Stages of pertussis infection

The early phase may include a runny nose, sneezing, mild [Fever](/symptoms/fever/), and an occasional [Cough](/symptoms/cough/). Because these symptoms can be subtle, infection may not be recognised immediately. The cough can then become more frequent and arrive in bursts. A person may gasp for breath after a bout, vomit, become exhausted, or make a high-pitched intake sound; babies may have pauses in breathing rather than a classic whoop. The coughing phase can continue after the initial infection has settled, and improvement is often gradual rather than sudden. Infants, older adults, and people with breathing problems can become seriously unwell.

[Whooping Cough](/conditions/whooping-cough/) information can help you compare the pattern with other causes of prolonged cough, but a clinician should assess breathing difficulty or symptoms in a young baby.

Contact a clinician early when pertussis is suspected, particularly if someone has been exposed or the cough is becoming repetitive. [Antibiotic Treatment](/treatments/medical-management/antibiotic-treatment/) may reduce spread when started at the appropriate point, although it may not immediately stop an established cough. Keep the person rested, offer small frequent drinks, and avoid smoke or other airway irritants. Follow local advice about staying away from school, childcare, work, or vulnerable household members. Ask whether household contacts need assessment or preventive treatment.

Seek emergency help if breathing is difficult, lips look blue or grey, there are pauses in breathing, the person cannot keep fluids down, or a baby is unusually sleepy or feeding poorly. Prompt medical review is also needed for repeated vomiting, dehydration, chest pain, or a cough that is worsening. Prevention through [Childhood Immunisation](/treatments/preventive-care-and-vaccination/childhood-immunisation/) is especially important for protecting babies and other vulnerable people.

Ask whether testing is useful, when the person can return to normal activities, how to reduce household spread, and which breathing changes should trigger urgent help.