When Whooping Cough Becomes a Worry

If you’ve ever heard someone with whooping cough trying to catch their breath, it’s not a sound you’ll soon forget, especially if it’s your child. The characteristic “whoop” sound that can happen during severe coughing fits is alarming for both adults and children. Infants and babies don’t always develop a cough, but they do struggle to breathe.

Mentions of whooping cough in the news, also referred to as pertussis, have been on the rise lately and you may be concerned. Pediatric infectious diseases specialist Hina Zaidi, MD, with Lehigh Valley Reilly Children’s Hospital, says the most important thing you can do to protect you and your family from whooping cough is ensure everyone is up to date on their vaccines against Bordetella pertussis, the bacteria that causes whooping cough.

“Young babies, especially those 6 months old and younger, are the most vulnerable when contracting whooping cough. This age group is at the highest risk for serious complications including hospitalization for difficulty or pauses in breathing (known as apnea), and death,” Dr. Zaidi says. “Infants are not yet fully vaccinated against pertussis. We recommend expectant mothers between 27-36 weeks gestation be vaccinated to provide passive immunity to their baby before they’re old enough to receive their own vaccine. Fathers-to-be and anyone else in the household who will be close with the newborn should also check their vaccine status. This is known as the cocooning strategy.”

Dr. Zaidi cares for children at LVPG Pediatric Infectious Diseases and says her practice has not seen an increase in cases or hospitalizations for whooping cough; however, small outbreaks are being reported in different areas across the country.

According to the Centers for Disease Control and Prevention (CDC), cases nationally are rising and returning to pre-pandemic levels of approximately 10,000 cases annually. Cases had lowered during the pandemic as people practiced social distancing and wore masks.

Outbreaks of whooping cough in a community depend on a few factors. No vaccine is 100 percent effective. For the vaccine against pertussis, the protective antibodies wane over time, which means booster vaccines later in life are essential for continued protection. In addition, communities have varying ranges of vaccine hesitancy, leaving gaps where outbreaks can happen.  

“Pertussis is highly contagious and spreads easily from person to person by respiratory droplets through coughing, sneezing and talking,” Dr. Zaidi says. “To reach herd immunity approximately 92 percent to 94 percent of the population needs to be vaccinated. That’s a large percentage and may be challenging to maintain, but critical to avoid outbreaks.”

Whooping cough is a “notifiable” disease in the U.S., meaning that health care workers are obligated to notify the CDC of reported cases. The CDC collects and analyzes data to identify outbreaks as early as possible.

The first week or two of whooping cough looks like a common cold with runny nose, congestion and watery eyes. If someone close to you has been exposed to whooping cough, or if cases are increasing in your child’s school or your place of work, let your doctor know as soon as possible.

“There is a nasal swab that looks for pertussis,” Dr. Zaidi says, “and your doctor may order this especially if you’ve been in contact with someone with whooping cough, or if there’s a known outbreak. When it’s caught early you can isolate, receive treatment and avoid spreading it to others.”

Unlike many respiratory infections, whooping cough is usually not associated with high fever; instead fever may be mild or absent. After a couple weeks, uncontrollable and powerful coughing fits can start and be prolonged in severe cases. These fits can be so bad that patients struggle to breathe, sometimes vomit and have even been known to fracture ribs.

We all need whooping cough vaccines throughout our lives. As an adult, the vaccine wanes every 5-10 years. Staying current with your vaccine protects you and your loved ones from contracting and spreading the disease.

The CDC recommends the following timelines for whooping cough vaccines:

Infants and children (DTap)

2, 4 and 6 months

15 to 18 months

4 to 6 years

Pre-teens, pregnant mothers and adults (Tdap)

Pre-teens age 11-12

Pregnant mothers 26-37 weeks

Adults – any time if you’ve never received it, with a booster every 10 years

If you are diagnosed with whooping cough, you should isolate to avoid spreading it to others. Your doctor will most likely prescribe an antibiotic called azithromycin for five days. After those five days, you are no longer contagious. Close contacts are also given antibiotics as a preventive measure, regardless of their vaccine status or if they have symptoms.

If you do not take antibiotics, you will be considered contagious for a longer period and should isolate for 21 days.

Unfortunately, even with antibiotics, coughing fits can linger for several weeks, giving whooping cough its nickname of the 100-day cough.

Routine supportive care can help relieve your symptoms, including staying hydrated, eating small, frequent meals, eating honey (for people 1 year and older) and using over-the-counter remedies.

“Your best chance at beating whooping cough is to avoid it altogether,” Dr. Zaidi says. “Ensure everyone is vaccinated – from the youngest baby who is eligible for vaccine starting at two months old, to the most elderly grandparent. Working together will help keep everyone in your family and the community protected from whooping cough.”