Bordetella pertussis symptoms: what to know

Early features may include a runny nose, sneezing, mild cough and a low-grade fever. After the infection develops, coughing may come in rapid bursts that make it hard to breathe between coughs. Some people make a high-pitched sound when breathing in after a bout, while others do not. Vomiting, exhaustion, or difficulty feeding can follow coughing. Babies may have pauses in breathing rather than a loud cough, so the absence of a whoop does not exclude pertussis.

A prolonged cough can have several causes. A clinician considers the pattern, duration, contact with illness, vaccination history and examination findings when assessing suspected whooping cough.

Arrange medical advice if coughing bouts are worsening, recurring at night, or interfering with sleep, fluids or meals. Rest between bouts, take small sips of fluid, and avoid smoke or strong fragrances that trigger coughing. Keep a young child upright during a coughing episode and watch their breathing. Do not share prescribed medicines, and do not start an antibiotic without an assessment. See [Whooping Cough](/conditions/whooping-cough/) for condition-focused information.

Seek emergency help for blue or grey lips, severe breathing difficulty, pauses in breathing, unusual limpness, or inability to wake normally. Prompt assessment is also needed when an infant is feeding poorly, has repeated vomiting after coughs, or seems dehydrated. A severe or rapidly worsening [Cough](/symptoms/cough/) deserves medical review even when fever is absent. A [Fever](/symptoms/fever/) in a very young baby should be discussed urgently with a clinician.

Could this cough be pertussis, and is testing appropriate? How should we reduce spread to babies or pregnant people? When can the person return to school, nursery or work? Does anyone in the household need preventive advice or [Childhood Immunisation](/treatments/preventive-care-and-vaccination/childhood-immunisation/)?