Children’s Health: What parents need to know about whooping cough
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.
Many years ago, there were lots of cases of whooping cough each year in the U.S., but those numbers have since dropped following the pertussis vaccine.
During the COVID pandemic, most of us were taking steps to lower the spread of infections by staying home, wearing masks and washing our hands often. Pertussis cases dropped as a result, but the number of cases has risen again.
In 2024, the number of whooping cough cases in the U.S. have been at least 5 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:
- 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.
- 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. However, vaccination is still very important.
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, a symptom that 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 but they may struggle to breathe or just stop breathing. Some experience vomiting after a long bout of coughs.
Infants under one 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, and other complications like seizures.
Whooping cough can be very serious in some infants, but typically they start to recover after two to four weeks. Older children and adults with whooping cough may have milder symptoms.
Contact your pediatrician if you have concerns, such as possible exposure to your child, a severe cough, or the child is struggling to breathe.
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. Antibiotics should be used after consulting a pediatrician.
Cough medicines do not relieve coughing spells, either. Your pediatrician can suggest other forms of home treatment to help manage your child's cough.
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.
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 15 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 one year old should get a booster shot. This lowers the risk of passing the infection to the infant.
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. Tdap vaccination during pregnancy protects 9 in 10 babies from being hospitalized with whooping cough, as per the CDC. Additionally, good hand hygiene goes a long way to prevent various infections.
• Children's health is a continuing series. This column was provided by the American Academy of Pediatrics. Author Dr. Shreya Doshi is a Fellow of the American Academy of Pediatrics.