Clinical features of whooping cough

Whooping cough is a contagious bacterial infection of the airways. It may begin like a mild cold, with a runny nose and a small amount of fever, before the cough becomes more intense. Coughing can come in clusters that leave someone red-faced, breathless or exhausted. Vomiting or difficulty feeding may follow a bout. The classic whoop may be absent in adults, vaccinated people and young infants, so the sound is not required for consideration of the illness.

Arrange prompt medical advice for a cough that is becoming paroxysmal, causes vomiting, or follows contact with whooping cough. Tell the clinician about the onset, exposure, vaccination history and anyone vulnerable at home. Antibiotic treatment may reduce spread when started at an appropriate stage, although the cough can take time to settle. Keep distance from infants and follow infection-control advice while contagious.

Get emergency help if breathing pauses, lips turn blue, the person cannot recover between coughing bouts, or severe breathing difficulty develops. Infants need urgent assessment for poor feeding, pauses in breathing, unusual sleepiness or a cough without a whoop. Seek prompt care for dehydration, repeated vomiting or rapidly worsening symptoms.

Ask whether testing is useful, how long the person may be infectious, whether household contacts need advice, and how to manage coughing at home. Check whether childhood immunisation or catch-up vaccination is indicated for eligible family members.