Whooping Cough in Adults: Why Cases Are Rising and When a Cough Is Pertussis

The cough that keeps a 42-year-old awake for a sixth straight week does not sound like a children’s disease. There is no whoop, no fever, nothing dramatic between fits. Then a swab comes back positive for pertussis, and the family starts counting backward to the newborn they visited. Scenes like this are why searches for whooping cough in adults have climbed sharply: as of spring 2025, US surveillance recorded more than 35,000 pertussis cases for 2024, roughly six times the 2023 total and the highest annual count since 2012.

Pertussis is a bacterial infection of the airways caused by Bordetella pertussis, and it never went away. What changed is who is getting it, and how often adults are the overlooked link in a chain that ends with an infant in intensive care.

This piece sets out what the surveillance numbers actually show, how an adult case looks and sounds, what treatment can and cannot do, and the specific moments when a lingering cough deserves a clinician’s attention.

What changed recently: why whooping cough in adults is back in the headlines

Three dated developments explain the current attention.

First, the US numbers. CDC surveillance for 2024 logged more than 35,000 reported pertussis cases, up from roughly 7,000 in 2023. The last year with a comparable total was 2012, when 48,277 cases were reported. Deaths were recorded in 2024 as well, most of them in infants younger than one year. CDC’s framing was deliberately measured: the country has returned to the pre-pandemic pattern of periodic surges, rather than facing something new.

Second, the UK experience ran in parallel. Through 2024, England saw its largest confirmed case count in more than a decade, with infant deaths reported, and NHS guidance stressed the pregnancy vaccine, offered from 16 weeks, as the main shield for newborns. Health services across Europe reported increases of ten times or more in 2023 and 2024 compared with the two preceding years, and WHO’s pertussis fact sheet notes that the disease still causes an estimated tens of thousands of deaths globally each year, overwhelmingly in young infants.

Third, the attention shifted toward adults. Pertussis in teenagers and adults is now recognised as common, underdiagnosed and the usual source of infant infection. Studies cited by CDC suggest that in a large share of infant cases where a source is identified, it is a parent, sibling or other household adult.

None of this is a change in the bacterium’s danger to healthy adults, which remains low. It is a change in visibility. More testing, more adults coughing for weeks, and a renewed understanding that the person who passes pertussis to a baby usually has no idea they are carrying it.

What is whooping cough, and is it really a 100-day cough?

Whooping cough is a highly contagious respiratory infection caused by the bacterium Bordetella pertussis. The medical name, pertussis, simply means “intense cough” in Latin. In parts of China the illness has long been called the 100-day cough, and that nickname is closer to the truth than the English one, because the whoop is optional and the duration is not.

The bacterium settles on the lining of the windpipe and bronchi, the airways leading into the lungs. There it releases toxins that paralyse cilia, the tiny hair-like structures that normally sweep mucus upward, and inflame the airway lining. Mucus pools, the airways swell, and the body responds with explosive bursts of coughing to clear what the cilia no longer can. That mechanism explains the signature feature: fits of coughing so prolonged that the person runs out of air, then gasps. In children the gasp passes through a narrowed, swollen airway and makes the whoop. Adults have wider airways, so the gasp is usually silent.

Pertussis spreads through droplets when an infected person coughs, sneezes or shares close breathing space. CDC describes it as among the most contagious infections known; without protection, most susceptible household contacts will catch it. The incubation period, meaning the time between exposure and first symptoms, is usually 5–10 days but can stretch to three weeks.

So does it last 100 days? Often, roughly, yes. Mayo Clinic and NHS both describe a cough that can persist for weeks to several months, long after the bacteria themselves are gone. The lingering cough is damaged airway lining slowly repairing itself, not ongoing infection. That distinction matters for treatment, contagiousness and reassurance, and later sections return to it.

Is whooping cough going around right now? How pertussis moves in cycles

Short answer: yes, in a predictable way. Pertussis never disappears from a population; it rises and falls in waves roughly every 3–5 years, as CDC surveillance has documented for decades. Each wave builds as the pool of susceptible people grows (new babies, and older children and adults whose vaccine protection has faded), then subsides once enough people have been infected or boosted.

