From the Guidelines
Pertussis (whooping cough) typically presents with a catarrhal stage, followed by a paroxysmal stage characterized by severe coughing fits, and finally a convalescent stage with gradual recovery, as described in the most recent and highest quality study 1. The illness begins with the catarrhal stage, lasting 1-2 weeks, which resembles a common cold with mild cough, runny nose, low-grade fever, and sneezing. This stage is often mild and may not be recognized as pertussis, contributing to its spread as patients may not yet realize they have the disease.
Key Signs and Symptoms
- The paroxysmal stage, lasting 1-6 weeks, is characterized by severe coughing fits (paroxysms) that often end with a distinctive high-pitched "whoop" sound when the patient rapidly inhales, as noted in 1 and 1.
- These coughing episodes may cause vomiting, exhaustion, and a red or blue face from effort.
- Infants may present differently, often with apnea (breathing pauses) rather than the classic whoop, and are at highest risk for complications, as highlighted in 1 and 1.
- Adults and vaccinated individuals typically experience milder symptoms, often just a persistent cough without the characteristic whoop, as reported in 1 and 1.
Disease Progression
- The final convalescent stage involves gradual recovery over weeks to months, with decreasing frequency and severity of coughing fits, though they may return with subsequent respiratory infections.
- Pertussis is most contagious during the early catarrhal stage before the distinctive cough develops, which contributes to its spread as patients don't yet realize they have the disease, as discussed in 1 and 1.
From the Research
Signs and Symptoms of Pertussis
The signs and symptoms of pertussis, also known as whooping cough, can be divided into several stages, including:
- Catarrhal stage: presents with nonspecific symptoms such as malaise, rhinorrhea, sneezing, lacrimation, and mild cough 2, 3
- Paroxysmal stage: characterized by severe outbreaks of coughing, often leading to a classic high-pitched whooping sound when gasping for breath 2, 3, 4
- Convalescent stage: marked by persistent cough and resolution of symptoms 2, 3
Complications of Pertussis
Complications of pertussis vary by age, with infants being more likely to experience severe complications such as:
- Apnea 2, 5, 6
- Pneumonia 2, 5
- Seizures 2, 6
- Death 2, 6 In adolescents and adults, complications are often the result of chronic cough 2
Diagnosis and Treatment of Pertussis
Diagnosis of pertussis depends on clinical signs and laboratory testing, including: