It’s difficult to watch your baby deal with the symptoms of a cold, and it’s an absolute nightmare if you see that your child can’t breathe because they’re coughing so hard.
That’s one of the threats of pertussis, more commonly known as whooping cough.
“Whooping cough can affect people of all ages, but it’s especially bad for babies,” says UNC Health pediatrician Edward Pickens, MD. “When teenagers and healthy adults get it, it’s a long, drawn-out cough that takes months to go away. But in babies and younger children, it interferes with their ability to breathe, causing serious damage to the lungs and even death.”
Whooping cough is extremely contagious and very common. Nationwide, 2024 cases were about six times higher than 2023 cases, and in North Carolina, more than seven times higher. Preliminary 2025 data indicates that cases have remained elevated.
“There are outbreaks all the time, and it’s in our community quite frequently,” Dr. Pickens says.
He explains what you need to know to keep your family safe.
Symptoms of Whooping Cough
Whooping cough, which is caused by the bacteria Bordetella pertussis, looks like a bad cold for the first week or two, causing a cough, stuffy, runny nose, sore throat and fever.
“At one to two weeks, the coughing fits start, and they will go on and on and on,” Dr. Pickens says. “That can be the most dangerous time, because the coughing goes on for minutes at a time, nonstop, and you can’t get a breath in. A person might cough so much they vomit, or the baby can turn blue because they can’t catch a breath.”
Whooping cough gets its name from the “whoop” sound someone makes when they try to force air into their lungs in the midst of a coughing fit. Not everyone who gets whooping cough will make that specific sound.
If you see that your child can’t breathe, it’s an emergency—call 911.
Even after the intense coughing fits end, the cough will linger for many weeks.
“It’s known as the ‘cough of a hundred nights,’ and that’s probably an underestimate,” Dr. Pickens says. “It’s at its worst for 100 nights, and then there will be residual coughing for many months.”
Whooping Cough Diagnosis and Treatment
If you take your child to their doctor because you’re worried about cold or flu symptoms, they will likely be tested for pertussis; it’s typically included in a respiratory pathogen panel test that’s also looking for RSV, COVID-19 and other viral and bacterial infections.
If the bacteria causing pertussis is found, the treatment is a course of antibiotics, typically azithromycin. While the antibiotics will not completely eliminate the long cough, they will make symptoms less severe and clear the infection so that the person is not contagious any longer.
Family members in the same home are typically prescribed antibiotics for prevention.
Cases of pertussis must be reported to the health department, so you may find out your child has been exposed to whooping cough at day care or school.
“Talk to your pediatrician about a known exposure,” Dr. Pickens says. “If the infection is in the same day care room or classroom, it’s probably a good idea to start the antibiotic.”
Recovery from pertussis is slow. While the antibiotic can lessen symptoms, it does not eliminate them entirely, and traditional cold and cough remedies do not typically reduce the length of the cough. Instead, focus on rest and hydration. Using a humidifier in a child’s room at night might help reduce nighttime coughing and make it easier to sleep.
“You have to wait it out, and the irritation of the airway takes a long time to heal,” Dr. Pickens says, noting that while children aren’t contagious after they’ve finished antibiotics, they may not be able to return to school because of the frequency of their coughing.
About 1 in 3 babies younger than 12 months who get whooping cough will require hospital care, where they will likely receive supplemental oxygen.
Vaccination and Boosters for Whooping Cough
The pertussis vaccine reduces your risk of catching whooping cough, and if you do become infected, it reduces the severity.
Babies should receive the DTaP (diphtheria, tetanus and acellular pertussis) vaccine at 2, 4 and 6 months old.
“Children are considered better protected after those first three,” Dr. Pickens says. “Babies who haven’t completed those first three doses are most susceptible.”
Children get a booster between 15 and 18 months old, and another before starting kindergarten.
Children get another booster before starting 7th grade. At that point, they typically receive the vaccine as Tdap; the name and capitalization changes reflect that older children and adults need a reduced dose of the diphtheria and pertussis vaccine to maintain immunity.
Adults should get a Tdap booster every 8 to 10 years.
“One of the reasons whooping cough is on the rise is that adults are not staying up-to-date with those boosters,” Dr. Pickens says.
It’s especially important to get a Tdap booster if you’re going to be around an infant; a Tdap vaccine is a recommended for women between 27 and 36 weeks of pregnancy.
“That booster keeps the mom from getting pertussis, and it gives the baby protection prior to their own vaccinations,” Dr. Pickens says. “A booster is also important for all caregivers. Dads and grandparents need to make sure they have their booster too so they don’t pass this on to babies.”
If you’re worried about your child’s symptoms, talk to their doctor. If you need a doctor, find one near you.