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What is Whooping Cough (Pertussis)?Updated 2-27-24
  • Pertussis, also known as whooping cough, is a very contagious respiratory illness that can spread when a person coughs or sneezes. It is caused by a type of bacteria called Bordetella pertussis.
  • Whooping cough can cause serious illness in people of all ages but is most dangerous for babies, especially babies younger than 2 months who are too young to get vaccinated.
  • Getting vaccinated is the best way to protect against severe illness.
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Fact Sheet

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Whooping Cough: Symptoms and Complications

Symptoms

Whooping cough usually starts with cold-like symptoms. These early symptoms can last for one to two weeks and usually include:

  • Runny or stuffy nose
  • Congestion
  • Fever
  • Mild, occasional cough (may be minimal or absent in babies)

Later, the traditional symptoms of whooping cough appear, which include:

  • Rapid and uncontrolled coughing fits followed by a high-pitched "whoop" when inhaling afterwards
  • Trouble breathing
  • Throwing up (vomiting), especially after coughing fits
  • Feeling very tired after coughing fits
  • Broken ribs (rare)
  • A pause in breathing in babies
  • Turning blue or purple in babies

The coughing fits can last for up to 10 weeks or more. For teens and adults, especially those who were vaccinated, the "whoop" is often not there, and the disease is generally less severe.

If you think you may have these symptoms, talk with your provider. If you are a provider whose patients have symptoms compatible with this disease, please click here to report to DPH.


Complications

Whooping cough can cause serious illness, leading to hospital stays and even death. Severe illness is often seen in babies less than 6 months old. Many infants may have only congestion and a runny nose, while others may gasp or gag, be tired, vomit, have seizures, or stop breathing. Unfortunately, some infants can die from whooping cough. If your infant has trouble drinking liquids, catching their breath, is breathing fast, has frequent vomiting after coughing, or seems more lethargic than usual, call your doctor right away or go to the nearest emergency room.

How does Whooping Cough Spread?

Whooping cough can easily spread through the air. When a person who has whooping cough sneezes or coughs, they can release small particles with the bacteria in them. Other people then breathe in the bacteria.

Some people have mild symptoms and don’t know they have whooping cough, but they can still spread it to others. Many babies who get whooping cough are infected by older siblings, parents, or caregivers who do not know they have it.

Information for the Public
Vaccine Information

There are two vaccines to help protect against whooping cough, and both provide protection against other diseases:

  • Diphtheria, tetanus, and pertussis (DTaP) vaccines
  • Tetanus, diphtheria, and pertussis (Tdap) vaccines

Babies and children younger than 7 years old receive DTaP, while older children and adults receive Tdap. Both vaccines are safe and effective and provide protection against severe illness.

CDC recommends whooping cough vaccination for all babies and children, preteens, and pregnant women. Adults who have never received one should also get a Tdap shot. Talk with your, or your child’s, doctor if you have questions about whooping cough vaccines.

Vaccine Recommendations
  • DTaP Vaccine: A 5-dose series is recommended, beginning at the age of 2 months, to protect against diphtheria, tetanus and whooping cough, which are especially dangerous for infants. CDC recommends receiving a dose at the following ages:
    • 2 months
    • 4 months
    • 6 months
    • 15 through 18 months
    • 4 through 6 years

In California, students entering school TK/K-12 require 5 doses of DTaP. Four doses are acceptable if one was given on or after 4th birthday. 3 doses accepted if one was given on or after 7th birthday. See Shots for School for more details.

  • Tdap Vaccine: 1 dose to boost their immunity.
    • Between 11-12 years of age

For 7th–12th graders, at least 1 dose of pertussis-containing vaccine is required on or after 7th birthday. See Shots for School for more details.

  • Tdap Vaccine: 1 dose to help protect newborns from whooping cough during their first few months of life when they are at highest risk of having severe complications from disease.
    • Protection happens through transfer of antibodies against whooping cough to the newborn.
    • Pregnant person should receive a Tdap vaccine during the early part of the 3rd trimester of every pregnancy.
  • Tdap Vaccine: All adults who have never received a Tdap vaccine should get 1 dose. This can be given at any time. Adults should receive a booster dose every 10 years.
  • The University of California system requires 1 dose of Tdap on or after aged 11 years, then Tdap every 10 years.
  • A person who has ever had a life-threatening allergic reaction after a previous dose of a diphtheria, tetanus, or pertussis containing vaccine, or has a severe allergy to any part of this vaccine, should not get a DTaP or Tdap vaccine.
  • Talk with your healthcare provider before getting the Tdap vaccine if you have any of the following:
    • Progressive or unstable neurologic disorder, including infantile spasms
    • Uncontrolled seizures or progressive encephalopathy.
    • A condition called Guillain-Barré Syndrome.
    • Are moderately or severely ill.
Where to get the Vaccine

There are many places to get the whooping cough vaccine. If you have insurance, talk to your doctor or check with your local pharmacy to see what vaccines are offered. Most health insurances cover the cost of all recommended vaccines for children and adults.

