Clinical Complications

Anyone, but especially infants and young children, may experience serious and potentially life-threatening complications from pertussis.

Complications are usually less severe in those who received pertussis vaccines.

Infants and children

Pertussis can cause serious and potentially life-threatening complications in infants and young children, especially those who have not received all the recommended vaccines. Pertussis can also be more severe for infants younger than 2 months of age whose mothers did not get Tdap while pregnant.

In infants younger than 12 months of age who get pertussis, about a third need treatment in a hospital. Hospitalization is most common in infants younger than 6 months of age.

Of those infants younger than 12 months of age with pertussis who need treatment in a hospital approximately

  • 68% will have apnea
  • 22% will get pneumonia
  • 2.2% will have seizures/convulsions
  • 1% will die
  • 0.6% will have encephalopathy (as a result of hypoxia from coughing or possibly from toxin)

Other complications can include

  • Anorexia
  • Dehydration
  • Difficulty sleeping
  • Epistaxis
  • Hernias
  • Otitis media
  • Urinary incontinence

More severe complications can include

  • Refractory pulmonary hypertension
  • Pneumothorax
  • Rectal prolapse
  • Subdural hematomas

Adolescents and adults

Adolescents and adults can also develop complications from pertussis. However, complications are usually less severe in this older age group, especially in those who received pertussis vaccines.

In one study, hospitalization rates were 0.8% for adolescents and 3% for adults with confirmed pertussis. Clinicians diagnosed pneumonia in 2% of each group.

The most common complications in another study of adults with pertussis were

  • Weight loss
  • Urinary incontinence
  • Syncope
  • Rib fractures from severe coughing

Other complications can include

  • Anorexia
  • Dehydration
  • Epistaxis
  • Hernias
  • Otitis media

More severe complications can include

  • Encephalopathy as a result of hypoxia from coughing or possibly from toxin
  • Pneumothorax
  • Rectal prolapse
  • Subdural hematomas
  • Seizures
  • Cortese MM, Bisgard KM. Pertussis. In: Wallace RB, Kohatsu N, Kast JM, ed. Maxcy-Rosenau-Last Public Health & Preventive Medicine, Fifteenth Edition. The McGraw-Hill Companies, Inc.; 2008:111–14.
  • National Notifiable Diseases Surveillance System, 2004–2014. Division of Integrated Surveillance Systems and Services, National Center for Public Health Informatics, Coordinating Center for Health Information and Service, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA 30333.
  • Tanaka M, Vitek CR, Pascual FB, Bisgard KM, Tate JE, Murphy TV. Trends in pertussis among infants in the United States, 1980-1999external iconJAMA. 2003;290:2968–75.