When it comes to seasonal illnesses, few are as dreaded - or as preventable - as whooping cough. The violent coughing fits, the struggle to breath, and the high pitched "whoop" sound that some people make when inhaling after a cough attack are all telltale symptoms of this unpleasant infection that's also known as pertussis. 

Fortunately, whooping cough is preventable by a series of vaccines that many people receive as an infant called DTaP - which stands for Diphtheria, Tetanus, and Pertussis. Another version of this vaccine, called TDaP, is often also administered to older children and adults - and both of these vaccines, plus several others, are highly effective at preventing the illness. 

Unfortunately, the Centers for Disease Control and Prevention (CDC) says that vaccinations that protect against whooping cough have waned slightly, and that rates of the illness are on the rise. "Given the potential severity of whooping cough in infants, the rise in whooping cough rates is a significant concern," says Dr. Jason Nagata, a pediatrician at UCSF Benioff Children’s Hospital in San Francisco.

What is whooping cough? 

Whooping cough is a highly contagious bacterial infection that affects children and adults alike - though it's more common and concerning in infants and toddlers. The infection primarily affects the upper respiratory system, "leading to severe and prolonged coughing episodes that can last for weeks or even months," explains Nagata. "These episodes are characterized by intense coughing fits that can hinder one's ability to breath momentarily, so they are sometimes followed by a high-pitched inhale that sounds like a 'whoop.'" 

One of the reasons the illness is more common in infants is because babies can't receive the vaccine until they’re at least 2 months old and can catch it from their parents, caregivers or other children before they finish the series of shots. Nagata says infants are also at higher risk for more severe symptoms such as breathing difficulties and other complications, causing about half of them to require hospitalization. "In some cases, these complications can be life-threatening," says Nagata. Some 20 babies in the U.S. die annually from the infection, per the CDC.

And while older children and adults fare better than babies in avoiding the worst outcomes of the illness, "whooping cough is still a miserable experience," says Dr. Andrew Pavia, director of the hospital epidemiology program at Intermountain Primary Children's Hospital in Salt Lake City. 

Indeed, infected adults and teens experience frequent work, school, and sleep disruptions, pneumonia, significant pain and discomfort, and coughing attacks that can become so intense that some people vomit, choke or break their ribs, says Nagata. 

What causes whooping cough? 

Pavia explains that whooping cough is caused by bacteria called Bordetella pertussis, and a closely related relative, called Bordetella parapertussis. 

Transmission occurs when an infected person coughs or sneezes, "and tiny drops containing the bacteria are released into the air, where they can be inhaled by others nearby," says Nagata. He explains that, once inhaled, the bacteria attach to the lining of the airways and release toxins that damage the tissue, which then leads to swelling and increased mucus production. "This combination of factors results in severe coughing that characterizes whooping cough," he says. 

Complicating matters, he adds that the illness is highly contagious and that infected individuals can spread the bacteria for weeks, "often without realizing they’re infected." 

How to prevent whooping cough

Preventing transmission of whooping cough starts with proper hygiene such as thorough hand washing and keeping fingers and hands away from one's mouth and nose. Avoiding close proximity with others when sick is also important. 

But the best way to prevent whooping cough, "is for parents, caregivers, and anyone in close contact with infants to have an up-to-date TDaP vaccine," says Dr. Beth Natt, chair of pediatrics at the Atlantic Health System’s Goryeb Children’s Hospital in New Jersey. 

Pavia echoes the importance of whooping cough vaccination and says that children - and especially babies - should get the vaccine as soon as they are old enough. "Pregnant people should also get a TdaP vaccine with each pregnancy to protect their babies for the first several months of life," he adds. 

If you or your child has whooping cough, Nagata says it’s essential to start treatment as soon as possible. "Antibiotics are typically prescribed to prevent the infection from spreading, although they won’t cure the cough itself," he says. To help the healing process along and to manage symptoms, he recommends getting plenty of rest, avoiding irritants that could cause coughing, taking painkillers such as ibuprofen when age-appropriate, staying hydrated, and using a cool-mist humidifier. 

"You should seek medical care if prolonged coughing spells cause you or your child to vomit, turn red or blue, struggle to breathe, or if you hear the telltale whooping sound when inhaling," he advises. "In the hospital, healthcare providers can monitor your child's breathing, clear their airways, and provide fluids to prevent dehydration."

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