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?

Vaccination helps protect your child from pertussis.

Children who've 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 haven't had at least 3 doses of the whooping cough vaccine

• Children and teens ages 11 to 18 who haven't had a booster shot of the vaccine

• Anyone who hasn't 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 often comes in spells that last 1 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 shouldn't be used unless your child's healthcare provider advises them. Never give aspirin to a child under age 18 years. It could cause a rare but serious condition called Reye syndrome. Generally, ibuprofen isn't advised for infants younger than age 6 months. During a visit to the emergency room (ER), children with whooping cough may: 

• Be given medicine to relieve inflamed airways

• Have their breathing carefully watched

• 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 provider may prescribe them to help make your child less contagious. In that case: 

• Make sure your child takes all of the medicine, even if they feel better. Otherwise the infection may come back.

• Make sure your child takes the medicine as directed. For instance, some antibiotics should be taken with food.

• Ask your child's provider or pharmacist what side effects the medicine may cause and what to do about them.

Keep your child home from school until they have completed at least 5 days of antibiotic treatment. If antibiotics aren't prescribed, keep your child home for 3 weeks (21 days) after the cough starts 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 fluid loss (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 healthcare provider 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. 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 their cough and may be harmful.

• Don't take your child with whooping cough to school or daycare until the provider says it's OK.

• Ask your child's providers if others in the home should get a booster shop to help keep them from getting sick.

When to call your child's healthcare provider

Call your child's provider right away if your child: 

• 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, extreme tiredness (lethargy), dark or strong-smelling urine

Call 911

Call 911 if your child:

• Doesn't pee for 6 to 8 hours

• Has seizures

• Turns blue, has trouble breathing

What to expect in the ER

A healthcare provider will ask about your child’s symptoms and do a physical exam. They'll 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 child's healthcare provider about whether your child needs a booster vaccination. Also ask if 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 and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow the provider’s specific instructions.

Fever readings for 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

Fever readings for 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 in a child of any age

• Fever of 100.4° F (38° C) or higher in baby younger than 3 months

• 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