Pertussis, or whooping cough, is a very contagious airway infection caused by the bacterium Bordetella pertussis. It is most dangerous for young infants, who may stop breathing instead of whooping, so vaccination in pregnancy and childhood is key.
Key symptoms
- Cold-like start: runny nose, mild cough, low fever
- Fits of rapid coughing followed by a whoop on breathing in
- Vomiting after coughing
- Cough that lasts for weeks
- In infants: pauses in breathing or turning blue
What you find on exam
- Often normal between coughing fits
- Watch a fit: color and oxygen saturation during the cough
- Hydration and weight in infants
- Small bleeds in the whites of the eyes from coughing
Tests
- Nasopharyngeal swab for Bordetella pertussis PCR, best in the first 3 weeks
- Blood count: high lymphocyte count in infants
- Chest X-ray if pneumonia is suspected
Treatment basics
- Azithromycin, most useful early in the illness
- Antibiotics for close contacts too
- Droplet precautions until 5 days of antibiotics
- Admit young infants for monitoring
- Prevention: Tdap in every pregnancy and DTaP for children
Red flags
- Pauses in breathing or turning blue
- Poor feeding or dehydration in an infant
- Fast breathing, fever or low oxygen suggesting pneumonia
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Related guides
Sources: NCCPA PANCE Content Blueprint; CDC, Guideline for Isolation Precautions (2007) and PPE sequence; NCSBN 2026 NCLEX-RN Test Plan. Written by Making Synapses. Making Synapses is not affiliated with these organizations.