Pertussis in older adults: what to know

Pertussis, also called whooping cough, often begins like a mild cold before repeated coughing fits develop. The cough may come in bursts, disturb sleep, trigger vomiting, or leave a person exhausted. Older adults may not make a noticeable whooping sound, so the absence of that sound does not exclude pertussis.

A cough lasting for weeks deserves medical assessment, particularly when it follows contact with someone who has a prolonged cough. Fever may be mild or absent. Existing heart or lung disease can make coughing episodes harder to tolerate.

Arrange a clinical assessment if the cough is severe, persistent, or worsening. A clinician may ask about exposure, listen to the chest, and decide whether testing or antibiotic treatment is appropriate. Antibiotics can reduce spread when started at the right stage, but they may not immediately stop an established cough.

Rest between coughing bouts, take fluids in small frequent sips, and avoid smoke or other airway irritants. Cover coughs, improve ventilation, and limit close contact with infants until a clinician advises that it is safe.

Seek urgent medical help for struggling or rapidly worsening breathing, blue or grey lips, confusion, fainting, chest pain, inability to keep fluids down, or markedly reduced urination. Call emergency services if breathing stops or the person cannot stay awake.

Ask whether the cough pattern suggests pertussis, whether testing is useful now, how long to avoid close contact, and whether household members need assessment or preventive treatment.