The 2020–2022 period broke that rhythm. Masking, distancing and school closures pushed pertussis to historic lows, with under 7,000 US cases in some years. Fewer infections meant fewer people with freshly boosted natural immunity, so the susceptible pool kept growing silently. When normal contact resumed, the pent-up wave arrived all at once. The 2024 surge is best read as a delayed and amplified peak, not an unprecedented event.

How can you tell whether it is circulating near you? Public health departments publish case counts, and clinicians in an area with a known cluster have a lower threshold for testing. For an individual, three clues raise the odds that a stubborn cough is pertussis rather than a leftover cold:

• A known contact with a confirmed case, at home, school or work, within the past three weeks.
• A local or regional outbreak reported by the health department.
• A cough that is getting worse in the second and third weeks instead of better, which is the opposite of the usual viral pattern.

Autumn and winter see more pertussis in temperate countries, but it has no strict season, and large outbreaks have occurred in summer. The honest answer to “is it going around” is that in a surge year, it is going around somewhere nearly all the time, and adults are a large part of why.

Why are cases rising? Waning immunity, a pandemic gap and better tests

Several forces are stacking up, and the evidence behind each differs in strength.

The best-supported factor is waning immunity from acellular vaccines. In the 1990s, the US and many other countries replaced whole-cell pertussis vaccines, which caused more fever and local reactions, with acellular versions that use purified pieces of the bacterium. Acellular vaccines are gentler and highly protective at first, but observational studies summarised by CDC show protection fading faster. After the fifth childhood dose, roughly 98 in 100 children are protected in the first year, falling to about 7 in 10 after five years. For the adolescent and adult booster (Tdap), protection is estimated at about 7 in 10 in the first year and 3 or 4 in 10 by four years. That decline means a generation of adults vaccinated only in childhood carries little residual protection.

The pandemic immunity gap is well documented in surveillance data. Two years with almost no circulating pertussis left more people susceptible at once.

Better diagnosis plays a real but smaller part. PCR testing, a laboratory method that detects the bacterium’s genetic material from a nose swab, is faster and more sensitive than the older culture method. Clinicians who once labelled a six-week adult cough as bronchitis now test, and find pertussis.

A fourth factor sits at the weaker end of the evidence. Some circulating strains have stopped producing pertactin, a surface protein included in acellular vaccines. Laboratory and observational studies suggest this may help the bacterium evade vaccine-induced immunity, but how much it contributes to case numbers is unsettled, and current vaccines still protect against severe disease.

Finally, uptake matters. Where vaccination coverage in infants or pregnancy has slipped, the youngest and most vulnerable are exposed to whatever adults bring home.

Pertussis symptoms in adults: why the whoop is usually missing

The single most useful fact about whooping cough in adults is that it rarely whoops. Mayo Clinic and CDC both note that teenagers and adults, especially those who were vaccinated as children, often have a milder, atypical picture that looks like a cold that refuses to end.

A typical adult course begins with a week or two of runny nose, sneezing, a mild cough and little or no fever. The person goes to work, visits relatives and shares a car, because nothing seems serious. Then the cough changes character. It arrives in fits, sometimes 10 or 20 coughs on a single breath, more often at night, and may finish with gagging or vomiting. Between fits, the person can feel almost normal, which is itself a distinguishing feature; most chest infections leave people unwell throughout.

Signs that should raise suspicion of pertussis in an adult include:

• Coughing fits that end in retching or vomiting (post-tussive emesis).
• A cough that worsens after the first two weeks rather than easing.
• Fits that leave you breathless, red-faced or light-headed; some adults briefly faint.
• Waking repeatedly at night with uncontrollable coughing, with a quiet daytime cough.
• Little or no fever, and a chest that sounds clear to a clinician between fits.

Complications in adults are usually mechanical, the result of violent coughing. Reported problems include rib fractures, urinary incontinence, abdominal hernias, nosebleeds, broken blood vessels in the eye and significant weight loss or sleep deprivation. Pneumonia is the main infectious complication and is more likely in older adults and people with asthma, COPD or weakened immunity. Death in otherwise healthy adults is very rare. The real stakes, for most adults, are weeks of exhaustion and the risk to infants in their orbit.

How long does whooping cough last? The three stages explained

Clinicians describe pertussis in three stages, and knowing which one you are in changes what treatment can do.

