooping cough typically begins with symptoms that closely resemble a common cold, making early diagnosis challenging. This initial phase, called the catarrhal stage, usually lasts one to two weeks.

During this early stage, patients may experience:

• Runny or stuffy nose with clear discharge
• Mild fever, usually low-grade (below 102°F or 38.9°C)
• Sneezing and watery eyes
• Mild, occasional cough that gradually worsens
• General feeling of being unwell or fatigued
• Loss of appetite in some cases

This stage is highly contagious, yet because symptoms seem like a typical cold, people often don’t realize they have pertussis. They may continue normal activities, unknowingly spreading the infection to others. This is why whooping cough can spread rapidly through communities, especially in schools and childcare settings.

7. Red or Watery Eyes and Facial Changes

The intense physical strain of severe coughing fits can cause visible changes to the face and eyes. These symptoms, while not dangerous themselves, indicate the severity of the coughing episodes.

Physical changes associated with whooping cough include:

• Bloodshot eyes: Small blood vessels in the eyes can burst from the pressure of coughing, causing redness
• Watery, teary eyes: Excessive tearing during and after coughing episodes
• Facial redness or flushing: The face may turn bright red or purple during coughing fits
• Swollen face or eyelids: Fluid retention from repeated strain on facial blood vessels
• Petechiae: Tiny red or purple spots on the skin caused by broken capillaries, particularly on the face and neck
• Subconjunctival hemorrhage: Red patches on the white of the eye from broken blood vessels

These visible signs often alarm patients and family members, but they typically resolve on their own as the coughing improves. However, their presence confirms the violent nature of the coughing and underscores the need for medical care.

Main Causes of Whooping Cough

Whooping cough is caused by infection with the bacterium Bordetella pertussis. Understanding how this infection spreads and who is at risk helps in prevention efforts.

Bacterial Infection

The Bordetella pertussis bacterium attaches to the cilia (tiny hair-like extensions) that line the upper respiratory system. The bacteria release toxins that damage the cilia and cause inflammation, leading to the characteristic symptoms of whooping cough.

Respiratory Droplet Transmission

Pertussis spreads easily from person to person through:

• Airborne droplets when an infected person coughs or sneezes
• Close face-to-face contact with an infected individual
• Sharing confined spaces with someone who has pertussis
• Direct contact with respiratory secretions

An infected person is most contagious during the early, cold-like stage and for about two weeks after the cough begins. People can remain contagious for up to three weeks or more if untreated.

Incomplete or Waning Immunity

Several immunity-related factors contribute to whooping cough cases:

• Unvaccinated individuals: Those who haven’t received pertussis vaccines are highly susceptible
• Incomplete vaccination series: Children who haven’t completed all recommended doses have reduced protection
• Waning immunity: Protection from pertussis vaccines decreases over time, typically after 5-10 years
• Young infants: Babies too young to be fully vaccinated are at highest risk

Close Contact with Infected Individuals

The majority of infant whooping cough cases are transmitted by family members, often parents, siblings, or caregivers who may have a mild case or don’t realize they’re infected. Household exposure significantly increases infection risk.

Prevention of Whooping Cough

Preventing whooping cough requires a multi-faceted approach focusing on vaccination, hygiene practices, and protective measures for vulnerable populations.

Vaccination

Vaccination is the most effective way to prevent whooping cough:

• DTaP vaccine for children: Children should receive five doses at 2 months, 4 months, 6 months, 15-18 months, and 4-6 years of age
• Tdap booster for preteens and adults: A booster dose is recommended at age 11-12 and for adults who haven’t received one
• Pregnancy vaccination: Pregnant women should receive Tdap during each pregnancy (preferably between 27-36 weeks) to pass antibodies to the baby
• Cocooning strategy: All family members and caregivers of newborns should be up-to-date on pertussis vaccination

While vaccines don’t provide 100% protection and immunity wanes over time, vaccinated individuals who do contract pertussis typically experience much milder symptoms.

