Photo of a baby being treated for severe pertussis infection. She received extracorporeal membrane oxygenation (ECMO), a procedure that can take over the work of the lungs and heart. She also received dialysis to help her kidneys keep working. Credit: CDC

Whooping cough basics: Pertussis complications, diagnosis & treatment

Complications of whooping cough

Why is whooping cough — also known as pertussis — so dangerous?

Pertussis in infants & children

Pertussis (whooping cough) can cause serious and sometimes life-threatening complications in infants and young children, especially those who are not fully vaccinated.

In infants younger than 1 year of age who get pertussis, about half are hospitalized. The younger the infant, the more likely treatment in the hospital will be needed. Of those infants who are hospitalized with pertussis about:

Photo of a baby being treated for severe pertussis infection. She received extracorporeal membrane oxygenation (ECMO), a procedure that can take over the work of the lungs and heart. She also received dialysis to help her kidneys keep working. Credit: CDC
Photo of a baby being treated for severe pertussis infection. She received extracorporeal membrane oxygenation (ECMO), a procedure that can take over the work of the lungs and heart. She also received dialysis to help her kidneys keep working. Credit: CDC

  • 1 in 4 (23%) get pneumonia (lung infection)
  • 1 or 2 in 100 (1.6%) will have convulsions (violent, uncontrolled shaking)
  • Two thirds (67%) will have apnea (slowed or stopped breathing)
  • 1 in 300 (0.4%) will have encephalopathy (disease of the brain)
  • 1 or 2 in 100 (1.6%) will die

Pertussis in teens & adults

Teens and adults can also get complications from pertussis. They are usually less serious in this older age group, especially in those who have been vaccinated with a pertussis vaccine.

Complications in teens and adults are often caused by the cough itself. For example, you may pass out or fracture a rib during violent coughing fits.

In one study, less than 5% of teens and adults with pertussis were hospitalized. Pneumonia (lung infection) was diagnosed in 2% of those patients. The most common complications in another study of adults with pertussis were:

  • Weight loss (33%)
  • Loss of bladder control (28%)
  • Passing out (6%)
  • Rib fractures from severe coughing (4%)
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Diagnosing whooping cough/pertussis

Pertussis (whooping cough) can be diagnosed by taking into consideration if you or your child has been exposed to pertussis, and by a medical professional doing a:

  • History of typical signs & symptoms
  • Physical examination
  • Laboratory test which involves taking a sample of secretions (with a swab or syringe filled with saline) from the back of the throat through the nose.
  • Blood test

Several types of laboratory tests are commonly used for the diagnosis of Bordetella pertussis. Culture is considered the gold standard because it is the only 100% specific method for identification. Other tests that can be performed include polymerase chain reaction (PCR) and serology (the scientific study of plasma serum and other bodily fluids).



Treatment for whooping cough

Pertussis is generally treated with antibiotics, and early treatment is very important. Treatment may make your infection less severe if it is started early, before coughing fits begin. Treatment can also help prevent spreading the disease to close contacts (people who have spent a lot of time around the infected person).

Also see: Preventing pertussis: Ways to whip whooping cough

Treatment after three weeks of illness is unlikely to help because the bacteria are gone from your body, even though you usually will still have symptoms because the bacteria have already done damage to your body.

There are several antibiotics available to treat pertussis. If you or your child is diagnosed with pertussis, your doctor will explain how to treat the infection. Learn more about the antimicrobial treatment recommended by CDC for treatment of pertussis here.

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If your child is treated for pertussis at home

Do not give cough medications unless instructed by your doctor. Giving cough medicine probably will not help, and is often not recommended for kids younger than 4 years old.

Manage pertussis and reduce the risk of spreading it to others by:

  • Following the schedule for giving antibiotics exactly as your doctor prescribed.
  • Keeping your home free from irritants — as much as possible — that can trigger coughing, such as smoke, dust, and chemical fumes.
  • Using a clean, cool mist vaporizer to help loosen secretions and soothe the cough.
  • Practicing good handwashing.
  • Drinking plenty of fluids, including water, juices, and soups, and eating fruits to prevent dehydration (lack of fluids). Report any signs of dehydration to your doctor immediately. These include dry, sticky mouth, sleepiness or tiredness, thirst, decreased urination or fewer wet diapers, few or no tears when crying, muscle weakness, headache, dizziness or lightheadedness.
  • Eating small, frequent meals to help prevent vomiting if occurring.

If your child is treated for pertussis in the hospital

Your child may need help keeping breathing passages clear, which may require suctioning (drawing out) of thick respiratory secretions. Breathing is monitored and oxygen will be given, if needed. Intravenous (IV, through the vein) fluids might be required if your child shows signs of dehydration or has difficulty eating.

Precautions, like practicing good hand hygiene and keeping surfaces clean, should be taken.

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