Signs of Pertussis: How to Spot Symptoms Early and Take Action

Pertussis, often called whooping cough, spreads fast and can leave lasting effects if missed early. Spotting signs of pertussis right away makes a real difference in getting care and stopping its spread. At first, symptoms may seem mild, like a low fever or stuffy nose, but they quickly turn into severe coughing fits.

Knowing these signs of pertussis helps you act before it gets worse. Here, you’ll find a clear guide to what to watch for, helping you tell ordinary coughs apart from this serious illness.

Pertussis at a Glance – What Sets It Apart

Stepping back for a moment, there’s a reason pertussis, or whooping cough, stands out from other coughs. This infection travels fast in families and schools, but that’s just the start. Instead of bringing only a mild fever or tickle in your throat, pertussis brings a certain rhythm of symptoms that make it easy to spot if you know what to watch for. Once you see its pattern, you won’t mistake it for a simple cold.

A Disease With Distinct Stages

Pertussis symptoms don’t arrive all at once. They show up in stages. At first, pertussis can fool you. It wears the mask of a regular cold:

• Runny nose
• Mild cough
• Sneezing
• Low fever

But don’t let this early phase give a false sense of security. Within a week or two, the mood changes. The mild cough turns into rapid, violent bursts. These are called coughing fits.

This “catarrhal stage” can last one to two weeks before you see the real signs of pertussis. According to the CDC, most people don’t even suspect pertussis until the intense coughing starts.

The Tell-Tale Whoop

Here’s what truly sets pertussis apart: the cough isn’t ordinary. During each fit, the person might cough over and over until the air is gone from their lungs. There’s no smooth breath in. Instead, they struggle to take a breath, and when they finally do, it often makes a “whooping” sound — the exact noise that gave the disease its name.

This signature “whoop” is more common in children than adults, but the pattern is classic. Not everyone will whoop, especially babies and older adults, but the breathless coughing should raise alarm bells.

A few signs that are often seen during a coughing attack include:

• Face turning red or blue
• Vomiting after a fit
• Extreme tiredness once the fit ends

These details set pertussis apart from the usual cold or even the flu, as outlined by the Mayo Clinic.

Symptoms Last for Weeks

Unlike a standard cold, pertussis can keep its grip for a long time. The coughing phase (called the “paroxysmal stage”) sticks around for three to six weeks, sometimes even longer. You may notice the person feeling fine between attacks, but the cough can sneak back, stronger, especially at night.

This long-lasting pattern is another reason pertussis stands out in a list of respiratory illnesses. Normal coughs fade quicker with rest. Pertussis keeps coming back, leaving lingering fatigue and rawness in the throat long after other signs of illness go away.

Not Just a Kid’s Disease

While many think only children get pertussis, adults can get it too — and often, they don’t realize what’s hit them. According to Johns Hopkins Medicine, adults may miss the classic “whoop,” blaming their cough on allergies or a seasonal bug. This helps the infection spread since adults might not stay home or seek care right away.

What makes pertussis dangerous is its ability to linger and spread before you even notice the true signs of infection. Whether you’re caring for a child or trying to sort out your own cough, watching these key signs of pertussis can help you act quickly. The earlier you recognize pertussis, the faster you can respond.

Recognizing Early Symptoms of Pertussis

Spotting pertussis in the first days can feel tricky. The signs of infection often look innocent, like the start of a regular cold. But acting fast depends on noticing these early clues. When you understand how these symptoms show up and shift, you can stay ahead and get help before the cough turns severe.

How Early Symptoms Feel and Progress: Make it easy for readers to imagine what a day with these signs of pertussis is like

Photo by Polina Tankilevitch

You wake up groggy, nose stuffy, throat scratchy. You feel run-down but tell yourself it’s just a cold. The cough is faint—maybe you barely notice it. Your head feels heavy, your eyes watery from the mild fever. Coffee doesn’t clear your sluggishness.

As the day moves on, you keep blowing your nose. You cough, but it’s not constant. Maybe a shiver runs down your spine, or your temperature creeps up just a notch. You reach for tissues. You even joke it’s allergy season. But something feels different.

At lunch, your symptoms stay mild. Talking tires you. The cough grates, building slowly. By evening, the feeling lingers—a dull ache in your chest, a stuffy nose that won’t clear, and a mild fever. You try to sleep but toss and turn, waking up to cough.

This is how pertussis sneaks in—quiet, like the calm before a storm. Early signs mimic common sickness, which is why many don’t realize what’s coming until the cough grows violent. According to the CDC, the first week brings a list of everyday symptoms:

• Runny or clogged nose
• Sneezing off and on
• Eyes watering more than usual
• Mild fever (under 100.4°F)
• Light, random cough

In children, these early symptoms may even include mild fussiness or waking up more at night, as described by KidsHealth. Adults might think it’s just a cold or even allergies, missing the connection to pertussis (Johns Hopkins Medicine).

