Pertussis
What is Pertussis?
Pertussis, commonly known as whooping cough, is caused by the bacteria Bordetella pertussis (B. pertussis). This is a highly contagious respiratory disease that can affect individuals of all ages. It is particularly dangerous for infants, who are at higher risk of complications including pneumonia, seizures, and in rare cases, death.
Whooping cough is on the rise in the U.S., a trend driven partly by declining vaccination rates. Vaccination is the most effective way to protect yourself, your family, and those around you. By staying up to date with vaccinations, you can help reduce the spread of this serious illness.
On this page, you can explore how whooping cough spreads, who is at risk, what the symptoms are, and how to prevent whooping cough.
of all pertussis deaths occur in newborns under 2 months old
How is whooping cough spread?
Whooping cough spreads easily through coughing or sneezing or by just sharing breathing space, such as holding a newborn close to your chest.
Since the symptoms of whooping cough can vary, some people with whooping cough may only have a mild cough and they can end up spreading it to babies they are in close contact with. In fact, approximately 90% of people who are unvaccinated and living with a family member who has whooping cough will get the disease.
Whooping cough is still common in the United States and outbreaks still occur, putting infants and young children, especially those too young to be fully vaccinated, at great risk.
Anyone can contract whooping cough, but babies under one year are especially at high risk for complications, even if they are otherwise healthy. These infants are too young to be vaccinated themselves, so they depend on antibodies passed from their mother through vaccination during pregnancy—if she was vaccinated.
Most deaths from whooping cough are among babies younger than 2 months old. The younger the baby is when they get whooping cough, the more likely they will need to be treated in a hospital.
In 2024, the U.S. had more than six times the number reported in 2023, and 10 deaths, the majority among infants under one year of age.
What are the symptoms of whooping cough?
In many children, whooping cough is a severe hacking cough followed by a high-pitched intake of breath that sounds like a “whoop.” However, the “whoop” may not always be present, especially in infants younger than six months, adolescents, and adults. Hear the “whooping” sound here.
Pertussis begins with mild symptoms that often resemble a common cold. These early signs typically appear 5 days to 3 weeks after exposure to the bacteria. As the illness progresses, symptoms become more severe. Thick mucus accumulates inside the airways, causing uncontrollable, severe coughing.
Symptoms in Infants (under 1 year old):
- Some babies may not cough at all but instead have trouble breathing or experience episodes where they stop breathing (apnea). These can be life-threatening.
Symptoms in Children (ages 1–10):
- Severe coughing fits: These can be violent and uncontrollable, often causing the person to gasp for air, which produces the characteristic “whooping” sound.
- Whooping sound: After a coughing fit, the intake of breath may produce a high-pitched “whoop.”
- Vomiting: Coughing fits can trigger vomiting.
- Difficulty breathing: Breathing may become labored, and the child may struggle to catch their breath.
- Cyanosis: The face may turn red or even blue due to a lack of oxygen.
- Broken ribs: Intense coughing can cause injury, including rib fractures.
- Difficulty with eating, drinking, or sleeping: Severe coughing can interfere with normal daily activities.
Symptoms in Older Children (over age 10), Teens, and Adults:
- Coughing spells may last for weeks or even months.
- The whooping sound may be absent, particularly in individuals who have been vaccinated or in those who are older.
- The illness is generally less severe in vaccinated individuals.
- Many adults, teens, and preteens may have mild or atypical symptoms and may not recognize they have pertussis.
What should I do if my child or I have been exposed to whooping cough?
Talk to a healthcare provider about preventive antibiotics that can help prevent you and/or your child from getting sick. Preventive antibiotics are recommended for household contacts within 21 days of exposure to pertussis, and are a priority for those at highest risk of serious complications, such as infants, pregnant women in their third trimester, and people with compromised immune systems.
How can I prevent whooping cough?
Vaccination is the best way to protect people of all ages, especially infants and young children, from whooping cough. The pertussis vaccine is combined with vaccines that protect against diphtheria and tetanus. For babies and young children, this vaccine is called DTaP. For preteens, teens, adults, and pregnant women, the vaccine is called Tdap.
The DTaP vaccine is given to infants and young children in 5 doses at age: 2 months, 4 months, 6 months, 15–18 months, and 4–6 years.Ensure that all family members, especially those who are pregnant, infants, and caregivers, are up to date on their pertussis vaccinations. The Tdap vaccine is recommended for adults and adolescents beginning at age 11–12.
Pregnant women should receive a Tdap vaccine between 27 and 36 weeks of gestation during every pregnancy.
The pertussis vaccine is combined with vaccines that protect against diphtheria and tetanus.
Babies and Children
For the best protection against whooping cough, your child needs all 5 recommended doses of the DTaP vaccine. Your child should receive doses at:
- 2 months
- 4 months
- 6 months
- Between 15 and 18 months
- Between 4 and 6 years
Preteens and Teens
The Tdap vaccine is the booster shot that helps protect preteens and teens from tetanus, diphtheria, and pertussis. All preteens are recommended to receive one dose of Tdap when they are 11–12 years old. Teens who did not get the Tdap vaccine at that age should get it as soon as possible. Tdap is especially important for anyone who is in close contact with a baby younger than 12 months of age, since infants and young children are at higher risk for serious whooping cough complications.
Adults
All adults (19 years and older) who have not yet received one dose of Tdap as a preteen, teen, or adult, need to get a Tdap vaccine, which protects against tetanus, diphtheria and pertussis. This vaccine will not only protect you from these diseases but will also help protect those around you from getting sick. This is especially important, if you are planning to be around any babies, all of whom are at high risk of serious complications from whooping cough.
After that, adults need a Td or Tdap vaccine booster shot every 10 years.
What if I cannot remember if I have been vaccinated against whooping cough?
If you are unable to recall if you have had a Tdap booster, talk to your healthcare provider about getting a Tdap booster.
Pregnancy
All pregnant women should get a Tdap vaccine between the 27th and 36th week of every pregnancy, preferably during the early part of this period, to protect both themselves and their babies from whooping cough. This recommendation is supported by the American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP), the American College of Nurse Midwives (ACNM), the American Academy of Family Physicians (AAFP), and the American Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN).
When a pregnant woman gets a whooping cough vaccine, her body creates protective antibodies and passes some of them to her baby before birth. These antibodies will provide the baby with short-term, early protection against whooping cough and its serious complications. This is very important since infants are too young to be protected by their own whooping cough vaccination series, which doesn’t start until 2 months old.
Recommended Vaccination Schedules
To ensure that your family is up to date on their vaccines, view or download the childhood and adult immunization schedules and talk to your healthcare provider.
Even if you’ve been vaccinated in the past, boosters are important to maintain protection. Pregnant women should receive the Tdap during each pregnancy, ideally between 27 and 36 weeks of gestation. And all adults should receive a Tdap vaccine every ten years.
Studies have shown that Tdap vaccination during pregnancy is safe and effective for pregnant women and their babies.
Learn more about vaccines for pregnant women and how they help protect both mom and baby in our Pregnancy section.
When you get a Tdap vaccine during your pregnancy, you will have antibodies in your breast milk that you can share with your baby as soon as your milk comes in. However, your baby will not get protective antibodies immediately if you wait to get the Tdap vaccine until after delivering your baby. This is because it takes about 2 weeks after getting vaccinated for your body to create antibodies. Learn more about the benefits of breastfeeding.
