Whooping cough, also known as pertussis or the 100 day cough, is a respiratory infection caused by the bacteria bordetella pertussis. Though this is a vaccine preventable disease, outbreaks still regularly occur due to decreasing vaccine coverage and efficacy of the current vaccine. This article covers the symptoms of whooping cough, conventional treatment, home care, natural remedies, and when to seek medical treatment.
What Are The Symptoms Of Whooping Cough?
Whooping cough symptoms are divided into three distinct stages: early symptoms, late symptoms, and recovery. These symptoms are most severe for babies and children, while teens and adults tend to get milder infections.
The pertussis vaccine is notoriously imperfect when it comes to preventing whooping cough; however, vaccinated individuals tend to get a milder course of the disease (1,2).
Stage 1: Early Symptoms (1-2 weeks)
Whooping cough starts out in the early stage (catarrhal stage) looking like any other upper respiratory infection with mild cough, low grade fever (less than 100.4° F), runny nose, and congestion. It is rare for doctors to be able to diagnose whooping cough in this stage unless there is a community outbreak or known exposure to whooping cough (1,2).
Note: Infants may not get these symptoms. Instead, they may have apnea – pauses in breathing that may cause them to turn blue or purple (1,2). This is a life-threatening symptom that requires urgent medical care.
Stage 2: Late Symptoms (6-10 weeks)
After a week or two of the mild symptoms listed above, symptoms change and it becomes clear that you’re dealing with whooping cough.
Whooping cough in the late stage (paroxysmal stage) is characterized by uncontrollable coughing fits of 5-10 harsh dry coughs in a row followed by a deep inhale that makes the telltale “whoop” noise from which whooping cough gets its name. Intense bouts of coughing often cause vomiting. The face can become red from exertion or blue around the mouth from lack of oxygen. It is common for people to become exhausted from whooping cough (1,2).
In between bouts of uncontrollable coughing, people in stage 2 of whooping cough appear relatively healthy. However, coughing may become worse and more frequent throughout the night.
Note: Infants may not experience these symptoms. They may continue to have apnea, develop cyanosis (turning blue or purple), and struggle to breathe throughout the whole course of the illness (1,2).
What Does Whooping Cough Sound Like?
This short video from the FDA features an audio recording of a child with whooping cough:
Stage 3: Recovery (Weeks To Months)
Over the next several weeks to months, late whooping cough symptoms resolve slowly during the final stage of the illness – recovery or convalescence. Coughing and vomiting are the first symptoms to go away and usually resolve within two to three weeks.
Susceptibility to other respiratory infections is increased during recovery for weeks to months. A secondary infection during the recovery stage may cause uncontrollable coughing to restart or worsen (1,2).
Serious Complications In Infants
Infants under 3 months old are at the highest risk of serious complications from whooping cough. It is estimated that half of all infants who contract whooping cough will require a hospital stay where they will need supplemental oxygen and mechanical ventilation. The fatality rate of whooping cough in newborns is 1-3%, and in infants it is 0.7% (1).
As mentioned above, infants infected with pertussis may not cough; instead, they may have pauses in breathing called apnea. Seizures are also possible and are thought to be associated with the low oxygen levels caused by apnea (1,2).
Whooping Cough In Older Kids, Teens, And Adults
Though older kids, teenagers, and adults may come down with a classic case of whooping cough, it is possible that they simply get symptoms that are difficult to diagnose because they are mild and lack the characteristic “whoop.” This is especially true if they have been fully vaccinated (1).
Serious complications from whooping cough in this population are rare but can include pneumothorax, nosebleed, subconjunctival (eye) hemorrhage, hernia, urinary incontinence, rib fracture, fainting, herniated intervertebral disk, hearing loss, angina, and more (1,2).
Note: A lack of symptoms is something to keep in mind if you are the parent of a young infant. Avoid close contact with people displaying even mild respiratory symptoms in order to protect your infant who is extremely vulnerable to whooping cough and other respiratory infections.
How Does Whooping Cough Spread?
Whooping cough is caused by the bordetella pertussis bacteria, which colonizes the airways of the infected person. It is spread through aerosolized respiratory droplets that are expelled through coughing or sneezing (3). 
People with whooping cough are contagious from the beginning of their cough (stage 1) until after three weeks of coughing or five days of antibiotic treatment, whichever comes first.
Whooping cough is very contagious, and it is estimated that one person can infect anywhere between 12-17 others (2).
Whooping Cough Treatment
Both conventional and natural medical systems agree on some essentials for whooping cough recovery:
- Rest. Whooping cough can be exhausting. Rest is essential for healing.