The catarrhal stage lasts about 1–2 weeks. Catarrhal simply means marked by mucus: a runny nose, sneezing, watery eyes, mild cough and perhaps a low fever. It is indistinguishable from a cold, and it is also the most contagious period, because the airways are full of bacteria and nobody is isolating.

The paroxysmal stage follows and typically lasts 1–6 weeks, occasionally up to 10. A paroxysm is a sudden, violent fit. This is when coughing attacks cluster, especially at night, and when post-tussive vomiting, breathlessness and exhaustion take hold. By this point the bacteria are already declining and the symptoms are driven by toxin damage to the airway lining, which is why antibiotics started here shorten contagiousness but do little for the cough itself.

The convalescent stage, meaning recovery, can run for weeks to months. Fits become less frequent and less severe, but any new respiratory virus can set them off again, because the airway lining is still healing. Many adults describe feeling fully recovered only after two or three months. Add the stages together and the Chinese nickname, the 100-day cough, looks accurate for a substantial minority of patients.

Contagiousness has a clearer boundary than the cough. CDC guidance treats a person as infectious from the start of symptoms until three weeks after the coughing fits begin, or until five full days of appropriate antibiotics have been completed. After that window closes, the ongoing cough is a nuisance, not a threat to others.

Vaccinated adults tend to pass through milder, shorter versions of each stage, though the cough can still be stubborn. Smokers and people with underlying lung disease often recover more slowly.

Cold, bronchitis, asthma or pertussis? How the coughs compare

Most prolonged adult coughs are not pertussis. Post-viral cough, asthma, acid reflux and postnasal drip are far more common causes of a cough lasting beyond three weeks. The table below sets out the patterns clinicians weigh; it is a guide to the conversation with your doctor, not a self-diagnosis tool, because the only reliable way to identify pertussis is a laboratory test.

Feature	Common cold	Post-viral bronchitis	Asthma cough	Pertussis (adult)
Usual duration	7–10 days	2–4 weeks	Weeks to months, recurring	6–12 weeks or longer
Trajectory	Improves steadily	Improves slowly	Fluctuates with triggers	Worsens in weeks 2–3, then slowly eases
Cough pattern	Intermittent	Wet, productive	Dry, wheezy, worse with exercise or cold air	Dry fits of many coughs on one breath
Vomiting after coughing	Rare	Rare	Occasional	Common
Night symptoms	Mild	Some	Often prominent	Markedly worse at night
Fever	Low or none	Low	None	Usually none
Feeling between coughs	Unwell	Tired	Normal	Often near normal
Known contact with a case	Not specific	Not specific	Not relevant	Strongly suggestive

Two patterns deserve emphasis. A cough that is getting worse in its third week is unusual for viral illness and should prompt a pertussis test. And a cough with retching or vomiting in an adult who otherwise feels well between attacks is a classic pertussis story, even though no single feature is diagnostic.

Two look-alikes are worth knowing. Mycoplasma pneumoniae, another bacterium, causes a prolonged dry cough and also surged after the pandemic. And adenovirus or RSV can mimic the early stages. Testing sorts them out, which is one more reason the fourth week of an unexplained cough is too late to still be guessing.

How is whooping cough diagnosed in adults, and why timing matters

Diagnosis rests on three things: the story, the timing and a swab.

The story is the pattern described above, plus any known exposure. Clinicians use a case definition that includes a cough lasting at least two weeks with coughing fits, a whoop, post-tussive vomiting or breathing pauses, so a detailed description of your fits is genuinely useful. If you can, record one on your phone; a 30-second clip of a night-time paroxysm often conveys more than any description.

The swab is taken from the nasopharynx, the area at the back of the nose above the throat. It feels unpleasant for a few seconds. Two laboratory tests are commonly used. Culture, which grows the bacterium, is highly specific but slow and becomes unreliable after the first two weeks. PCR, which detects bacterial DNA, is the workhorse in most settings and remains useful for about three weeks after cough onset, sometimes four. Both tests lose sensitivity once antibiotics have started.

Beyond that window, the bacteria have largely cleared and swabs turn negative even in true cases. Serology, a blood test for antibodies against pertussis toxin, can help diagnose adults who present late, typically between two and twelve weeks after the cough began, although results are harder to interpret in people recently vaccinated.

