Yes, Adults Can Get Whooping Cough. Here Are the Signs to Look Out For

Erica Sloan
·11 min read

Marta Lebek/Stocksy/Adobe Stock

When you get stuffy and come down with a nasty cough, you might assume the culprit is the common cold. Feeling seriously unwell could point you in the direction of the flu, COVID-19, or RSV (respiratory syncytial virus). What probably isn’t on the tip of your tongue? Whooping cough (or pertussis). It’s a respiratory infection that tends to get the most airtime among parents of infants, as young children are especially likely to catch it and have a bad case. But adults can certainly get it too. And according to CDC data, that may be increasingly likely these days: More than six times as many whooping cough cases were reported in the final week of 2024 than in the same period in 2023, and the total for last year even soared past pre-pandemic levels.

Caused by the bacterium Bordetella pertussis (B. pertussis), whooping cough is marked by coughing fits so powerful you can barely catch a breath, Mark Loafman, MD, MPH, a family medicine physician specializing in infectious disease and chair of family and community medicine at Cook County Health, in Chicago, tells SELF. The “whoop,” he says, is the high-pitched whistle you might let out while gasping for air between croaks (though it’s worth noting that not everyone with the condition makes this signature sound).

Part of the reason whooping cough may not be in your everyday lexicon is because cases have dropped precipitously since a vaccine was introduced in the 1940s and included in the childhood vaccination regimen. (The CDC recommends multiple doses of a shot protecting against diphtheria, tetanus, and pertussis for infants, kids, and adolescents.) But even if you were vaccinated as a child, your immunity may have waned—and pertussis boosters aren’t included in the official vaccine recommendations for adults (more on this later). Hence why you might become more susceptible during an outbreak as you age, Dr. Loafman says.

The reasons for the recent uptick aren’t totally clear, but experts think pertussis might be experiencing a similar post-pandemic rebound as other contagious conditions like influenza and walking pneumonia. “We saw a decrease in all of these infections that correlated with pandemic precautions,” Dr. Loafman says, such as social distancing and masking. Like COVID, whooping cough primarily spreads via droplets (the spray that happens when you cough or sneeze), so there’s reason to think we were also taming its transmission during the lockdown. Now that people are back out again and not following the same public-health protocols, “we’re going to see a return to normal,” he says. But that still doesn’t explain why the count for 2024 surpassed that for 2019—with more than 35,000 reported cases compared to roughly 18,000. Dr. Loafman points to a potential link with the recent dip in childhood vaccination (a trend which previous research has shown can increase risk).

While the current total is still relatively low for an infectious disease, experts suspect that for every reported case of whooping cough, there are countless more unreported ones—for instance, in folks who can’t or choose not to seek medical care, perhaps mistaking the condition for a cold. Read on to learn the key signs of whooping cough in adults, and what can be done to treat or prevent a run-in with this highly disruptive bug.

What are the symptoms of whooping cough in adults?

Early signs of whooping cough in adults look very much like a common cold, Dr. Loafman says.

For the first week or so of feeling sick, you can expect:

  • Congestion

  • Runny nose

  • Watery eyes

  • Low-grade fever

  • Mild cough

After that point, your cough will evolve and worsen, Jorge Mercado, MD, a pulmonologist and critical care medicine specialist at NYU Langone Hospital–Brooklyn, tells SELF. The continued hacking is usually a good clue that you’re dealing with something beyond a cold, he says. “An upper respiratory infection should last you five or seven days maximum, so if symptoms surpass that threshold, it’s time to say, ‘Wait a minute, what’s going on here?’”

In the second week and beyond (usually for a few weeks), you can expect frequent and intense coughing fits that could cause you to:

  • Struggle to breathe or make a high-pitched whistling sound as you inhale

  • Bring up a lot of mucus

  • Get dizzy or pass out

  • Feel very tired

  • Have difficulty sleeping at night

  • Vomit

Generally, a pertussis cough is what doctors call “spasmodic” or “paroxysmal,” which means “you’re overcome with it and can’t control or stop it,” Dr. Loafman says. The inability to catch a break and get some air is what can trigger the more severe symptoms above. (It’s worth noting that noninfectious causes like postnasal drip, asthma, and GERD can also lead to a lingering cough, which is why it’s always essential to get evaluated by a doctor to suss out if pertussis is to blame.) However, Dr. Loafman adds, folks who’ve been vaccinated against pertussis will have a swifter immune response to it, which can prevent some of the worst hacking.

The reason whooping cough can bring on such a gnarly, well, cough in the first place is because of how B. pertussis wreaks havoc: These bugs latch on to the cilia (a.k.a. tiny hairlike protrusions) on cells in your respiratory tract and ooze toxins, triggering inflammation and swelling. “Your body is trying to make you cough out or expel the problem,” Dr. Loafman says, “so what you’re really suffering from is that inflammatory response.” The tricky thing is, even when you eventually clear the bacteria from your system, your cells can remain on high alert, causing that inflammation to keep smoldering. That’s why you might experience a nagging cough for several weeks, Dr. Loafman says. Some people also get a resurgence of bad wheezing during the next two or three routine colds they catch, he adds. “It can take a while for that response to burn out.”

How is whooping cough diagnosed?

Because so many signs of whooping cough in adults can resemble a cold—particularly at the early stages and in vaccinated folks with milder cases—and catching a cold is still far more common, your doctor may not run a test for pertussis if you’ve only been coughing for a few days. But that can change if you’re located in a state or city where the illness has been especially spiking (as has recently occurred in Washington and California); medical providers are required to report any cases of the condition they see to their local health department, so doctors will receive alerts when there’s a notable uptick in their area and will then test sooner and more frequently than they might otherwise, Dr. Loafman says.