You move through your day, unsure if you should worry. These small signs of trouble can last one or two weeks—often just long enough to spread the infection to others. If you notice your cough gets sharper, longer, or more painful, or your tiredness grows, it’s time to pay close attention. Realizing these changes early gives you a head start in taking the right steps.

Classic Signs of Pertussis – Cough Phases

The classic signs of pertussis unfold in clear stages. After early cold-like symptoms, the illness shifts—coughing fits take center stage and can last for many weeks. Breaking down the cough phases gives you a roadmap to spot the sickness and know what to expect as pertussis moves through its cycle.

The Paroxysmal Stage: Severe Coughing Fits

Photo by Towfiqu barbhuiya

This is when pertussis reveals its most dramatic signs. The cough moves far beyond the mild, scattered coughs of a cold. At this stage, you or your loved one may have bursts of quick, deep coughs that leave you gasping for air. Doctors call these “paroxysms”—sudden, repeated hacking you can’t control.

During a fit, people often cough so hard their face turns red or their eyes water. They struggle for breath, and when they finally inhale, the classic “whoop” sound bursts out. Not everyone makes this sound, especially adults and babies, but when you hear it in a child, it’s very distinct.

With each coughing fit, you may notice:

• Rapid, hacking coughs in a row (can happen 10–20 times in one breath)
• Gasping or “whooping” on inhaling
• Vomiting right after a long coughing spell
• Extreme tiredness, to the point of total exhaustion

Some people, especially infants, may not cough much—but might pause breathing for a few seconds. For adults, the coughing may lack the whoop but still comes in overwhelming spells that sap all energy.

What makes this stage dangerous is how often and how hard the cough comes. It can last for weeks and brings a risk of complications such as broken ribs, fainting, or even pneumonia. Each coughing fit makes it hard to eat, sleep, or catch a breath. Serious issues can develop if you don’t rest and seek care. Extra caution is needed for babies—complications here can be life-threatening. More detail on these stages can be found at the CDC’s clinical features overview.

Convalescent Stage: Recovery Signs and Lingering Effects

Surviving the paroxysmal stage feels like making it through a storm. The body is worn out, but now the cough grows less violent. This convalescent stage marks the start of healing, but it does not bring instant relief. Instead, symptoms slowly improve, and your energy returns little by little.

The cough may linger for weeks—often two or more. These leftover coughs are usually less intense and happen less often but can still pop up if you laugh, cry, or exercise. Fatigue and weakness may last just as long as the cough.

During this slower recovery, you may see:

• Cough spells get weaker and less frequent
• Appetite and sleep gradually improve
• Energy returns with plenty of rest and fluids

Most people stop spreading pertussis toward the end of this stage, but coughs can still echo on. Sometimes, they fade in and out, coming back with colds or allergies for months. Lingering symptoms are not rare—pertussis likes to—hang on. For a full timeline and more, see this whooping cough fact sheet.

Staying on alert for late signs of trouble helps. If you notice shortness of breath, lasting fever, or other worries, follow up with your doctor. While most people get better with time and support, some may need extra help to bounce back completely. The persistent cough is a reminder of the infection’s strength and the importance of knowing these signs of pertussis.

Signs of Pertussis in Different Age Groups

The signs of pertussis aren’t the same for everyone. How the infection shows up depends on your age. Adults and children might get the harsh cough that fits the textbook case, but babies often show a quieter, more silent danger. If you’re caring for someone young or old, or dealing with a cough yourself, knowing these patterns means you won’t miss early trouble.

Infants: The Stealthy Signs of Serious Illness

Babies don’t always read the rulebook on pertussis. Their symptoms often hide behind quiet changes that are easy to miss. Where you might expect endless coughing, infants can look fine—until they aren’t.

Photo by Anna Tarazevich

Babies are most at risk from pertussis. Many don’t cough much at all. Instead, these are the signs of pertussis to watch for:

• Apnea: Long pauses in breathing. These stops can be silent and last for a few seconds to over a minute. You may see the baby’s lips or face turn blue or pale.
• Poor feeding: Sudden trouble with nursing or feeding, or refusing to eat, which can be an early warning. This happens because they’re using so much effort just to breathe.
• Low energy or listlessness: They might seem unusually tired or floppy. Crying may sound weak.
• Minimal or no cough: Some infants never develop the classic cough.
• Gagging or gasping: Noisy breathing or gasping for air after short coughing bursts.
• Seizures: In rare cases, the infection can bring on seizures or convulsions.

Since pertussis is most deadly in this group, never brush off these changes. Seek care right away. The CDC explains more about pertussis in infants and why action matters fast.

Older Children and Adults: Recognizing the Warning Signs

Older kids and adults are likely to follow the “classic” pertussis path but don’t always hit every note. Symptoms stretch from mild colds to unrelenting coughs.

