Signs & Symptoms
Español: Signos y síntomas
In those who have been vaccinated:
- In most cases, the cough won’t last as many days
- Coughing fits, whooping, and vomiting after coughing fits occur less often
- The percentage of children with apnea (long pause in breathing), cyanosis (blue/purplish skin coloration due to lack of oxygen) and vomiting is less
Pertussis (whooping cough) can cause serious illness in infants, children and adults. The disease usually starts with cold-like symptoms and maybe a mild cough or fever. After 1 to 2 weeks, severe coughing can begin. Unlike the common cold, pertussis can become a series of coughing fits that continues for weeks.
In infants, the cough can be minimal or not even there. Infants 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 infants younger than 1 year of age who get the disease are hospitalized. Learn more about pertussis complications.
Pertussis can cause violent and rapid coughing, over and over, until the air is gone from the lungs and you are forced to inhale with a loud "whooping" sound. This extreme coughing can cause you to throw up and be very tired. The "whoop" is often not there and the infection is generally milder (less severe) in teens and adults, especially those who have been vaccinated.
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 infants)
Because pertussis in its early stages appears to be nothing more than the common cold, it is often not suspected or diagnosed until the more severe symptoms appear. Infected people are most contagious up to about 2 weeks after the cough begins. Antibiotics may shorten the amount of time someone is contagious.
Would You Know Pertussis?
Hear how the cough may sound
It is important to know that not everyone with pertussis coughs or "whoops".
As the disease progresses, the traditional symptoms of pertussis appear and include:
- Paroxysms (fits) of many, rapid coughs followed by a high-pitched "whoop"
- Vomiting (throwing up)
- Exhaustion (very tired) after coughing fits
The coughing fits can go on for up to 10 weeks or more. In China, pertussis is known as the "100 day cough."
Although you are often exhausted after a coughing fit, you usually appear fairly well in-between. Coughing fits generally become more common and severe as the illness continues, and can occur more often at night. The illness can be milder (less severe) and the typical "whoop" absent in children, teens, and adults who have been vaccinated with a pertussis vaccine.
Recovery from pertussis can happen slowly. The cough becomes less severe and less common. However, coughing fits can return with other respiratory infections for many months after pertussis started.
- Barlow RS, Reynolds LE, Cieslak PR, et al. Vaccinated children and adolescents with pertussis infections have decreased illness severity and duration, Oregon 2010-2012. Clin Infect Dis. 2014 Mar 14. [Epub ahead of print]
- Stehr K, Cherry JD, Heininger U, et al. A comparative effectiveness trial in Germany in infants who received either the Lederle/Takeda acellular pertussis component DTP (DTaP) vaccine, the Ledele whole-cell component DTP vaccine, or DT vaccine. Pediatrics. 1998;101(1 Pt 1):1-11.
- Tozzi AE, Ravá L, Ciofi ML, et al. Clinical presentation of pertussis in unvaccinated and vaccinated children in the first six years of life. Pediatrics. 2003;112(5):1069-75.
- Ward JI, Cherry JD, Swei-Ju C, et al. Bordetella pertussis infections in vaccinated and unvaccinated adolescents and adults, as assessed in a national prospective randomized acellular pertussis vaccine trial (APERT). Clin Infect Dis. 2006;43:151-7.
- Page last reviewed: August 28, 2013
- Page last updated: May 22, 2014
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