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Pertussis (Whooping Cough): When to Go to Emergency

Healthcare provider preparing to give baby a shot.
Vaccination helps protect your child from pertussis.
Pertussis (also known as whooping cough) is a highly contagious infection of the respiratory tract. It spreads through droplets when an infected person coughs or sneezes. Because pertussis can be very serious, it’s important to know when to seek medical care.

Risk Factors

Babies and preschool-age children are most at risk. At age 2 months, most infants in the United States start the vaccination series to prevent pertussis. But the effects of the vaccine fade as children get older, so teens and adults can also get the disease.

When to go to the emergency department (ED)

At first, pertussis may seem like a cold. Your child is likely to have a runny nose, mild fever, and a slight cough. After 1 to 2 weeks, the cough tends to become very severe. Coughing spells may last as long as a minute. These produce a “whooping” sound as your child gasps for air. Sometimes, your child may turn red or blue or vomit from the cough. Call your healthcare provider right away if you suspect pertussis. Seek emergency help if your child:

  • Has a blue color to his or her skin (check fingertips and around mouth). (If there is a blue color, call 911.)

  • Stops breathing, even for an instant. (Call 911.)

  • Unless advised otherwise by your child’s healthcare provider, call the provider right away if:

    • Your child is of any age and has repeated fevers above 104°F (40°C).

    • Your child is younger than 2 years of age and a fever of 100.4°F (38°C) continues for more than 1 day.

    • Your child is 2 years old or older and a fever of 100.4°F (38°C) continues for more than 3 days.

    Vomits often, or becomes dehydrated

What to expect in the ED

A healthcare provider will ask about your child’s symptoms and perform a physical exam. He or she will likely take samples of secretions from your child’s nose or throat. These will be checked in a lab for the bacteria that cause pertussis. Your child also may have blood tests or X-rays.

Treatment

Infants and children with severe pertussis are likely to be admitted to the hospital for treatment with antibiotics and fluids. Milder cases may be treated at home with antibiotics, fluids, and bed rest. Cough and cold medicines are not very helpful. Because of the possibility of serious side effects, they should not be used in children younger than age 4 years. These medicines should be used only in children between ages 4 and 6 years, if your healthcare provider recommends them. Never give aspirin to a child under age 18 years. It could cause a rare but serious condition called Reye's syndrome. Generally, ibuprofen is not recommended for infants younger than age 6 months.

Prevention

Getting vaccinated is the best way to protect against pertussis. Talk to your healthcare provider about whether your child needs a booster vaccination. Also, be sure to ask whether you need a booster as well.

Online Medical Reviewer: Fetterman, Anne, RN, BSN
Online Medical Reviewer: Image reviewed by StayWell art team.
Online Medical Reviewer: Lentnek, Arnold, MD
Last Review Date: 1/1/2017
© 2000-2017 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.