The paroxysmal stage of pertussis

Airway irritation makes coughs cluster into attacks. A person may gasp after a burst, become flushed, bring up mucus or feel exhausted. Infants may show pauses in breathing, poor feeding or a change in colour rather than the classic whoop. The cough can linger after the initial infection has improved. A mild fever does not rule out pertussis, and the severity can vary between people.

Keep the person upright and calm, offer small sips of fluid between attacks and allow quiet recovery afterwards. Avoid smoke, vapour and strong scents. Arrange medical review to discuss testing, antibiotic treatment and protection of household members, especially babies. Follow any isolation advice and keep vaccination records available. Never force food or drink during an active coughing fit.

Call emergency services if breathing stops or remains difficult, lips turn blue or grey, the person becomes faint, confused or unusually difficult to wake, or chest pain is severe. A baby with pauses in breathing, repeated vomiting, poor feeding or fewer wet nappies needs urgent assessment. Contact a clinician promptly when attacks are becoming more frequent or recovery between them is poor.

Ask whether the illness is in the paroxysmal stage, whether testing can still help, how to protect close contacts and how to recognise dehydration or breathing trouble. Tell the clinician when the cough began and whether there has been a known exposure.