Pertussis, also called whooping cough, is a bacterial respiratory infection caused by Bordetella pertussis. In adults, it can be difficult to recognize because the illness often begins like an ordinary cold. As it progresses, the cough can become severe, prolonged, and exhausting. If you are experiencing a persistent cough, understanding the difference between strep throat symptoms in adults and respiratory infections can help put your symptoms into context.

The characteristic “whoop” is also less common in adults than in children. Vaccinated adults may have an even milder presentation. CDC

What Is Pertussis?

Pertussis is a contagious bacterial infection that affects the respiratory tract.

It typically develops in three stages:

1. Catarrhal stage
2. Paroxysmal stage
3. Convalescent stage

Symptoms usually appear 5 to 10 days after exposure, although the incubation period can sometimes be as long as three weeks.

The illness can last for many weeks, particularly because the cough may continue long after the initial infection has improved.

What Are the Early Pertussis Symptoms in Adults?

The early stage often resembles a common cold.

Symptoms may include:

• Runny or stuffy nose
• Sneezing
• Mild cough
• Low-grade fever
• Fatigue
• Mild respiratory discomfort

These symptoms generally last around one to two weeks. Because they are nonspecific, adults may not realize they have pertussis during this stage.

This early period is particularly important because pertussis is highly contagious before the more recognizable coughing fits develop.

1. Severe Coughing Fits

The most recognizable later symptom is a series of rapid, forceful coughing episodes.

Instead of an occasional cough, you may experience repeated bursts that are difficult to stop.

A coughing fit can leave you:

• Exhausted
• Breathless
• Sweaty
• Lightheaded
• Unable to speak normally during the episode

These coughing attacks can occur several times a day and are often worse at night.

2. The “Whoop” Sound

Pertussis gets its nickname from the high-pitched sound that can occur when someone takes a deep breath after a coughing fit.

However, adults do not always make this sound.

The whoop is less frequently seen in adolescents and adults, particularly in people who were previously vaccinated. Therefore, the absence of a whoop does not rule out pertussis.

3. Vomiting After Coughing

Strong coughing attacks can trigger vomiting.

This is known as post-tussive vomiting.

You may notice that vomiting happens:

• Immediately after a coughing fit
• After several rapid coughs
• More often at night
• Without the usual stomach illness symptoms

Repeated vomiting can make it difficult to maintain adequate fluid intake.

If vomiting or diarrhea is also present, watch for signs of dehydration, particularly reduced urination, dizziness, dry mouth, or significant weakness.

4. Extreme Tiredness After Coughing

A coughing fit can use a considerable amount of energy.

You may feel exhausted afterward even if you feel relatively normal between episodes.

Other effects can include:

• Difficulty sleeping
• Chest or abdominal muscle soreness
• Headache
• Reduced appetite
• General weakness

The repeated interruption of sleep can make fatigue increasingly noticeable as the illness continues.

5. Difficulty Breathing

Severe coughing can temporarily make it difficult to catch your breath.

Some people may struggle to breathe normally during or immediately after a coughing episode.

Breathing difficulty should be taken seriously, particularly if it occurs outside coughing fits or is becoming progressively worse.

Seek immediate medical care for significant breathing problems.

6. Rib or Chest Pain

Repeated forceful coughing can strain the muscles between the ribs and around the chest.

This may cause soreness or pain that becomes worse when coughing, moving, or taking a deep breath.

In severe cases, intense coughing can even cause complications such as rib fractures.

Persistent or severe chest pain should be medically evaluated rather than automatically attributed to coughing.

The Three Stages of Pertussis

Understanding the stages can make the illness easier to recognize.

Stage 1: Catarrhal Stage

This usually lasts around one to two weeks.

Symptoms resemble a cold and may include:

• Runny nose
• Mild cough
• Sneezing
• Low-grade fever

The cough gradually becomes more severe.

Stage 2: Paroxysmal Stage

This is when the characteristic coughing fits develop.

The stage can last several weeks and may continue for up to 10 weeks in some cases.

Coughing attacks may cause:

• Whooping
• Vomiting
• Exhaustion
• Difficulty breathing
• Sleep disruption

The frequency of coughing fits often increases during the first one to two weeks of this stage.

Stage 3: Convalescent Stage

Recovery happens gradually.

The coughing fits become less frequent and less severe, but the cough may continue for weeks or even months. Subsequent respiratory infections can temporarily trigger coughing fits again.

How Is Pertussis Different From a Regular Cold?

A cold usually improves within a relatively short period.