The timing lesson is simple: a negative swab in week six does not rule pertussis out, and a test in week two is far more informative than one in week five. Adults who wait until the cough is truly unbearable often arrive after the useful testing window has closed.

Pertussis is a notifiable disease in the US, the UK and most countries, meaning a confirmed case is reported to public health authorities. That is not a bureaucratic afterthought; it triggers contact tracing and protective antibiotics for vulnerable household members, which is where much of the public health benefit of diagnosis lies.

How do you treat whooping cough in adults?

Treatment has two goals that are easy to confuse: clearing the bacterium, and easing the cough. Antibiotics accomplish the first. Nothing reliably accomplishes the second.

Guidelines from CDC and NHS recommend a course of macrolide antibiotics, a class that targets Bordetella pertussis, for people diagnosed with pertussis, with an alternative class available for those who cannot take macrolides. The choice of drug, the course and any adjustment for other medicines or health conditions belong entirely to the prescribing clinician.

What antibiotics do depends on timing. Started in the catarrhal stage or the first week or two of coughing, they can shorten the illness and lessen its severity. Started later in the paroxysmal stage, they no longer change the cough much, because the damage driving the fits is already done. They still matter, because they clear the bacterium and end contagiousness after five days, protecting infants and others. CDC generally advises treatment for adults within three weeks of cough onset, and up to six weeks for pregnant people and those in contact with infants.

Antibiotics do not stop the cough. Patients who finish a course and keep coughing for another month have not failed treatment; they are in convalescence.

For the cough itself, the evidence is sobering. A Cochrane systematic review, a rigorous pooling of randomised trials, examined antihistamines, corticosteroids, inhaled bronchodilators and pertussis immunoglobulin and found no convincing benefit for any of them. Over-the-counter cough syrups have not been shown to help either. Clinicians may still consider options for specific patients, and that is a decision for the treating doctor.

Most adults recover at home. Hospital care is reserved for complications such as pneumonia, fainting, severe dehydration from vomiting, or significant underlying lung or heart disease. Rest, fluids, small frequent meals and avoiding smoke and other airway irritants are expert-recommended supportive measures rather than trial-proven ones, and they are discussed in the next section.

How to manage a whooping cough at night

The night is where pertussis does its worst. Lying flat lets mucus pool, airway irritation builds in a dry room, and the fits arrive in clusters that leave people afraid to sleep. Honesty first: no randomised trial has shown that any home measure shortens or prevents pertussis coughing fits. What follows is the supportive advice given by NHS, Mayo Clinic and MedlinePlus, grounded in expert consensus and airway physiology rather than trial evidence.

• Keep the bedroom air clean and slightly humid. A cool-mist humidifier may soothe irritated airways; the key is a clean filter, since mould or dust will make things worse. No tobacco smoke, wood smoke, strong scents or aerosol sprays anywhere near the sleeper.
• Sleep propped up. Extra pillows or raising the head of the bed reduces pooling of mucus and may reduce the reflex to cough.
• Drink steadily through the evening. Vomiting after fits dehydrates, and dehydration thickens mucus. Warm drinks are comforting, though no specific drink has been shown to help.
• Eat small, frequent, bland meals rather than a large dinner. A full stomach makes post-tussive vomiting more likely and more unpleasant.
• Keep a basin and tissues within reach, and a glass of water to rinse the mouth after vomiting.
• Rest during the day where possible. Sleep debt accumulates quickly and exhaustion lowers the coughing threshold.

Partners often ask whether to wake someone mid-fit. Sitting up and leaning slightly forward helps clear the airway and reduces panic; otherwise, staying calm and present is the useful contribution.

Honey has modest trial evidence for easing night-time cough in children with ordinary colds, but it has not been studied in pertussis, and it must never be given to infants under one year because of botulism risk. Cough suppressants have not shown benefit in pertussis, and anyone considering a medicine for sleep or cough should ask their clinician, particularly if they have other health conditions or take regular medicines.

What the evidence actually says, and how strong it is

Pertussis attracts strong claims in both directions. Here is where the main ones sit on the evidence ladder, from randomised trials at the top to expert opinion at the bottom.

