Whooping Cough in Adults: Long Coughing Spells, Pertussis Signs and Care

What it involves

MedlinePlus explains that pertussis is a highly contagious bacterial disease, caused by Bordetella pertussis, that causes uncontrollable, violent coughing that can make it hard to breathe. It spreads in droplets when an infected person coughs or sneezes. Symptoms often last six weeks but can last as long as ten. The deep whoop is often missing in adults, which is why the cough alone can be misread.

Who this is for

• Adults whose cough has lasted more than two weeks and comes in hard, repeated fits.
• Patients whose coughing spells end in vomiting or leave them struggling to catch their breath.
• Adults who live with or care for a baby and have a worsening cough.
• People who were around someone diagnosed with whooping cough and now have cold symptoms.

What to expect

• Questions about how the cough started, how long the fits last, and whether anyone around you has had a similar cough
• A listen to the lungs and a check of oxygen, temperature and breathing rate
• Testing, which may include a nose or throat sample and blood work, or a chest x-ray ordered elsewhere
• Guidance on treatment, how long you may be contagious, and keeping babies away until you are cleared

How the illness unfolds

MedlinePlus says the first symptoms look like a common cold and develop about a week after exposure. Severe coughing episodes start about ten to twelve days later. Coughing spells may lead to vomiting or a short loss of consciousness, and MedlinePlus says pertussis should always be considered when vomiting occurs with coughing. Other symptoms include a runny nose, low-grade fever and diarrhea. A cough that drags on is covered in the persistent cough guide.

Why it is easy to miss in adults

In adults the cough is the whole story, because the whoop MedlinePlus describes is rare after infancy. A cold, flu, bronchitis, asthma or reflux can all cause a long cough, so a provider looks at the pattern. The cold versus flu guide, the acute bronchitis guide and the asthma guide describe the common lookalikes. The distinguishing features are fits of coughing, vomiting after coughing, and a cough that keeps getting worse for weeks.

How it is diagnosed

MedlinePlus says the initial diagnosis is most often based on symptoms, but that pertussis can be hard to diagnose when they are not obvious. A sample of mucus from the nose can be sent to a lab, and a complete blood count may show many lymphocytes. Because the test takes time, treatment is often started before the result is back. Serenity By A Dr. Sareen lists blood work among its services, and the complete blood count guide explains that test.

Treatment and why timing matters

Antibiotics can make symptoms go away more quickly if started early enough, but MedlinePlus says most people are diagnosed too late for them to help much. They still reduce how long a person can spread the disease, which matters most around infants. MedlinePlus also says cough mixtures, expectorants and suppressants are usually not helpful. A provider decides on a prescription, and the sick visit, urgent care or ER guide helps you choose where to go.

Complications and warning signs

MedlinePlus lists pneumonia, nosebleeds and ear infections among the complications, with seizures and breathing pauses mostly a risk in infants. It says to call 911 or go to the emergency room for bluish skin color, periods of stopped breathing, seizures, high fever, persistent vomiting or dehydration. The pneumonia guide describes the signs of a chest infection, and the shortness of breath guide explains when trouble breathing is urgent.

Prevention and protecting babies

MedlinePlus says the childhood DTaP series protects against pertussis, and that the Tdap vaccine is given at age 11 or 12 and during pregnancy to protect the newborn. Babies are at highest risk, so an adult with a lingering cough should avoid close contact with infants until a provider says it is safe. Serenity By A Dr. Sareen does not list vaccines among its services, so ask when you call about where to get one. A cough that lasts for weeks and then brings up blood is a different situation from a routine cough, and the coughing up blood guide explains how it is evaluated and when to call 911.

Sources

• MedlinePlus: Whooping Cough (health topic)
• MedlinePlus: Pertussis (medical encyclopedia)