Here is a brief explanation of what to do if you suspect your child has whooping cough. This page will be expanded into a full explanation soon. Here are some highlights:
First, how can you tell if your child has whooping cough? It will start like any other mild cough and runny nose, so you can’t tell at first. This will last for a few days. Then, the big coughing fits will start. It goes something like this: cough, cough, cough, cough – big inhaling whooping sound (like the airway is mostly closed and it’s hard to get in air) – cough, cough, cough, cough, cough, cough, cough – big inhaling whoop – cough, cough, cough, cough, – whoop – cough, cough, cough, cough, cough, cough, cough, cough … run out of air, gag, face turns red, maybe throw up, then able to gasp for air and stop coughing, breath heavy, catch your breath, then seem fine again. If you do an online search for what whooping cough sounds like, you’ll hear some good examples. Your child might start with mild coughing fits with short whoops at first, then progress over a few days to the worse full fits.
Other clues to whooping cough are that your child will seem 100% fine when not coughing. She may go an hour or two without coughing, then suddenly a huge fit will hit for 30 seconds or longer, then she’ll seem totally fine again. This is very different than most illnesses like flu, covid, normal colds, and croup in that these other kids will always have a sick look and will cough every few minutes. Another clue is your child may get red spots on the face and neck called petechia (little burst blood vessels in the skin) from the pressure of coughing.
Note: Croup, which is a different illness caused by a virus, can sometimes be mistaken for whooping cough (and vice versa): croup has a barky cough that sounds like a seal barking (whereas whooping cough does not) and croup doesn’t cause long fits of coughing (just short two or three cough bursts that are very barky). With croup, the voice will sound hoarse like laryngitis, whereas with whooping cough the voice is fine (except when whooping during a big coughing fit). The one thing that these two illnesses do have in common, though, is the whooping sound when breathing in. But with croup, a child may have this raspy whooping inhaling sound even when not coughing – they’ll have it when crying and when having the short 2 or 3 coughing bursts. Croupy kids will also have some raspy breathing in and out even when not coughing. Check out the croup page here if you think your child has croup.
2. It’s contagious for about 3 weeks from when the runny nose and cough start, so keep your child home.
3. Treatment with high dose vitamin C (specifically the sodium ascorbate white powder version) may reduce the severity of the coughing fits. High-than-normal dosing is required and is OK as long as there isn’t severe diarrhea (reduce dose if this occurs). This may reduce the cough.
Give the following doses 6 times daily:
Infants 10 to 12 pounds – 250 mg
Infants 13 to 17 pounds – 400 mg
Infants 18 to 25 pounds – 600 mg
Children 26 to 35 pounds – 800 mg
Children 36 to 45 pounds – 1200 mg
Children 46 to 55 pounds – 1500 mg
Children 56 to 65 pounds – 1800 mg
Children 66 to 80 pounds – 2000 mg
Kids 81 pounds and higher – 2500 mg
You can also search for Dr. Suzanne Humphries’ high-dose vitamin C protocol online for a full explanation on how this can reduce coughing fits. You’ll see more details on how to manage this high dosing and how to calculate your child’s specific dose based on weight using the following equation: Child’s weight in pounds divided by 2.2 times 375 gives you the total daily milligrams – divide this into 6 doses. So, a 20 pound infant would take 20/2.2 equals 9, then times that by 375 equals 3400 mg. Divide this by 6 and you get about 568 mg six times daily.
4. Treatment with azithromycin antibiotics, if started within a few days of the onset of the severe cough, may also reduce the severity of the coughing fits and help resolve them completely. This also will make a child no longer contagious after the 5 days of antibiotic treatment. But the longer you wait to get antibiotics, then less they will work, and they are unlikely to help reduce the coughing fits at all if you wait more than 5 days after the severe coughing fits start. So, if you want antibiotics, contact our office early in the course of the illness. Treating exposed family members with antibiotics may prevent the illness completely if started before they show symptoms. Or, you can start antibiotics in family members at the very first sign of coughing, and you will likely see the illness resolve quickly.
5. If you don’t use antibiotics, it’s possible the coughing fits will last for as long as 3 months. The vitamin C may reduce this severity of these and may reduce the number of weeks that the cough will last, but it also may not help. The best way to help the illness to resolve quickly and not become severe is to start antibiotics within the first day or two of severe coughing fits, or at least within the first 5 days. Otherwise, you are stuck riding it out for an unpredictable amount of time, possibly as long as 3 months.
6. The diagnosis is usually made simply by observing the cough. Infants 6 months and younger sometimes don’t have the classic “whooping” sound when inhaling, like older infants and kids will show. So, the diagnosis may not be as obvious in younger infants. Since kids usually won’t cough at the doctor’s office, a video of the severe fits is essential so the doctor can see how bad the coughing is. Nasal swab testing can be done to confirm the illness, but it is considerably inaccurate in that it often misses the germs and has a high rate of false negative results. It is more likely to be positive if done in the first day or two or severe coughing, but even then it can miss the germs. One value of testing, however, is that if the illness is confirmed this way, the public health department will be contacted to enlist their help in making sure the sick person is properly quarantined and any exposed family members limit their exposure to others.