Vaccines prevent pertussis, with protection that fades. Strength: high. Acellular vaccines were licensed on the basis of large randomised controlled trials in the 1990s showing substantial protection against typical pertussis in infants and children. The waning seen since comes from extensive observational studies, particularly case-control analyses during US outbreaks, which consistently show protection dropping over four to five years. Observational data cannot rule out all bias, but the consistency across countries makes the pattern robust.

Vaccination in pregnancy protects newborns. Strength: moderate to high. Randomised trials established that antibodies cross the placenta; large observational studies in the UK and US then found roughly 9 in 10 infants under two months protected against pertussis when the mother was vaccinated in pregnancy. No safety signal for mother or baby has emerged in these datasets.

Early antibiotics shorten illness; late antibiotics mainly stop spread. Strength: moderate. A Cochrane review of randomised trials confirmed that macrolides eradicate the bacterium from the airway. The benefit for symptoms when started early rests on observational data and biological plausibility; the lack of benefit for an established cough is consistent across studies.

Symptomatic treatments for the cough. Strength of evidence against benefit: moderate. Randomised trials pooled by Cochrane found no clear benefit from antihistamines, steroids, bronchodilators or immunoglobulin, though the trials were small.

Home measures (humidity, propping up, small meals). Strength: expert opinion only. Reasonable, low-risk, untested.

Pertactin-deficient strains drive the surge. Strength: low to moderate. Laboratory and observational signals exist; the size of the effect is unresolved.

The pattern is clear. The strongest evidence supports prevention. The weakest supports anything that promises to quiet the cough once it has taken hold.

Whooping cough vaccine for adults: who is eligible and when

Adult eligibility differs between countries, so the guidance below is quoted as the public health agencies state it. Any individual decision, including timing around other vaccines, allergies or pregnancy, belongs with your clinician or vaccination service.

United States (CDC). Children receive a five-dose series of DTaP, the pediatric vaccine combining protection against diphtheria, tetanus and acellular pertussis, at 2, 4, 6 and 15–18 months and 4–6 years. Adolescents receive one dose of Tdap, the adolescent and adult formulation, at 11–12 years. Adults who have never received Tdap should get one dose, regardless of when they last had a tetanus booster. After that, CDC recommends a tetanus-containing booster, either Td or Tdap, every 10 years. Pregnant people are advised to receive Tdap during every pregnancy, ideally between weeks 27 and 36, to pass protective antibodies to the baby. CDC also recommends Tdap for adults who will be in close contact with infants under 12 months, and for healthcare workers.

United Kingdom (NHS). Infants receive pertussis protection in the 6-in-1 vaccine at 8, 12 and 16 weeks, with a preschool booster at 3 years 4 months. Pregnant women are offered the whooping cough vaccine from 16 weeks of pregnancy, ideally around the 20-week scan, in every pregnancy. The NHS does not routinely offer pertussis boosters to adults outside pregnancy, although vaccination may be advised during outbreaks or for specific occupational reasons.

Global (WHO). WHO recommends a primary infant series with boosters, and maternal vaccination in pregnancy where infant pertussis is a concern.

Adults who have had pertussis are still advised to follow the vaccine schedule, because natural immunity also wanes. Common side effects are a sore arm, tiredness and mild fever for a day or two; severe allergic reactions are rare and are the reason vaccines are given where staff can respond.

Why an adult's cough matters most for the babies around them

For a healthy adult, pertussis is an ordeal. For a baby under three months, it can be fatal. Infants are too young to have completed their vaccine series, their airways are tiny, and instead of coughing they may simply stop breathing, turn blue or struggle to feed. CDC reports that about one in three infants under one year who get pertussis need hospital care, and most pertussis deaths occur in babies younger than three months. WHO estimates that pertussis still causes tens of thousands of infant deaths worldwide each year.

Where do infants catch it? When a source is identified, it is usually a family member: a parent, sibling or grandparent with a cough that nobody considered dangerous. That is the central reason whooping cough in adults is a public health issue rather than a personal inconvenience.