Good Hygiene Practices

Implementing proper hygiene can reduce transmission risk:

• Wash hands frequently with soap and water for at least 20 seconds
• Cover your mouth and nose with a tissue when coughing or sneezing
• Cough or sneeze into your elbow if a tissue isn’t available
• Dispose of used tissues immediately
• Avoid touching your face, especially mouth, nose, and eyes
• Clean and disinfect frequently-touched surfaces regularly

Isolation and Avoiding Exposure

Limiting contact helps prevent spread:

• People diagnosed with whooping cough should stay home from work, school, or childcare for at least 5 days after starting appropriate medical care, or for 3 weeks if untreated
• Keep infected individuals away from infants and people with weakened immune systems
• Limit visitors if you have a newborn, especially during pertussis outbreaks
• Wear a mask if you must be around others while symptomatic

Early Medical Consultation

Seek medical attention promptly if you or your child develops:

• A persistent cough lasting more than a week
• Coughing fits that cause vomiting or breathing difficulties
• Any symptoms of whooping cough after exposure to an infected person

Early diagnosis and medical guidance can help reduce severity, prevent complications, and limit transmission to others. Your healthcare provider can advise on appropriate measures for your specific situation.

Frequently Asked Questions About Whooping Cough

How long does whooping cough last?

Whooping cough typically lasts 6-10 weeks, though it can persist for several months. The illness progresses through three stages: the catarrhal stage (1-2 weeks) with cold-like symptoms, the paroxysmal stage (2-6 weeks) with severe coughing fits, and the convalescent stage (weeks to months) with gradual recovery. This prolonged duration has earned it the nickname “the 100-day cough.”

Can adults get whooping cough?

Yes, adults can definitely get whooping cough. Adult cases are increasingly common due to waning immunity from childhood vaccination. However, adults often experience milder symptoms than children and may not develop the characteristic “whoop,” making diagnosis more challenging. Adults with persistent coughs can unknowingly spread pertussis to vulnerable infants.

Is whooping cough contagious?

Whooping cough is highly contagious. An infected person can spread the bacteria from about 6 days after exposure through approximately 3 weeks after the onset of severe coughing (or 5 days after starting appropriate medical care). The disease is most contagious during the early cold-like stage when people often don’t realize they have pertussis.

How do I know if my cough is whooping cough or just a regular cough?

Whooping cough differs from a regular cough in several ways: it occurs in rapid, uncontrollable fits that can last several minutes; it may be followed by a high-pitched “whoop” sound when inhaling; coughing often causes vomiting; and the cough persists for weeks despite treatment. If you have a severe, prolonged cough lasting more than a week, especially with these characteristics, consult a healthcare provider for evaluation.

Can you get whooping cough if you’ve been vaccinated?

Yes, it’s possible to get whooping cough even after vaccination, though vaccinated individuals typically experience milder symptoms and shorter illness duration. Vaccine immunity wanes over time, usually after 5-10 years, which is why booster shots are recommended. However, vaccination remains the best protection against severe disease and complications.

What should I do if my infant has been exposed to whooping cough?

Contact your pediatrician immediately if your infant has been exposed to whooping cough. Infants under 6 months are at highest risk for severe complications and may require preventive medical care even before symptoms appear. Watch closely for symptoms including coughing, breathing difficulties, or pauses in breathing (apnea), and seek emergency care if these occur.

When should I seek emergency medical care for whooping cough?

Seek emergency medical attention immediately if you or your child experiences: difficulty breathing or pauses in breathing; bluish or purple color to the lips, face, or fingertips; severe dehydration from vomiting; seizures; or extreme lethargy. Infants with any breathing difficulties or suspected whooping cough should be evaluated urgently as they’re at highest risk for life-threatening complications.

How is whooping cough diagnosed?

Healthcare providers diagnose whooping cough through a combination of methods including: reviewing symptoms and medical history, physical examination, and laboratory tests. Tests may include a nasal or throat swab to detect the pertussis bacteria (most accurate in early stages), blood tests, or chest X-rays to check for complications. Early testing is more reliable, as the bacteria become harder to detect as the illness progresses.

References:

• Centers for Disease Control and Prevention (CDC) – Pertussis Signs and Symptoms
• World Health Organization (WHO) – Pertussis Fact Sheet
• Mayo Clinic – Whooping Cough Symptoms and Causes
• NHS – Whooping Cough
• Johns Hopkins Medicine – Pertussis (Whooping Cough)