Whooping Cough (Pertussis) and Your Child
Whooping cough (pertussis) is a highly contagious infection of the respiratory tract. It spreads easily from person to person through droplets when an infected person coughs, sneezes, or talks. Thick mucus forms deep inside the airways. This leads to serious coughing spells that make a "whooping" sound. The sound is caused by a sharp intake of breath. Because whooping cough can be very serious, it's important to know when to seek medical care.
Who is at risk for whooping cough?
Children who have had all of their vaccines are usually protected from whooping cough. Babies and preschool-age children are most at risk. At age 2 months, most babies in the U.S. start the vaccine series to prevent pertussis. But the effects of the vaccine fade as children get older, so teens and adults can also get the disease.
But others are at risk. They include:
- Babies 6 months and younger who have not had at least 3 doses of the whooping cough vaccine
- Children and teens ages 11 to 18 who have not had a booster shot of the vaccine
- Anyone who has not had the vaccine or a booster shot of the vaccine
What are the symptoms of whooping cough?
At first, whooping cough seems like a common cold. Symptoms at that point include a runny nose, sneezing, mild fever, and a slight cough.
The cough gets more severe 1 to 2 weeks later. The coughing usually comes in spells that last a minute or more and end with a high-pitched whoop. The intense coughing can cause a child to break a rib, vomit, turn blue, or even pass out. This stage can last 1 to 6 weeks or longer.
What is the treatment for whooping cough?
Babies and children with severe whooping cough 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 unless your healthcare provider recommends them. Never give aspirin to a child under age 18 years. It could cause a rare but serious condition called Reye syndrome. Generally, ibuprofen is not recommended for infants younger than age 6 months. During a visit to the ER, children with whooping cough:
- May be given medicine to relieve inflamed airways
- Have their breathing carefully monitored
- May have their airways suctioned to remove mucus
- Get antibiotics through an IV (intravenous line)
If antibiotics are prescribed
Antibiotics won't cure whooping cough in most cases. But, the doctor may prescribe them to help make your child less contagious. In that case:
- Make sure your child takes all of the medicine, even if he or she feels better. Otherwise, the infection may come back.
- Be sure your child takes the medicine as directed. For example, some antibiotics should be taken with food.
- Ask your child's doctor or pharmacist what side effects the medicine may cause and what to do about them.
Keep your child home from school until he or she has completed at least 5 days of antibiotic treatment. If antibiotics are not prescribed, keep your child home 3 weeks (21 days) after the onset of the cough before returning to school or daycare.
Caring for your child at home
To help your child recover fully from whooping cough:
- Provide plenty of fluids, such as water, juice, or warm soup. Fluids help loosen mucus so your child can breathe more easily. They also help prevent dehydration.
- Offer smaller meals. Small amounts of food are easier to eat when coughing is severe.
- Make sure your child gets enough rest. Ask your child's doctor about the best position to improve breathing.
- Run a cool-mist humidifier in your child's bedroom to relieve coughing and loosen mucus in the airways. Be sure to clean the humidifier regularly to prevent growth of mold and bacteria.
- Keep your house free of irritants that can trigger coughing spells. These include tobacco smoke and fumes from a fireplace.
- Don't give your child over-the-counter cough syrups. They won't ease your child's cough and may be harmful.
- Don't take your child with whooping cough to school or daycare until the doctor says it's OK.
- Ask your child's doctors if others in the household should get a booster shop to help keep them from getting sick.
When to call your child's healthcare provider
Call your child's doctor right away if your child:
- Turns blue, has trouble breathing (call 911)
- Is exhausted after coughing spells
- Has loss of appetite and eats poorly
- Vomits after coughing spells
- Is weak and looks sickly
- Has a fever (see Fever and children, below)
- Has signs of dehydration such as sunken eyes, dry mouth, dark or strong-smelling urine, or no urine output for 6 to 8 hours (go to the emergency room)
- Develops seizures (call 911)
What to expect in the ER
A healthcare provider will ask about your child's symptoms and do 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 whooping cough. Your child also may have blood tests or X-rays. If these tests are done, the results will be negative most of the time.
How can I prevent whooping cough?
Being vaccinated is the best way to protect against whooping cough. Talk to your healthcare provider about whether your child needs a booster vaccination. Also, be sure to ask whether you and other adults in contact with your children need a booster as well. Most children get a vaccine against whooping cough starting at 2 months of age. It's often combined with vaccines for 2 other diseases, diphtheria and tetanus. The combination vaccine, called DTaP, is given in a series of 5 shots at these ages:
- 2 months
- 4 months
- 6 months
- 15 to 18 months
- 4 to 6 years
Fever and children
Use a digital thermometer to check your child's temperature. Don't use a mercury thermometer. There are different kinds of digital thermometers. They include ones for the mouth, ear, forehead (temporal), rectum, or armpit. Ear temperatures aren't accurate before 6 months of age. Don't take an oral temperature until your child is at least 4 years old.
Use a rectal thermometer with care. It may accidentally poke a hole in the rectum. It may pass on germs from the stool. Follow the product maker's directions for correct use. If you don't feel OK using a rectal thermometer, use another type. When you talk to your child's healthcare provider, tell him or her which type you used.
Below are guidelines to know if your child has a fever. Your child's healthcare provider may give you different numbers for your child.
A baby under 3 months old:
- First, ask your child's healthcare provider how you should take the temperature.
- Rectal or forehead: 100.4°F (38°C) or higher
- Armpit: 99°F (37.2°C) or higher
A child age 3 months to 36 months (3 years):
- Rectal, forehead, or ear: 102°F (38.9°C) or higher
- Armpit: 101°F (38.3°C) or higher
Call the healthcare provider in these cases:
- Repeated temperature of 104°F (40°C) or higher
- Fever that lasts more than 24 hours in a child under age 2
- Fever that lasts for 3 days in a child age 2 or older
StayWell last reviewed this educational content on 6/1/2019
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