Two strategies protect the youngest. The strongest is vaccination in pregnancy, which transfers maternal antibodies across the placenta so the baby arrives with protection that lasts until its own vaccines take effect; observational studies in the UK and US found roughly 90 percent effectiveness against infant pertussis in the first two months of life. The second is cocooning, a term for making sure everyone who will be close to a newborn is up to date with pertussis vaccination before the baby arrives. Cocooning has weaker supporting evidence than maternal vaccination, mainly because it is hard to achieve in practice, but it remains part of CDC guidance.

If you have been diagnosed with pertussis, or are being tested, the practical steps are these: stay away from infants and pregnant people until a clinician confirms you are no longer contagious; tell the household so that close contacts, especially those with babies, can be assessed for preventive antibiotics; and let anyone who visited you during the catarrhal stage know. Those conversations are awkward. They are also the most effective thing an adult with pertussis can do.

Common myths about whooping cough in adults

Surges bring viral claims. Here are the ones that circulate most, corrected against mainstream evidence.

“Only children get whooping cough.” False. Adolescents and adults account for a substantial share of reported cases, and because their illness is milder and often untested, the true share is higher. Adult cases are the main route by which infants are infected.

“If there is no whoop, it is not pertussis.” False. The whoop is a feature of narrow childhood airways. Most adults with laboratory-confirmed pertussis never whoop; coughing fits with gagging or vomiting are the adult signature.

“Vaccinated people cannot catch it, so the vaccine must not work.” Both halves miss the point. Protection from acellular vaccines fades over several years, so vaccinated adults can catch pertussis. Observational studies consistently show that vaccinated people who do become infected have milder, shorter illness and are less likely to need hospital care, and vaccination in pregnancy sharply reduces infant deaths.

“The vaccine can give you whooping cough.” False. Acellular pertussis vaccines contain purified components of the bacterium, not live bacteria, and cannot cause infection.

“Antibiotics will stop the cough.” Not once the fits are established. Antibiotics clear the bacterium and stop you infecting others; the cough runs its course as the airway heals.

“High-dose vitamin C treats pertussis.” There is no reliable evidence for this. The claim rests on anecdotes from the pre-antibiotic era, and no controlled trial supports it. Large doses can cause digestive side effects and kidney stones in susceptible people.

“Natural infection gives lifelong immunity, so it is better than the vaccine.” Immunity after infection also wanes, typically within 4–20 years according to studies cited by CDC, and infection carries real risks that vaccination does not.

“A cough test in week six will settle it.” Usually not. By then swabs are often negative even in genuine cases, which is why early testing matters.

When to see a doctor about a cough that will not quit

Most adult coughs settle within three weeks and need no appointment. Pertussis is one of several reasons not to wait beyond that, and the testing window makes earlier better. Book a routine appointment if any of these apply:

• A cough that has lasted more than two weeks, especially if it is getting worse rather than better.
• Coughing fits that end in gagging, vomiting or a gasp for air.
• A cough that started within three weeks of contact with someone later confirmed to have pertussis, even if your symptoms feel like a mild cold.
• You are pregnant and have a new cough, or you live with or care for an infant under 12 months.
• You are over 65, have asthma, COPD, heart disease or a weakened immune system, and have developed a persistent cough.
• You are unsure whether you have ever received a pertussis-containing vaccine as an adult, or you are planning a pregnancy or a visit to a newborn.

Seek urgent care the same day, or emergency care, for red-flag signs:

• Difficulty breathing or breathlessness between coughing fits, not just during them.
• Lips or face turning blue or grey during or after a fit.
• Fainting, or near-fainting, with coughing.
• Coughing up blood, or sharp chest pain with breathing that could indicate a rib fracture or pneumonia.
• Signs of dehydration from repeated vomiting: very dark urine, dizziness on standing, confusion.
• A high or persistent fever, which is unusual in pertussis and may signal pneumonia or a different infection.

Any infant with a cough, breathing pauses, difficulty feeding or colour change needs emergency assessment immediately, because pertussis in babies can worsen within hours.

Bring a note of when the cough started, what the fits look like (a phone video helps), any known contacts and your vaccination history. Decisions about testing, antibiotics, preventive treatment for household contacts and vaccination belong with your clinician, who can weigh the stage of illness and your personal risk. The role of an article like this is to make sure you walk in early enough for those decisions to matter.

Frequently asked questions

Does whooping cough really last 100 days?

