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Whooping cough (pertussis) for health professionals

Pertussis is a highly contagious bacterial respiratory disease. It is a nationally notifiable disease. We monitor and report on national case numbers and epidemiological trends. We publish case definitions and national guidelines to support health professionals.

For health professionals For everyone

Disease

  • Pertussis is caused by the bacteria Bordatella pertussis, a gram-negative coccobacillus. 

    B. pertussis only infects humans. There is no known animal or environmental reservoir. 

  • Pertussis is a prolonged coughing illness. Clinical presentation varies with age and immunity (from vaccination or previous infection).

    The initial (catarrhal) phase is characterised by upper respiratory tract symptoms including:

    • coryza (runny nose)
    • sneezing
    • mild dry cough
    • low-grade fever (uncommon).

    The cough gradually worsens over the next 1 to 2 weeks and can become paroxysmal. This is when severe, heavy coughing occurs in a series during a single expiration. The cough can last 2 to 8 weeks and can involve:

    • vomiting
    • cyanosis (blueish lips and skin)
    • a distinctive high-pitched ‘whooping’ sound when breathing in. 

    Serious complications can include:

    Infants, especially those younger than 6 months, might present with more severe disease and need hospitalisation for complications. These can include:

    Read more about symptoms, diagnosis and treatment of pertussis.

Public health importance

  • Pertussis is a highly contagious, vaccine-preventable bacterial respiratory illness. It can cause severe disease, complications and death, particularly in infants aged under 6 months.

    People with whooping cough can be contagious for several weeks, which means there may be many opportunities to pass on the infection.

    The pertussis vaccine is safe and highly effective in protecting people from infection and serious complications of pertussis. 

    This highlights the importance of: 

  • Pertussis infections are common in Australia, with epidemics occurring every 3 to 4 years.

    Although there is no clear seasonal pattern, pertussis notifications generally peak during early November.

    Before the COVID-19 pandemic, between 2016 and 2019, pertussis was responsible for:

    • 2,034 hospitalisations, with the highest rates in the infants aged under 6 months
    • 10 deaths.

    In 2024, Australia recorded the highest number of pertussis notifications since we started recording in 1991. More than 57,000 cases were reported, with the highest notification rate in children aged 9 to 11 years.

    Since routine pertussis vaccination during pregnancy began in 2015, the pertussis notification rate in infants aged under 2 months has fallen.

    But pertussis hospitalisations for this age group remain a concern, as they have: 

    • remained the highest out of all age groups (followed by infants aged 2 to 3 months)
    • declined at a slower rate than pertussis case notifications.

    For the latest information on pertussis cases in Australia, see our data visualisation tool.

Spread of infection

  • Pertussis is mainly transmitted by respiratory droplets that are aerosolised when an infected person coughs. 

    Less commonly, transmission may occur by direct contact with the respiratory secretions of an infected person. 

    Outside the human body, B. pertussis can only survive for a few hours in respiratory secretions. 

    Indirect spread through fomites is rare.

  • The incubation period is usually 7 to 10 days, but can range from 4 to 21 days.

  • Cases are considered infectious from the onset of symptoms until the earlier of either: 

    • 21 days after the onset of cough
    • 14 days after onset of paroxysmal cough
    • 5 days of an appropriate antibiotic course have been completed.

Priority populations

  • Pertussis poses a greater risk of severe illness for:

    • infants, particularly those aged under 6 months
    • children who have not been fully vaccinated
    • adults who have not been fully vaccinated and: 
      • have underlying chronic conditions
      • are aged 65 years and over.

    Read more about:

  • People may be more likely to be exposed to pertussis if they:

    • are in a place where pertussis is circulating in the community
    • live, work or go to school or childcare with somebody who has pertussis.

    See what measures people can take to protect themselves.

  • Pertussis can spread quickly in homes and other settings, including:

    • childcare centres
    • schools
    • healthcare facilities.