If your doctor is suspicious of pertussis based on the nature and duration of your symptoms, a coinciding local outbreak, or both, they may use lab testing to diagnose you. The two most common methods both involve gathering a bit of fluid from the back of your nose, either via a long swab (think of the original COVID tests, rather than the at-home rapid ones) or aspiration (for which your doc will pump a saline solution into your nose, then gently suction it back out). A bacterial culture test will scan that sample for evidence of B. pertussis, and a PCR test will scout it for the microbe’s genetic material. In some cases, your provider may run a “multiplex” PCR panel to test for evidence of a bunch of different pathogens, including B. pertussis, using one sample, Dr. Loafman notes. (Just note this type of test may be expensive and not fully covered by insurance.)

While, again, your provider may not test you for whooping cough if you’ve only been feeling lousy for a couple days, both Dr. Mercado and Dr. Loafman emphasize making an appointment if you’ve had cold-like symptoms for more than a week and/or have developed an intense cough. After all, if you do have whooping cough, the sooner you can get diagnosed and receive an antibiotic, the more effective that treatment will be (more on this in a minute). That’s also why, if your illness seems to have progressed substantially, your doctor may make a diagnosis simply by reviewing your symptoms and listening to your cough, and not spend time confirming it with lab testing before offering treatment.

What is the treatment for whooping cough?

As soon as you get diagnosed, your doc will likely prescribe you an antibiotic called azithromycin (a.k.a. a Z-pack) to kill off the B. pertussis. (You might recognize it from its use in fighting a variety of other bacterial menaces, too, including pneumonia, ear and sinus infections, and some STIs.) By the end of the five-day course, you should be feeling better, though, again, the cough can linger. During this time, you’ll also reduce your “bacterial load,” or how much of the bug is in your system, which lowers your chances of transmitting it, Dr. Mercado says. Just know that, like most antibiotics, azithromycin can mess with your GI tract, potentially triggering side effects like diarrhea or nausea.

One important caveat: If your doctor suspects you’ve had whooping cough for three or more weeks by the time you’re diagnosed, they may not prescribe you an antibiotic, given the bacteria itself is likely not still present in your body. As mentioned above, symptoms can stick around even in the absence of an imminent threat when your immune response keeps firing anyway. In this case, there’s not much in the way of medication that can help; Dr. Mercado notes that OTC drugs haven’t actually been proven effective for softening a bad rasp. But you’re likely to recover on your own with adequate R&R: Give yourself plenty of time to rest, stay nourished and well-hydrated, and try to minimize sources of stress, Dr. Loafman says.

That said, it’s important to stay in touch with your doctor if your symptoms get worse or aren’t resolving, whether you’re taking an antibiotic or not. Though rare in adults, complications of pertussis can include pneumonia, encephalitis (brain inflammation), and seizures. What’s more common is repercussions from a continued bad cough, Dr. Mercado says, like breaking a rib, collapsing a lung, or even causing a hernia in your belly—so you definitely want to inform your provider if the coughing fits won’t let up.

How can I avoid whooping cough?

It’s especially important to get vaccinated against pertussis if you didn’t receive the usual series recommended for infants, kids, and adolescents; that means getting the combined Tdap shot, which includes protection for tetanus, diphtheria, and pertussis. As mentioned above, the CDC doesn’t currently recommend that people who got the suggested childhood shots receive additional pertussis boosters throughout adulthood, but it does recommend that all adults get the Td booster (for tetanus and diphtheria) every 10 years. Given that immunity decreases with time for all three conditions, the CDC notes that healthcare providers may choose to offer Td or Tdap to adults—and Dr. Loafman says that the latter has become increasingly commonplace as whooping cough resurfaces.

The American Lung Association specifically recommends that high-risk adults, including those with asthma or chronic obstructive pulmonary disease (COPD), get vaccinated against pertussis. And the CDC also says that pregnant people should get the Tdap vaccine between 27 and 36 weeks to give their newborn some antibodies to help protect them against whooping cough in the time before they’re eligible to get their first shot for the condition, at two months.

In some scenarios, you can also take steps to ward off an infection if you recently shared airspace with a sick person. Because pertussis is so contagious—and is known to spread quickly among people under the same roof, even when everyone is vaccinated—the CDC suggests that certain folks who’ve been exposed to it get antibiotic treatment before they get ill, as a preventative tactic. That includes people who live with the infected person as well as anyone at high risk (like infants and folks who are immunocompromised) and those who will be in close quarters with them. And you have plenty of time to act, Dr. Loafman says. The condition’s incubation period (the time from when someone gets exposed to when they have symptoms) can be as long as three weeks, he says, so taking antibiotics at any point within that window post-exposure could prevent you from ever falling victim to it.

Otherwise, keep in mind the usual guidance for tamping down the spread of respiratory illness: Wear a mask in crowded areas, Dr. Mercado says, and put some space between you and anyone who’s actively coughing or seems to be sick. Also, “whenever you come into your home, wash your hands before you do anything else,” Dr. Loafman says. And in general, do your best to avoid rubbing your eyes or touching your face—there’s always a chance you recently touched a surface sprayed with pertussis droplets, and you don’t want to give those bugs an assist with making it into your body.

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Originally Appeared on Self