- Avoid lung irritants. This includes air pollution (indoor and outdoor), dust, allergens, smoke, etc.
- Stay hydrated. A hydrated body heals faster and hydrated lungs are less reactive. Good sources of hydration include herbal teas, electrolyte drink, bone broth, and water. For infants, breastmilk and/or formula are optimally hydrating.
- Eat small nutritious meals. Nutrient dense meals are important for rebuilding strength. Eating small amounts reduces the likelihood of vomiting after a meal from excessive coughing.
Check out our recipes for homemade electrolyte drink, bone broth, gelatin-enhanced popsicles, and spice tea.
Are Antibiotics Needed For Whooping Cough?
Whooping cough is caused by the bacteria bordetella pertussis, so it is natural to wonder if antibiotics are helpful for whooping cough. The short answer is that antibiotics are recommended for whooping cough patients, but the long answer is more complicated.
Antibiotics Are Most Helpful In The Early Stage Of Whooping Cough
Antibiotics given during the early stage of whooping cough, when symptoms are mild and non-specific, can be helpful in shortening the length of disease and preventing transmission (1,2).
Unfortunately, whooping cough is rarely detected in the early stages because it presents like a common cold. The exception is when there is a community outbreak or known exposure. In these cases, suspicion of whooping cough is high, making testing and treatment more likely (1,2).
Antibiotics In The Late Stage Of Whooping Cough Help Prevent Transmission
Antibiotic treatment in the late stage of whooping cough (when the characteristic “whoops” appear) isn’t helpful for reducing symptoms or duration of whooping cough, therefore antibiotic treatment during this phase can be somewhat controversial. However, antibiotics administered during this phase can help reduce the transmission of whooping cough to other people in the home and community (1,2).
Whooping cough is very contagious, and people can spread whooping cough for the first three or more weeks of their cough. However, if antibiotics are administered, that time period shrinks to five days. Antibiotic treatment provides family protection, community protection, and allows the person with whooping cough, and their family members, to resume their normal lives more quickly (1,2).
There is, however, the trade off of antibiotic side effects, including damage to the microbiome. For most people, the benefits of antibiotics outweigh the risks, but there are always exceptions. This is something to discuss with your family doctor.
Read about how to prevent antibiotic side effects: How To Avoid Side Effects of Antibiotics Using Natural Medicine – Dr. Green Mom
Post-Exposure Prophylactic Antibiotics Are Recommended For Close Contacts
Antibiotics are recommended for people in close contact with someone with a known case of whooping cough regardless of their vaccination status. This is to reduce their chances of developing whooping cough (2).
Close contacts include:
- Family members
- Roommates
- Anyone who has had face-to-face contact with someone with whooping cough within three to four feet
- Anyone who has shared confined space with a person with whooping cough for more than an hour
- Anyone who has had direct contact with body fluids of someone with whooping cough
When deciding whether or not to use antibiotics preventatively, consider:
- How sick was the person you were in contact with?
- How long were you in contact with them?
- How is your immune system and overall health?
Which Antibiotics Are Used For Whooping Cough?
The antibiotics typically used for whooping cough include azithromycin, clarithromycin, and erythromycin. Azithromycin is preferred because it requires less doses and has less interactions with medications and herbs (2).
Can I Use “Natural Antibiotics” To Treat Whooping Cough?
Herbal remedies can be used to help manage the symptoms of any upper respiratory infection. They can be used for their antimicrobial and immune boosting effects and beneficial effects on coughing. It is my opinion that herbal medicine is much more helpful than antibiotics during the second and third stages of whooping cough.
However, we simply don’t have any info about how natural remedies affect the spread of whooping cough. So, when it comes to preventing the spread of whooping cough and treating it during the first stage, I believe that pharmaceutical antibiotics are a better choice for most people.
Are Inhalers (Bronchodilators and Corticosteroids) Useful For Whooping Cough?
Several studies have looked at various conventional treatments for whooping cough in the second stage, including bronchodilators, OTC cough medicines, antihistamines, and antitoxin (pertussis immunoglobulin). So far, study results have been inconclusive, and these medicines are generally not recommended (2).
Instead, natural whooping cough remedies that strengthen and soothe tissues may be a better choice, especially given their lower cost and side effect profiles.
Natural Whooping Cough Remedies
While there are no scientifically proven conventional medications that significantly improve the symptoms of late stage whooping cough or speed recovery, there is a wealth of traditional wisdom about how to support people through this condition and to help them rebuild their strength afterwards.
