Pertussis or Whooping Cough

Pertussis, a respiratory illness commonly known as whooping cough, is a very contagious disease caused by a type of bacteria called Bordetella pertussis. These bacteria attach to the cilia (tiny, hair-like extensions) that line part of the upper respiratory system. The bacteria release toxins (poisons), which damage the cilia and cause airways to swell.

Pertussis is a very contagious disease only found in humans. Pertussis spreads from person to person. People with pertussis usually spread the disease to another person by coughing or sneezing or when spending a lot of time near one another where you share breathing space. Many babies who get pertussis are infected by older siblings, parents, or caregivers who might not even know they have the disease.

Infected people are most contagious up to about 2 weeks after the cough begins. Antibiotics may shorten the amount of time someone is contagious.

While pertussis vaccines are the most effective tool to prevent this disease, no vaccine is 100% effective. When pertussis circulates in the community, there is a chance that a fully vaccinated person, of any age, can catch this disease. If you have gotten the pertussis vaccine but still get sick, the infection is usually not as bad.

Pertussis (whooping cough) can cause serious illness in babies, children, teens, and adults. Symptoms of pertussis usually develop within 5 to 10 days after you are exposed. Sometimes pertussis symptoms do not develop for as long as 3 weeks.

The disease usually starts with cold-like symptoms and maybe a mild cough or fever. In babies, the cough can be minimal or not even there. Babies may have a symptom known as “apnea.” Apnea is a pause in the child’s breathing pattern. Pertussis is most dangerous for babies. About half of babies younger than 1 year who get the disease need care in the hospital.

Early symptoms can last for 1 to 2 weeks and usually include:

• Runny nose
• Low-grade fever (generally minimal throughout the course of the disease)
• Mild, occasional cough
• Apnea – a pause in breathing (in babies)

Pertussis in its early stages appears to be nothing more than the common cold. Therefore, healthcare professionals often do not suspect or diagnose it until the more severe symptoms appear.

After 1 to 2 weeks and as the disease progresses, the traditional symptoms of pertussis may appear and include:

• Paroxysms (fits) of many, rapid coughs followed by a high-pitched “whoop” sound
• Vomiting (throwing up) during or after coughing fits
• Exhaustion (very tired) after coughing fits

Pertussis can cause violent and rapid coughing, over and over, until the air is gone from your lungs. When there is no more air in the lungs, you are forced to inhale with a loud “whooping” sound. This extreme coughing can cause you to throw up and be very tired. Although you are often exhausted after a coughing fit, you usually appear fairly well in-between. Coughing fits generally become more common and bad as the illness continues, and can occur more often at night. The coughing fits can go on for up to 10 weeks or more. In China, pertussis is known as the “100 day cough.”

The “whoop” is often not there if you have milder (less serious) disease. The infection is generally milder in teens and adults, especially those who have gotten the pertussis vaccine.

Recovery from pertussis can happen slowly. The cough becomes milder and less common. However, coughing fits can return with other respiratory infections for many months after the pertussis infection started.

Pertussis spreads easily from person to person through coughing and sneezing. A person with pertussis can infect up to 12 to 15 other people. That’s why being up to date with pertussis vaccines and practicing good cough and sneeze etiquette are so important.

Older siblings, parents, or caregivers who might not know they have the disease infect many babies who get pertussis. If pertussis is circulating in the community, there’s a chance that even a fully vaccinated person of any age can catch this very contagious disease. But if you received pertussis vaccines, your infection is usually less serious.

If you or your child develops a cold that includes a very bad cough or a cough that lasts a long time, it may be pertussis. The best way to know is to contact your doctor.

Babies are at greatest risk for getting pertussis and then having serious complications from it, including death. About half of babies younger than 1 year old who get pertussis need care in the hospital, and 1 out of 100 babies who get treatment in the hospital die.

There are two strategies to protect babies until they’re old enough to receive vaccines and build their own immunity against this disease.

First, vaccinate pregnant women with Tdap between 27 and 36 weeks of each pregnancy, preferably during the earlier part of this time period. Second, make sure everyone around the baby is up to date with their pertussis vaccines. This includes parents, siblings, grandparents (including those 65 years and older), other family members, and babysitters, among others.

It’s also critical that healthcare professionals are up to date with a one-time Tdap booster dose, especially those who care for babies.

When enough of a population is immune to an infectious disease, through vaccination or prior illness, its spread from person to person is unlikely. Public health experts call this ‘herd immunity’ (or community immunity). Even people not vaccinated (such as newborns and those with chronic illnesses) typically have protection because the disease has little opportunity to spread within their community. Public health experts cannot rely on herd immunity to protect people from pertussis since:

• Pertussis spreads so easily
• Vaccine protection decreases over time
• Acellular pertussis vaccines may not prevent colonization (carrying the bacteria in your body without getting sick) or spread of the bacteria

Vaccines are the most effective tool doctors have to provide protection against pertussis. It’s important that everyone get their recommended pertussis vaccines to protect themselves.

No, but those traveling to an area with a pertussis outbreak should make sure they are up to date on their pertussis vaccines. People who did not get all the recommended pertussis vaccines, including babies too young to be vaccinated, are putting themselves at risk for catching pertussis.