    An outbreak of pertussis in these settings may require a public health response.

Prevention

  • Pertussis-containing vaccines have been shown to be highly effective for preventing severe disease in children and reducing the risk of symptomatic disease. But immunity wanes over time.

    Routine vaccination is recommended for:

    • infants
    • children 
    • adolescents
    • pregnant people.

    Routine booster vaccination is recommended for adults who are in special risk groups or in contact with a special risk group, such as:

    • healthcare workers
    • early childhood educators and carers
    • people in close contact with infants.

    See the Australian Immunisation Handbook for more information, and who is eligible for free pertussis vaccination under the National Immunisation Program.

  • Other prevention measures include:

    • hand hygiene
    • respiratory hygiene 
    • avoiding contact with babies aged under 6 months and pregnant people when unwell
    • keeping unwell children home from childcare or school
    • seeking medical advice for illnesses with symptoms compatible with pertussis.

  • Vaccination in all recommended populations helps protect priority populations, including babies. This is due to both:

    • community immunity 
    • transfer of pertussis antibodies through the placenta to the fetus during pregnancy and in breast milk.

Diagnosis and clinical management

  • Pertussis is diagnosed through laboratory testing of nasopharyngeal swabs or aspirates. Throat swabs are sometimes used, although these are not as sensitive.

    Samples are most often tested using nucleic acid testing (NAT) or culture.

    After the fourth week of cough, testing is less likely to detect bacterial DNA in the nasopharynx. But NAT can be positive for 5 weeks or longer.

    Pertussis can also be diagnosed using serological testing (via a blood test). Serology can be useful for illnesses present for more than 2 weeks but IgA and IgG may remain elevated for a long time after vaccination.

  • Read more about laboratory testing and the laboratory case definition.

  • Pertussis is treated with antibiotics. 

    Treatment should be initiated as soon as possible. Early antibiotics can reduce the period of communicability.

    Read more about the clinical management of pertussis.

Notification and reporting

Public health response

  • The CDNA national guidelines for public health units inform the public health response to pertussis.

  • Public health units investigate high-priority confirmed pertussis cases, including:

    • children aged under 5 years 
    • cases who may have had close contact with infants aged under 6 months 
    • people in the last month of pregnancy.

    Case management focuses on:

    • identifying any contacts
    • preventing transmission.

    People with pertussis infection should:

    • stay home and not attend work, school, preschool and childcare until they are no longer infectious
    • avoid contact with priority populations while they are infectious.

  • Public health units and medical professionals identify potential high-risk contacts, where possible to: 

    • provide advice and public health education
    • offer antibiotic prophylaxis, where appropriate.

    Antibiotic prophylaxis may be offered to:

    • infants aged under 6 months 
    • people who can transmit pertussis to infants.

    Unvaccinated or incompletely vaccinated contacts should avoid childcare settings where there are children aged under 6 months until either:

    • they have completed 5 days of appropriate antibiotic (if applicable) 
    • 14 days have passed since the first exposure to infectious case.

  • Public health agencies responses to pertussis cases and outbreaks depends on: 

    • state or territory legislation
    • local reporting requirements 
    • the nature of the cases or outbreak 
    • available resources. 

    See information about how public health units should respond to pertussis notifications.

    Control measures used during outbreaks may include:

    • monitoring people for symptoms where the outbreak is occurring
    • promoting vaccination to people who live or work where the outbreak is occurring
    • alerting healthcare professionals in the community
    • temporarily closing an affected childcare facility
    • issuing media alerts to the wider community.

  • Special situations and high-risk settings might require extra infection and control actions. These include cases in:

    • early childhood education and care centres 
    • playgroups
    • schools
    • healthcare settings attended by pregnant people or neonates.

    See information about how public health units should respond to these situations.

Resources

We are adding new content to this website and expanding these pages, including a suite of disease-related information. In the meantime, information about diseases in Australia is available on the Department of Health and Aged Care’s website. 

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