The following remedies are indicated for late stage (paroxysmal) symptoms and during the recovery (convalescence) stage. As mentioned above, it’s my opinion that pharmaceutical antibiotics are the best choice during the early stage (catarrhal) of whooping cough.
Consult an expert in natural medicine for guidance on putting these together into a treatment plan. Some herbs may not be suitable for all people and may interact with antibiotics and other medications.
Herbal Remedies
The most commonly cited herb for treating whooping cough is common thyme. Research has shown that thyme helps with spasm in the lungs and may reduce lung damage from bacterial pertussis toxins (4,5). Thyme also has antibacterial effects, though to my knowledge it hasn’t been tested against bordetella pertussis – the bacteria responsible for whooping cough (6). Thyme can be taken as a tincture, tea, glycerite, or capsule. However, for whooping cough, I believe it would be best administered as a tea or glycerite. Thyme is also great because it doesn’t interact with any antibiotics; see more about thyme-drug interactions here: Thyme – RxList.
Other herbs that may be helpful include: lobelia, pulmonaria, and wild cherry. Chronic cough and lung damage may be helped with herbs like inula and mullein (7).
Homeopathic Remedies
There are case reports showing that homeopathic treatment can help shorten the intensity and duration of whooping cough. The remedies cited in the case studies were pertussinum 30C (once per week) combined with drosera 6C (3x per day) (8).
Other homeopathic remedies that may be helpful as part of whooping cough treatment include: bryonia, cuprum, and ipecac.
For more information about how to select and prescribe homeopathic remedies, see: How To Use Homeopathic Remedies – A Quick-Start Guide For Parents – Dr. Green Mom
When To Seek Medical Help
Urgent medical care is needed if you, or your child, ever struggle to breathe or have noticeable pauses in breathing. In addition, seek medical care for any of the characteristic whooping cough symptoms, including inhaling with a whooping sound (see video linked above for audio recording), turning red or blue after coughing, and/or vomiting after coughing.
Summary
Whooping cough is a highly contagious respiratory infection that results in a long illness characterized by uncontrollable coughing. While it is treatable if caught early, it is usually not detected until the characteristic “whooping” sound develops alongside coughing. At this stage there are no accepted conventional medications that can significantly improve the symptoms or duration of the cough. However, antibiotics are usually still advised in order to prevent community spread of the condition. There are some natural remedies, including herbal medicine and homeopathics, that may improve symptoms and speed recovery of whooping cough.
References:
- Nieves, D. J., & Heininger, U. (2016). Bordetella pertussis. Microbiology spectrum, 4(3), 10.1128/microbiolspec.EI10-0008-2015. https://doi.org/10.1128/microbiolspec.EI10-0008-2015
- Kilgore, P. E., Salim, A. M., Zervos, M. J., & Schmitt, H. J. (2016). Pertussis: Microbiology, Disease, Treatment, and Prevention. Clinical microbiology reviews, 29(3), 449–486. https://doi.org/10.1128/CMR.00083-15
- Warfel JM, Beren J, Merkel TJ. Airborne transmission of Bordetella pertussis. J Infect Dis. 2012 Sep 15;206(6):902-6. doi: 10.1093/infdis/jis443. Epub 2012 Jul 17. PMID: 22807521; PMCID: PMC3501154.
- Engelbertz, J., Lechtenberg, M., Studt, L., Hensel, A., & Verspohl, E. J. (2012). Bioassay-guided fractionation of a thymol-deprived hydrophilic thyme extract and its antispasmodic effect. Journal of ethnopharmacology, 141(3), 848–853. https://doi.org/10.1016/j.jep.2012.03.025
- Wan, L., Meng, D., Wang, H., Wan, S., Jiang, S., Huang, S., Wei, L., & Yu, P. (2018). Preventive and Therapeutic Effects of Thymol in a Lipopolysaccharide-Induced Acute Lung Injury Mice Model. Inflammation, 41(1), 183–192. https://doi.org/10.1007/s10753-017-0676-4
- Liu, Q., Meng, X., Li, Y., Zhao, C. N., Tang, G. Y., & Li, H. B. (2017). Antibacterial and Antifungal Activities of Spices. International journal of molecular sciences, 18(6), 1283. https://doi.org/10.3390/ijms18061283
- Wood, M., Ryan, D. (2016). The Earthwise Herbal Repertory: The Definitive Practitioner’s Guide. United States: North Atlantic Books.
- Chung Y. (2018). Whooping Cough Alleviated by Homeopathic Medicines: A Case Report. Alternative therapies in health and medicine, 24(2), 58–61.
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