Often, roughly, yes. The infection itself clears within a few weeks, but the cough can persist for 6–12 weeks and sometimes longer, because the toxin-damaged airway lining heals slowly. The three stages, catarrhal, paroxysmal and convalescent, add up to two or three months in many adults. New colds during recovery can reignite coughing fits. A long cough after pertussis is expected and does not mean the treatment failed or that you remain contagious.

Is whooping cough going around right now?

Pertussis is circulating at the highest levels in more than a decade in the US, the UK and much of Europe, following a post-pandemic rebound. It peaks in natural 3–5 year cycles and never disappears entirely. Local health departments publish case counts, and a known contact, a regional outbreak or a cough worsening into its third week all raise the chance that a stubborn adult cough is pertussis rather than a leftover virus.

How do you treat whooping cough in adults?

Clinicians prescribe a course of macrolide antibiotics, or an alternative if those are unsuitable, which clears the bacterium and ends contagiousness after five days. Antibiotics started early can shorten and soften the illness; started once fits are established they do little for the cough. No cough medicine, steroid or antihistamine has shown benefit in trials. Rest, fluids, small frequent meals and avoiding smoke are the supportive measures. All treatment decisions rest with the prescribing clinician.

How can you stop whooping cough fits at night?

Nothing reliably prevents them, but expert guidance suggests measures that may reduce them: sleep propped up, keep the bedroom free of smoke and strong scents, use a clean cool-mist humidifier, drink steadily through the evening, and eat small bland meals rather than a large dinner to limit vomiting. Sitting forward during a fit helps clear the airway. Cough suppressants have not been shown to help in pertussis; ask your clinician before taking any medicine.

What are the pertussis symptoms in adults?

Adults typically begin with a week or two of cold-like symptoms with little or no fever, then develop a dry cough that arrives in fits of many coughs on one breath, worse at night, often ending in gagging or vomiting. Most adults never whoop. Between fits they may feel almost well. Complications from violent coughing include rib fractures, urinary leakage, fainting, weight loss and exhaustion; pneumonia is the main infectious complication.

Can you get whooping cough if you have been vaccinated?

Yes. Protection from acellular vaccines fades over several years, so adults vaccinated only in childhood, or more than a few years ago, can catch pertussis. Observational studies show that vaccinated people who become infected tend to have milder, shorter illness and are less likely to need hospital care. This waning is exactly why CDC recommends a Tdap dose for adults who have never had one and vaccination in every pregnancy.

How long is whooping cough contagious in adults?

CDC treats a person as contagious from the start of cold-like symptoms until three weeks after the coughing fits begin, or until five full days of appropriate antibiotics have been completed, whichever comes first. The earliest, cold-like stage is the most infectious, which is why pertussis spreads before anyone suspects it. The cough that lingers for weeks afterward is airway healing, not ongoing infection, and does not pose a risk to others.

Do adults need the whooping cough vaccine?

In the US, CDC recommends one dose of Tdap for any adult who has never received it, then a tetanus-containing booster every 10 years, plus Tdap in every pregnancy at 27–36 weeks and for adults in close contact with infants. In the UK, the NHS offers the vaccine in every pregnancy from 16 weeks but does not routinely boost other adults outside outbreaks. Your clinician or vaccination service can confirm what applies to you.

How long does whooping cough last compared with a normal cough?

A common cold cough fades within 7–10 days and post-viral bronchitis within 2–4 weeks, both improving steadily. Pertussis typically worsens in weeks two and three, peaks with coughing fits for 1–6 weeks, then eases over further weeks to months, for a total of 6–12 weeks or more. A cough that is getting worse in its third week is unusual for a virus and is a reason to ask about pertussis testing.

Can you get whooping cough twice?

Yes. Immunity after natural infection wanes, with studies cited by CDC suggesting protection lasts somewhere between 4 and 20 years, so repeat infections in adulthood do occur. Second episodes are often milder but still contagious to infants. Because of this waning, people who have had pertussis are advised to keep up with the recommended vaccine schedule rather than relying on past infection for protection.

References

• CDC: About Whooping Cough
• CDC: Whooping Cough Vaccination
• NHS: Whooping cough
• MedlinePlus: Whooping Cough

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.