Red flags & when to go in person for Pertussis (Whooping Cough) - Triage

Audience: pediatric

Pertussis, also known as whooping cough, is a contagious respiratory infection that often causes severe coughing fits, especially in children. While many cases can be managed at home, some symptoms require prompt medical attention. This guide helps parents and caregivers understand when to seek in-person care for children suspected of having pertussis. It outlines warning signs that suggest a child needs urgent evaluation, explains what telemedicine can and cannot do, and offers practical advice for preparing for a virtual visit. Remember, this information is for education and triage only and does not replace professional medical diagnosis or treatment. If your child shows any serious symptoms, it is important to seek care in person immediately.

Red flags — go in person / ER

• Child has difficulty breathing, rapid breathing, or blue lips/fingertips — seek emergency care immediately.
• Infant younger than 6 months with any cough or breathing difficulty — go to a healthcare facility promptly.
• Child shows signs of dehydration such as dry mouth, no tears when crying, or very few wet diapers — seek urgent medical attention.

What telemedicine can do

• Initial evaluation of mild symptoms
• Providing advice on symptom management
• Determining if in-person care is needed
• Follow-up consultations after diagnosis

What telemedicine cannot do

• Physical examination or lung function tests
• Administering emergency treatments
• Diagnosing severe cases requiring hospitalization
• Performing laboratory tests

What is Pertussis (Whooping Cough)?

Pertussis is a bacterial infection that affects the lungs and breathing tubes. It causes severe coughing spells that can make it hard for a child to breathe, eat, or sleep. The "whooping" sound sometimes heard after coughing fits is a common sign, but not all children make this noise. Pertussis spreads easily through coughing or sneezing.

Common Symptoms in Children

Children with pertussis often start with cold-like symptoms such as a runny nose, mild cough, and low fever. After 1 to 2 weeks, coughing fits become more frequent and severe. These fits may end with a high-pitched "whoop" or vomiting. Babies and young children may cough less but can have trouble breathing or stop breathing briefly.

When to Seek In-Person Care

Certain signs mean your child needs urgent medical evaluation in person:

If you notice any of these, go to the nearest healthcare facility immediately.

How Telemedicine Can Help

Telemedicine can be useful for:

However, telemedicine cannot perform physical exams, breathing tests, or provide emergency interventions.

Preparing for a Telemedicine Visit

Before your virtual visit, have ready:

This helps the healthcare provider give better advice.

How to prepare for your tele-visit

• Note the start date and progression of symptoms
• Gather vaccination records and recent exposure history
• Prepare a list of questions or concerns
• Ensure a stable internet connection and device with video capability
• Find a quiet, well-lit space for the telemedicine visit

After your tele-visit

• Follow the healthcare provider's advice on medication and symptom care
• Monitor the child's symptoms closely for worsening signs
• Keep the child hydrated and rested
• Schedule follow-up appointments if recommended
• Seek emergency care if red flags develop after the visit

FAQs

Can pertussis be treated at home?

Mild cases of pertussis may be managed at home with rest, fluids, and prescribed antibiotics. However, close monitoring is important to watch for worsening symptoms or complications.

Is pertussis contagious?

Yes, pertussis spreads easily through coughing or sneezing. It is important to keep the infected child away from others, especially infants and people with weakened immune systems.

How can I protect my child from pertussis?

Vaccination is the best way to protect children from pertussis. Make sure your child is up to date with recommended vaccines and follow public health advice during outbreaks.

When should I call emergency services for my child?

Call emergency services if your child has trouble breathing, turns blue around the lips or face, has a seizure, or becomes unresponsive. These are signs of a medical emergency.

Sources

1. Pertussis (Whooping Cough) — Centers for Disease Control and Prevention (CDC).
2. Whooping Cough (Pertussis) — MedlinePlus, U.S. National Library of Medicine.
3. Pertussis — Mayo Clinic.
4. Pertussis (Whooping Cough) — National Library of Medicine.

This telemedicine guidance is for educational and triage purposes only and is not a substitute for in-person medical evaluation, diagnosis, or treatment. If your child has severe symptoms or you are concerned about their health, please seek immediate medical care.