Pertussis (Whooping Cough): Symptoms, Complaints, Signs

The following symptoms and complaints may indicate pertussis (whooping cough):

Symptoms in the catarrhal stage (initial stage with a cold-like cough; usually lasts 1-2 weeks).

Symptoms in the convulsivum stage (bouts of coughing (staccato cough); usually lasts 4-6 weeks).

Coughing fits that occur intermittently, clustered at night; are often accompanied by regurgitation of mucus
May also occur simply as a prolonged cough

Symptoms of stage decrementi (about 6-10 weeks).

Other indications

Any persistent cough (no resolution after 7-14 days), which often occurs in attacks and at night, should be thought of pertussis!
After the coughing attacks may be inspiratory stridor (breathing sound when inhaling) or vomiting.
Apneas (cessations of breathing) may occur in infants.
In adulthood often shows an atypical mild course with nonspecific dry cough. In the stage catarrhale, the distinction from a cold is often difficult. After one to two weeks (stage convulsivum), the typical attack-like barking cough occurs, which can last four weeks or longer.

Diagnosis-leading symptoms in pertussis (whooping cough) in children and adults; recommendations of the CHEST Guideline and Expert Panel Report.

Children	Adults
Age group 0-18 years; vomiting after cough attack:sensitivity 60.0%; specificity 66%.	Cough attacks and absence of fever:sensitivity (93.2% and 81.8%, respectively); specificity (20.6% and 18.8%, respectively)
Recommendations	Recommendations
Three typical features should be assessed in children with acute cough (<4 weeks): Coughing spells, vomiting after coughing, and inspiratory stridor (consensus without grade of recommendation). Vomiting after coughing attacks should be thought of as a possible cause of pertussis (recommendation grade 2C) When coughing attacks or inspiratory whistling occur, pertussis should be thought of as a possible cause (consensus without grade of recommendation)	In adults with acute (<3 weeks) or subacute cough (3-8 weeks), four key features should be assessed to include or exclude pertussis: Cough attacks, vomiting after cough attacks, inspiratory stridor, and absence of fever (recommendation grade 2C). If there is inspiratory whistling or vomiting after the coughing attack, the diagnosis of pertussis should be considered likely (Grade of Recommendation 2C) If the patient has a fever or the cough is not seizure-like, Bordetella pertussis infection is unlikely (Grade of Recommendation 2C).