8 Whooping Cough Symptoms Everyone Should Know
Updated: Aug. 21, 2023
Coughing fits, thick mucus, red eyes—these are just a few of the symptoms of whooping cough. Here's what to know about this infectious illness.
What is whooping cough?
Also known as pertussis, whooping cough is a highly contagious bacterial infection. It’s named for the distinctive whooping sound that people make as they struggle to inhale after severe coughing spells.
Although babies are most in danger from whooping cough, adults can—and do—contract the infection, which is caused by a germ called Bordetella pertussis.
“In infants, pertussis can be a life-threatening infection,” says Michael Steiner, MD, pediatrician in chief at UNC Children’s in Chapel Hill, North Carolina. “In older children or adults, it generally is not as dangerous but can make people uncomfortable for a very long time with a chronic, harsh cough.”
The symptoms of whooping cough are easily confused with other respiratory infections. Here’s what you need to know.
A cold that won’t go away
Whooping cough has three different stages, each of which lasts about two weeks.
Symptoms during the first stage, called the catarrhal stage, can look a lot like those of a number of other respiratory illnesses.
In addition to a low fever, you could have a runny nose, sneezing, and tearing of the eyes as well as the beginnings of the famous cough. This is your body’s reaction to the infection, explains Dr. Steiner.
At this point, though, the cough can be relatively mild and doesn’t happen as frequently, which is why it may not raise alarm bells right away.
(Ask your doctor these questions about antibiotics anytime you’re prescribed them.)
Uncontrollable coughing fits
The mild, occasional coughing you get in the beginning stages of pertussis can later turn into violent coughing fits called paroxysms.
The coughs, which are more likely to occur at night, can cause bulging eyes and pronounced neck veins as well as more saliva production than usual.
The paroxysms can be so bad that they lead to broken or cracked ribs, seizures, a collapsed lung, a groin hernia, and even inflammation of the brain (encephalitis). The coughing can even cause people to pass out.
In children, the cough is the easiest way to identify pertussis, which can lead to pneumonia and even cause kids to temporarily stop breathing, says Dr. Steiner.
A prolonged cough, sometimes lasting weeks or months, is the most common symptom in adolescents and adults.
The paroxysms will eventually subside as you enter the final “convalescent” stage.
However, Linda Yancey, MD, an infectious diseases specialist at Memorial Hermann Hospital, notes, “Only half of pertussis cases present with a typical ‘whooping cough,’ so you can’t rule out the disease due to a lack of the characteristic ‘whoop.'”
A whooping sound when you inhale
The hallmark “whooping” sound of the infection happens when you try to inhale air between coughs.
Although it’s familiarly associated with pertussis, this whooping sound can also happen with any violent cough, says Len Horovitz, MD, a pulmonary specialist at Lenox Hill Hospital in New York City.
However, this high-pitched whooping sound is a sign that you may have pertussis. Not everyone makes the whooping noise when coughing, and it’s more common in children than adolescents and adults.
People who are vaccinated tend to have a milder infection and also are less likely to make the characteristic whooping noise.
Thick mucus
Mucus production can signal many different conditions, including a cold or allergies. But with pertussis, the mucus is thick and stringy—and there’s a lot of it. It can be difficult to expel it all.
Mucus is actually a good thing, acting as a trap for items that shouldn’t be in your respiratory tract.
When you have an infection, you produce more mucus, so it can wrangle the invaders. The cough helps expel not just the mucus but any toxins.
Vomiting
Both the thick mucus and the dramatic coughing fits of pertussis can end in vomiting. In fact, any severe coughing can cause you to vomit.
Red eyes
In the earlier stages of pertussis, the lining of the eyes can become red and a little puffy, says Dr. Horovitz.
But this can also happen in the later stages.
The coughing episodes can raise the blood pressure in the blood vessels of your eyes, and lead to rupture of the tiny blood vessels. This can result in small bruises or red spots, called petechiae, in the face and whites of the eyes.
Nosebleeds
The intense coughs don’t just raise blood pressure in the vessels of your eyes; they can do the same in the blood vessels of your nose. Some people even end up with nosebleeds.
Exhaustion
Illness can be tiring. It requires extra energy to fight infections.
“Whenever you have any kind of infection, you can feel fatigued,” says Dr. Horovitz.
But the coughing of whooping cough takes even more of a toll and you’re likely to feel exhausted, not just tired.
What to do and when
The best way to avoid the complications of pertussis is to get vaccinated. The whooping cough vaccine is credited with slashing rates of the highly infectious illness.
But you can’t just get vaccinated once; you need to follow up with regular boosters.
“While the vaccine works relatively well, the immunity wanes over time,” says Dr. Steiner. “It is important that adults get their booster doses of pertussis immunization when they get their tetanus boosters.”
The children’s vaccine is called DTaP (which stands for diphtheria, tetanus, and pertussis) and is for those younger than age 7.
The booster shot is called Tdap and is administered to everyone older than that, including adults and pregnant women. Learn about the differences between Tdap and DTaP.
In most cases, your body will get over whooping cough infections on its own. Sometimes, your doctor may prescribe pertussis treatments.
If antibiotics, such as azithromycin, are given early in the illness, they can shorten the length of the illness and they can help decrease the illness in others. That’s important because whooping cough is highly contagious.
Because whooping cough can be serious—even deadly—in children, check with a doctor if your infant shows any of these symptoms.
Next, learn the six precautions you can take to avoid pertussis (and stop its spread).
- Michael Steiner, MD, pediatrician in chief at UNC Children's in Chapel Hill, North Carolina
- Boston Health Care for the Homeless Program: "Pertussis (Whooping Cough)"
- Centers for Disease Control and Prevention: "Pertussis (Whooping Cough) Clinical Features"
- National Organization for Rare Diseases: "Pertussis"
- Len Horovitz, MD, pulmonary specialist at Lenox Hill Hospital in New York City
- University of North Carolina Health Care: "Mucus, Our Body's Silent Defender"
- St. Luke's Health: "When Whooping Cough Becomes an Emergency"
- Nationwide Children's Hospital: "Pertussis (Whooping Cough)"
Medically reviewed by Originally Published: June 08, 2021
