Pathophysiology of pertussis

The bacteria attach to the tiny hair-like structures that normally move mucus out of the breathing tubes. Irritation and mucus build-up interfere with this clearing action, so coughing becomes forceful and repetitive. Early illness can resemble a cold, with a runny nose and mild fever. As airway irritation continues, coughing fits may end with vomiting or a noisy intake of breath. The cough can continue after the bacteria have reduced because the airway lining needs time to recover. Explore more about [Whooping Cough](/conditions/whooping-cough/), [Cough](/symptoms/cough/), and [Fever](/symptoms/fever/).

Arrange medical assessment when a cough is persistent, comes in bursts, or affects feeding or sleep. Testing may be considered early in the illness. Take prescribed [Antibiotic Treatment](/treatments/medical-management/antibiotic-treatment/) exactly as directed; it may reduce spread and is most useful when started early, although it may not stop an established cough immediately. Offer small, frequent fluids and keep the environment free from smoke and strong fragrances. Ask about [Childhood Immunisation](/treatments/preventive-care-and-vaccination/childhood-immunisation/) for prevention and about protecting babies or other vulnerable household members.

Get urgent help for pauses in breathing, blue or grey lips, severe breathing difficulty, unusual sleepiness, repeated vomiting with inability to drink, or signs of dehydration. Babies may have breathing pauses without a dramatic cough, so seek prompt advice if feeding drops or breathing looks abnormal.

Could this cough be pertussis, and is testing useful now? How long should the person stay away from others? Which household contacts need preventive treatment or vaccination advice? What warning signs should prompt emergency care?