Pertussis often follows a different pattern:

A prolonged or increasingly severe cough deserves medical assessment, especially after close contact with someone diagnosed with pertussis.

Can Vaccinated Adults Get Pertussis?

Yes.

Pertussis vaccination provides important protection, but it does not guarantee that infection will never occur.

Adults who develop pertussis after vaccination may have a milder illness, and the characteristic whoop may be absent.

CDC recommends pertussis vaccination for adults who have not previously received Tdap.

How Long Is Pertussis Contagious?

Pertussis can spread from the beginning of the early cold-like stage and continue into the coughing stage.

Without treatment, people can remain contagious for weeks. Effective antibiotic treatment generally makes a person no longer contagious after five days of appropriate treatment.

Because adults may initially have mild symptoms, they can unknowingly spread pertussis before the diagnosis is recognized.

This is particularly concerning when they are around babies and young children, who are at much greater risk of serious complications.

How Is Pertussis Diagnosed?

A healthcare professional may suspect pertussis based on the pattern and duration of the cough.

Testing can involve a sample collected from the nose or upper airway, particularly when pertussis is suspected.

Diagnosis is important because treatment and precautions can help reduce transmission.

How Is Pertussis Treated?

Healthcare professionals generally treat pertussis with antibiotics.

Treatment is most effective when started during the first one to two weeks, before severe coughing fits develop. Early treatment can reduce illness severity and help prevent transmission.

If pertussis is suspected, do not start leftover antibiotics or someone else's medication. A healthcare professional should determine the appropriate treatment.

When Should You See a Doctor?

Contact a healthcare professional if you have:

• A cough that is becoming increasingly severe
• Repeated violent coughing fits
• Vomiting after coughing
• A cough lasting several weeks
• A whooping sound after coughing
• Difficulty breathing
• Known exposure to pertussis

Early assessment is particularly important if you live with or regularly care for a baby.

When Is Pertussis an Emergency?

Seek immediate medical care if you develop:

• Severe difficulty breathing
• Blue or gray lips or face
• Fainting
• Confusion
• Severe chest pain
• Signs of significant dehydration
• Coughing that prevents you from breathing adequately

Adults usually experience fewer severe complications than infants, but serious complications such as pneumonia can still occur.

Conclusion

Pertussis symptoms in adults can begin with nothing more than a runny nose, mild cough, and low-grade fever. After one to two weeks, the cough may become much more severe, producing repeated coughing fits, vomiting, exhaustion, breathing difficulty, and sometimes the characteristic whoop.

Adults do not always develop the whooping sound, particularly if they have previously been vaccinated. A prolonged or increasingly severe cough can therefore be an important clue even without the classic whoop.

If your cough is accompanied by vomiting or you are struggling to maintain adequate fluid intake, watch for signs of dehydration. If you develop significant breathing difficulty, fainting, confusion, or blue lips, seek urgent medical attention.

Early medical evaluation matters because appropriate antibiotic treatment can reduce transmission and may lessen the severity of illness when started early.

Frequently Asked Questions

What Are the First Symptoms of Pertussis in Adults?

Early symptoms usually resemble a cold and may include a runny or stuffy nose, sneezing, low-grade fever, and a mild cough. These symptoms typically last one to two weeks.

Can Adults Have Pertussis Without a Whoop?

Yes. Adults are less likely than young children to develop the classic whooping sound. Vaccinated people may also have a milder illness without a noticeable whoop. CDC

How Long Does Pertussis Cough Last in Adults?

The severe coughing stage can last several weeks, sometimes up to 10 weeks. Recovery is gradual, and a milder cough can persist even longer.

Can Pertussis Cause Vomiting in Adults?

Yes. Severe coughing fits can trigger vomiting, known as post-tussive vomiting.

Is Pertussis Contagious in Adults?

Yes. Adults can spread pertussis to other people, particularly during the early stages and before the illness is recognized. Effective antibiotics generally reduce contagiousness after five days of appropriate treatment.

Can You Get Pertussis After Being Vaccinated?

Yes. Vaccination reduces the risk and can make illness less severe, but breakthrough infections can occur.

When Should I See a Doctor for a Persistent Cough?

Seek medical advice if the cough becomes severe, lasts for several weeks, causes vomiting, produces a whooping sound, or occurs after known exposure to pertussis.

Is Pertussis Dangerous for Adults?

Adults generally have fewer severe complications than infants, but pneumonia and other complications can occur. Breathing difficulty, fainting, confusion, or blue lips require urgent medical attention.