While the current total is still relatively low for an infectious disease, experts suspect that for every reported case of whooping cough, there are countless more unreported ones—for instance, in folks who can’t or choose not to seek medical care, perhaps mistaking the condition for a cold. Read on to learn the key signs of whooping cough in adults, and what can be done to treat or prevent a run-in with this highly disruptive bug.
What are the symptoms of whooping cough in adults?
Early signs of whooping cough in adults look very much like a common cold, Dr. Loafman says.
For the first week or so of feeling sick, you can expect:
- Congestion
- Runny nose
- Watery eyes
- Low-grade fever
- Mild cough
After that point, your cough will evolve and worsen, Jorge Mercado, MD, a pulmonologist and critical care medicine specialist at NYU Langone Hospital–Brooklyn, tells SELF. The continued hacking is usually a good clue that you’re dealing with something beyond a cold, he says. “An upper respiratory infection should last you five or seven days maximum, so if symptoms surpass that threshold, it’s time to say, ‘Wait a minute, what’s going on here?’”
In the second week and beyond (usually for a few weeks), you can expect frequent and intense coughing fits that could cause you to:
- Struggle to breathe or make a high-pitched whistling sound as you inhale
- Bring up a lot of mucus
- Get dizzy or pass out
- Feel very tired
- Have difficulty sleeping at night
- Vomit
Generally, a pertussis cough is what doctors call “spasmodic” or “paroxysmal,” which means “you’re overcome with it and can’t control or stop it,” Dr. Loafman says. The inability to catch a break and get some air is what can trigger the more severe symptoms above. (It’s worth noting that noninfectious causes like postnasal drip, asthma, and GERD can also lead to a lingering cough, which is why it’s always essential to get evaluated by a doctor to suss out if pertussis is to blame.) However, Dr. Loafman adds, folks who’ve been vaccinated against pertussis will have a swifter immune response to it, which can prevent some of the worst hacking.
The reason whooping cough can bring on such a gnarly, well, cough in the first place is because of how B. pertussis wreaks havoc: These bugs latch on to the cilia (a.k.a. tiny hairlike protrusions) on cells in your respiratory tract and ooze toxins, triggering inflammation and swelling. “Your body is trying to make you cough out or expel the problem,” Dr. Loafman says, “so what you’re really suffering from is that inflammatory response.” The tricky thing is, even when you eventually clear the bacteria from your system, your cells can remain on high alert, causing that inflammation to keep smoldering. That’s why you might experience a nagging cough for several weeks, Dr. Loafman says. Some people also get a resurgence of bad wheezing during the next two or three routine colds they catch, he adds. “It can take a while for that response to burn out.”
How is whooping cough diagnosed?
Because so many signs of whooping cough in adults can resemble a cold—particularly at the early stages and in vaccinated folks with milder cases—and catching a cold is still far more common, your doctor may not run a test for pertussis if you’ve only been coughing for a few days. But that can change if you’re located in a state or city where the illness has been especially spiking (as has recently occurred in Washington and California); medical providers are required to report any cases of the condition they see to their local health department, so doctors will receive alerts when there’s a notable uptick in their area and will then test sooner and more frequently than they might otherwise, Dr. Loafman says.
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