When you think of pertussis, you picture coughing fits that leave a person gasping and exhausted. In this age group, the warning signs include:

• Gradual start: First, a few days of stuffy nose, sneezing or sore throat.
• Mild fevers: Temperatures stay below 100.4°F (38°C).
• Classic paroxysmal cough fits: These are rapid, deep coughs that may end with a “whoop”—a loud, breathy gasp when breathing in. Vomiting after fits can happen.
• Red or blue face: During a fit, the lack of air sometimes turns the face red or blue.
• Wheezing or difficulty catching breath: Gasping for air stands out.
• Subtle infections: Adults may have only a lingering dry cough, which makes it easy to mistake for allergies, bronchitis or a cold.

Sometimes the cough is so mild, or lacks the “whoop,” you brush it off. But weeks of hacking, fatigue, or coughing that makes you vomit are all warning lights. Even without a whoop, recurring bouts often reveal the true cause.

You’ll find more on how symptoms show up by age at the Mayo Clinic’s pertussis symptoms guide and the Children’s Hospital of Philadelphia. Recognizing the less obvious signs of pertussis is key, especially since older children and adults can spread it before realizing what’s happening.

Spotting these patterns—silent in babies, stubborn in teens, or sneaky in adults—makes you a step ahead in catching pertussis early.

When to Seek Care for Pertussis Symptoms

Signs of pertussis aren’t always loud at first. Sometimes, the cough trails quietly behind sniffles and sneezes. But certain signals should never be brushed aside. Getting help quickly can make all the difference, especially for the youngest or those whose cough grows worse each day. Here’s how to know when it’s time to put down the tea, dial your doctor, or head straight for medical care.

Red Flags That Mean You Need Medical Help

Some symptoms of pertussis tell you it’s time for more than rest. These are signs you shouldn’t ignore:

• Coughing fits so strong, you gasp, vomit, or struggle to breathe.
• Lips or face turning blue or dusky during a fit.
• Long pauses in breathing, especially in babies.
• Trouble drinking, eating, or keeping food down.
• High fever or signs of dehydration: dry mouth, crying without tears, no pee for hours.

These signs call for immediate care. In infants, any pause in breathing, or “apnea,” is an emergency. Don’t wait or try to manage it at home—babies can get sicker in minutes.

For adults and older kids, seek help if you:

• Cough so hard, you can’t catch your breath.
• Collapse or pass out during fits.
• Cough lasts longer than three weeks.
• Feel pain in your chest, have trouble talking, or sense your cough is getting much worse.

Your doctor will want to know if you’ve been around anyone with pertussis—or if you missed your vaccine booster. For more on severe warning signs, visit the CDC’s list of pertussis symptoms that require a doctor’s visit.

When Mild Signs Should Still Be Checked

Not every cough means whooping cough. But sometimes, a “mild” cough holds clues that you need care:

• You know you’ve been exposed to pertussis, even with mild symptoms.
• Your child coughs but doesn’t have the strength for normal play or eating.
• You or your child have trouble sleeping due to cough.
• The cough lingers, growing worse at night, or leaves you exhausted.

Children who stop eating or drinking, even without severe cough, still need a doctor. Infants always need extra caution—don’t wait for things to settle on their own.

If you’re not sure whether it’s time to go in, trust your gut. Doctors want you to bring in a child or adult if common signs turn odd or seem to stick around. You can learn more about when to seek care for whooping cough from the Cleveland Clinic guide on pertussis symptoms and treatment.

Special Advice for Those Most at Risk

Certain people face more risk—from infants under one year, to those with lung or heart problems. With these groups, the line between “wait and see” and “call now” is thin. Babies can get dangerously sick without much warning. The right move is to seek care at any sign of trouble.

High-risk people who should always be seen quickly include:

• Babies under 12 months.
• Pregnant women late in pregnancy.
• Those with asthma or other lung problems.
• People with weakened immune systems.

Even if coughs seem mild, make an appointment when these folks show signs of pertussis. The Mayo Clinic offers more advice about when to call a doctor with whooping cough symptoms.

What to Expect When You Reach Out

Doctors may ask about the pattern of cough, how you breathe during fits, and if you’ve been around known cases. They might test for pertussis with a nose or throat swab and will want to protect others around you. Depending on your age and the severity of signs, you could be given antibiotics or even need to stay in the hospital. Fast action can stop pertussis from getting worse—and can keep the signs of illness from hitting others.

Photo by Andrea Piacquadio

Reacting quickly to the right signs of pertussis means more than comfort. It can mean safer breathing, fewer complications, and a smoother path to recovery for every age. Don’t wait if you see the warning lights—moving fast matters most with pertussis.

Conclusion

Spotting the signs of pertussis means more than keeping an eye on a stubborn cough. You need to watch for the early hints, like a runny nose or slight fever, then act if they turn into fierce coughing fits or long spells of breathlessness. These symptoms set pertussis apart and show when help is needed.

Trust your judgment if something feels off. You know your family and friends best. If you catch these warning signs early, you can slow the spread and keep those at risk safer.

Paying attention, speaking up, and reaching out for care when the cough changes could keep someone out of danger. Look out for one another, especially for babies, older adults, and people with weak immune systems. Quick action saves breath, protects health, and brings peace of mind.