Whooping Cough (Pertussis) is Serious!

Boo, the older sister, came to talk with me one night. “Please let Emi sleep in your room.  I just know she’s going to die, and I don’t want to be sleeping next to her when she does.” Emily will soon be 22, but Boo’s prediction was much closer to reality than I ever imagined.

Pertussis, the whooping cough, is caused by the bacteria Bordetella pertussis, which produces a toxin that paralyzes and inflames the respiratory tract.

A week or two after exposure, pertussis presents with a runny nose, sneezing, mild fever and a cough – very similar to mild cold symptoms. During the second stage of the disease, patients realize this is not your typical common cough. Patients will have fits of coughing that start suddenly, prevent breathing and increase in severity and frequency. Patients suffocate during the coughing and once the throat relaxes often sound a characteristic “whoop” as they try to again get air into their emptied lungs. Untreated, this severe stage can last up to 10 weeks. Patients then gradually recover; their parents and siblings gradually recover, too.

Take Whooping Cough Serious!

Take Whooping Cough Seriously!

Pertussis is pretty serious by itself, but can be even more serious when patients develop pneumonia or brain damage as a result of the coughing and lack of oxygen.

The disease is much more serious and deadly in younger children. Adults may just have a prolonged cough that wakes them up at night. Those with whooping cough can spread the disease for about a month during the illness, and 80% of susceptible contacts will catch it.

My family is way too familiar with the whooping cough. My mom, who will be 90 years old in October, lost her baby brother to pertussis and has never been comfortable hearing children cough or choke. I had whooping cough as an infant in the 1950s; fortunately it was the advent of the antibiotic era and given my mom’s sensitivity to coughing, I was treated after an early whoop.

My Emily had the whooping cough when she was a year old. Our family returned from our state pharmacy convention with pertussis. The coughs developed within a week or two. For adults, it was just a bad cough. For my three older kids, it was a serious cough. For Emily, it was life-threatening and for weeks we could not get anyone to recognize it. One afternoon I was at home when she started to cough … and cough … and cough. I held her on my shoulder and whacked on her back to help, but it didn’t. I held her in my arms as she looked at me, begging to breathe again – but there was nothing I could do. Her wee blue eyes rolled up into her head as she lost consciousness and relaxed in my arms still coughing an unable to breathe. I spoke to her, “don’t give up … don’t give up”.

I thought for sure I was going to lose her. After what seemed like forever, she whooped in a lungfull of air and shortly thereafter began to come back to life. She was clearly traumatized. We headed back over to our doc and to the emergency room, but by then she wasn’t coughing and I was again viewed as an overwrought dad. Eventually, a microbiologist colleague got help for her. Emily was tested and found positive for pertussis. Whooping cough can be treated with common antibiotics and she started recovering immediately.

The acellular pertussis vaccine protects against the whooping cough, and is administered as the DTaP along with the diphtheria and tetanus vaccines.

Recommendations are:

  • for infants to begin as early as six weeks of age and continue at 1-2 month intervals for three shots with an additional booster shot given at 1½ years of age.
  • Immunity occurs in about 80% of those receiving the vaccine, but gradually wears off.
  • Current recommendations include additional booster immunizations, called Tdap. These renew immunity and help prevent adults, particularly parents and grandparents, from carrying pertussis to young children.

If you wake up early enough and watch the right cable channels, you’re likely to see a grandmother with a cough turn into the big bad wolf as she hugs her grandchild dressed in red. The fairy tale bigbadcough.com (1) advertisements are sponsored by GSK, the makers of the pertussis vaccine.  Fairy tales can take the place of real wolves or monsters to scare the bejeebers out of children so they behave appropriately.  A lot like vaccines and immunization take the place of the real disease to teach the body to respond appropriately to deadly bacteria and viruses.

August is National Immunization Awareness Month, and September is the peak season for the whooping cough. Talk to you doctor, nurse or pharmacist about your recommended immunizations.


  1. http://www.helppreventdisease.com/adult_vaccines/whooping-cough/for-grandparents.html
  2. http://www.cdc.gov/features/pertussis
  3. http://www.mayoclinic.org/diseases-conditions/whooping-cough/basics/definition/con-20023295



Dr. Peter J. Rice

About Dr. Peter J. Rice

Dr. Peter J. Rice is a professor of Pharmacology emeritus at the East Tennessee State University Quillen College of Medicine and Professor of Clinical Pharmacy at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. --------------------------------------------------------------------------He received his BS in pharmacy from Northeastern University, PhD in pharmacology from the Ohio State University and PharmD from the University of Kentucky. He is a Board Certified Pharmacotherapy Specialist and practices in the ambulatory care and community pharmacy settings. Professor Rice is the author of Understanding Drug Action: An introduction to pharmacology (APhA, 2014) and is a fellow of the American Pharmacists Association. --------------------------He welcomes interesting medication questions and suggestions for future columns.
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