Pertussis (Whooping Cough): When to Go to Emergency
Pertussis (also known as whooping cough) is a highly contagious infection of the respiratory tract. It spreads through droplets when an infected person coughs or sneezes. Because pertussis can be very serious, it’s important to know when to seek medical care.
Babies and preschool-age children are most at risk. At age 2 months, most infants in the United States start the vaccination series to prevent pertussis. But the effects of the vaccine fade as children get older, so teens and adults can also get the disease.
When to Go to the Emergency Department (ED)
At first, pertussis may seem like a cold. Your child is likely to have a runny nose, mild fever, and a slight cough. After 1 to 2 weeks, the cough tends to become very severe. Coughing spells may last as long as a minute. These produce a “whooping” sound as your child gasps for air. Sometimes, your child may turn red or blue or vomit from the cough. Call your health care provider right away if you suspect pertussis. Seek emergency help if your child:
Has a blue color to his or her skin (check fingertips and around mouth). (If there is a blue color, call 911.)
Stops breathing, even for an instant. (Call 911.)
Has a high fever within the following ranges:
In an infant younger than age 3 months, a rectal temperature of 100.4°F (38.0°C) or higher
In a child ages 3 to 36 months, a rectal temperature of 102°F (39.0°C) or higher
In a child of any age who has a temperature of 103°F (39.4°C) or higher
A fever that lasts more than 24 hours in a child younger than age 2 years, or for 3 days in a child ages 2 years or older
Has had a seizure caused by the fever
Vomits often, or becomes dehydrated
What to Expect in the ED
A health care provider will ask about your child’s symptoms and perform a physical exam. He or she will likely take samples of secretions from your child’s nose or throat. These will be checked in a lab for the bacteria that cause pertussis. Your child also may have blood tests or X-rays.
Infants and children with severe pertussis are likely to be admitted to the hospital for treatment with antibiotics and fluids. Milder cases may be treated at home with antibiotics, fluids, and bed rest. Cough and cold medicines are not very helpful. Because of the possibility of serious side effects, they should not be used in children younger than age 4 years. These medicines should be used only in children between ages 4 and 6 years, if your health care provider recommends them. Never give aspirin to a child under age 18 years. It could cause a rare but serious condition called Reye's syndrome. Generally, ibuprofen is not recommended for infants younger than age 6 months.
Getting vaccinated is the best way to protect against pertussis. Talk to your health care provider about whether your child needs a booster vaccination. Also, be sure to ask whether you need a booster as well.