If you are uninsured or underinsured, there are programs available to help cover the cost of vaccines. Children who are 18 years of age or younger are eligible to receive vaccines at no cost through the Vaccines for Children (VFC) Program if they are:

  • Eligible for or are enrolled in Medi-Cal
  • American Indian or Alaskan Native
  • Uninsured (do not have health insurance)
  • Underinsured (private health insurance does not cover the full cost of vaccines)

Click to see if your child is eligible to receive VFC vaccines: English | Spanish

Uninsured or underinsured adults can access free or low cost vaccines at select clinics enrolled in the Vaccines for Adults (VFA) program. For more information on who is eligible, read VFA Eligibility Based on Insurance Status. You can use the following resources for more information on locating clinics:

You can also dial 2-1-1 for a list of free or low cost vaccine clinics. This includes Vaccines for Children (VFC) provider locations that serve Medi-Cal eligible children and uninsured or underinsured adults. Learn more about specific vaccine information for different age groups:

Keeping Record of Your Immunization Records

Are you not sure if you have been vaccinated against whooping cough or you can’t find your vaccine records?

If you need official copies of your vaccine records, or if you need to update your personal records:

Additional Resources

General Pertussis Information and Resources:

Resources for Schools:

Resources for Parents:

Pregnancy and Pertussis Information and Resources:

Information for Providers
Disease Recommendations

Bordetella pertussis is a gram-negative bacteria that causes a highly contagious respiratory disease (whooping cough) that affects people of all ages, and can be very serious, even deadly, for infants fewer than 12 months old. Clinical presentation may vary by age and immunization status.

Consider and evaluate patients for B. pertussis, if:

  • The patient has a cough illness lasting 2 or more weeks AND
  • At least one (1) of the following signs or symptoms:
    • Paroxysms of coughing
    • Inspiratory whoop
    • Post-tussive vomiting or gagging
    • Apnea and/or cyanosis
Isolation of Suspected Cases
  • Isolate patients presenting with a persistent cough from waiting areas or place a well fitted medical grade mask over the patient’s mouth and nose and seat patient 3-6 feet apart from other patients.
  • Use tissues and dispose in no-touch receptacle.
  • Observe hand hygiene after soiling of hands with respiratory secretions.
  • Employers and employees should follow the Aerosol Transmissible Diseases (ATDs) precautions and wear a well-fitted medical-grade mask when caring for patients with suspected or confirmed pertussis.
Reporting

Please contact the County of Los Angeles Department of Public Health Vaccine-Preventable Disease Control Program to report a case or obtain technical assistance with specimen collection or completion of forms for the reporting of pertussis cases.

Report suspected or confirmed pertussis cases within 1 business day by electronic transmission (email or digital fax), telephone, or mail (IAW Title 17, California Code of Regulations (CCR), Section 2500

Documents to include:

Digital Fax: 213-351-2782
Email: vpdc@ph.lacounty.gov
Weekday Telephone (7:30 AM to 5:00 PM):  213-351-7800
Non-Business Hours/Weekend Telephone: 213-974-1234
Mail: Vaccine-Preventable Disease Control Program, ATTN: Surveillance Team, 3530 Wilshire Blvd, Suite 700, Los Angeles, CA 90010

Diagnostic Testing

A diagnosis of B. pertussis can be challenging based on clinical presentation alone. Multiple diagnostic laboratory tests are available to support as confirmatory evidence.

Culturing B. pertussis from a respiratory specimen is the gold standard, as it is the only 100% specific method available. However, this can be time intensive and is not widely available.  Most commonly, providers obtain respiratory specimens for B. pertussis PCR, which is both highly sensitive and will give results quickly, allowing for prompt isolation and treatment of infected patients.

Culture

Optimal timing of pertussis specimen for culture is within the first 2 weeks following cough onset.

Collect a nasopharyngeal (NP) swab and place immediately into transport medium for delivery to laboratory services.

Culture testing can take up to 7 days to provide results.

PCR

Obtain a nasopharyngeal (NP) swab or aspirate within the first 3-4 weeks after cough onset for Bordetella pertussis PCR testing.

A positive PCR result for B. pertussis supports confirmed case classification when paired with clinical criteria.

Patients who are asymptomatic or who have completed 5 days of antibiotics, should not be PCR tested regardless of their exposure status.

Vaccine Recommendations

Timely vaccination with a pertussis-containing vaccine, such as DTaP and Tdap, is the most effective way to prevent B. pertussis. Studies show fully vaccinated individuals with pertussis like symptoms should receive evaluation and testing, especially if they have been exposed.

Review the CDC’s Catch-up Guidance for infants and children whose vaccine series may be delayed.

Additional DTaP/Tdap Vaccine Resources

Treatment and Post Exposure Prophylaxis

Early treatment of pertussis is most effective for reducing symptom severity and contagiousness. Treating B. pertussis early with antibiotics may make the infection less serious and help to prevent spreading the bacteria to others. 

Recommended antimicrobial agents for treatment and chemoprophylaxis of pertussis are:

  • Azithromycin
  • Clarithromycin
  • Erythromycin
  • Trimethoprim-sulfamethoxazole (TMP-SMX) 

Patients should stay home from work or school until the full course of treatment is completed.

Chemoprophylaxis treatment is recommended to contacts at high risk for severe disease (e.g. infants, persons in 3rd trimester of pregnancy, persons with chronic lung disease), household members of patient, and to persons who will have close contact with those at high risk of developing severe pertussis (eg healthcare workers, infant daycare workers).  Refer to the CDC Pertussis (Whooping Cough) Treatment Guidelines for detailed guidance regarding elevated pertussis risk factors.



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  • Public Health has made reasonable efforts to provide accurate translation. However, no computerized translation is perfect and is not intended to replace traditional translation methods. If questions arise concerning the accuracy of the information, please refer to the English edition of the website, which is the official version.

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