Early symptoms of whooping cough

By which I mean the first 2 weeks

Sore throat, or hoareseness of voice, or dry tickly cough, or blocked nose, or runny nose, or slight fever, or general debility, or any combination of these.

Typical whooping cough, with nothing except choking attacks of coughing, vomiting or retching afterwards, and sometimes a whoop after a few seconds of breath-holding, usually takes about 2 weeks to develop. 

During this first phase the symptoms are very variable from person to person. It can last for a couple of weeks and during that time there is nothing to indicate that it is whooping cough. A culture test or PCR test especially, should be positive in this phase. Culture tests are quite often negative but PCR is a much better test and most often done nowadays. Read lab-test page.

Blood tests are only useful AFTER 2 weeks of symptoms.

The best way to a quick diagnosis is PCR.

A clinical diagnosis of whooping cough can only be made with hindsight. It can take 2 to 4 weeks before the situation becomes clear.

Feverishness is unusual, but listlessness in the early stages seems quite common.

Sometimes the cough is worse in the day, or only at night, or when lying down. It varies tremendously from person to person. 

Many people do not have catarrh symptoms in my experience, although most sources of information describe it.

I believe that having a cough or cold makes people more susceptible to whooping cough. So people who turn out to have whooping cough, have sometimes had a viral cough and cold before it,

So if that happens the catarrh is from the cold, not the whooping cough. That makes for confusion because it will be impossible to know then the whooping cough actually started. This situation happens quite a lot and makes sorting it out an almost impossible task for doctors.

It is particularly difficult for asthmatics

It can be very confusing for asthmatics, who are quite used to coughing, sometimes with choking. But asthmatics are more susceptible to whooping cough and are likely to be undiagnosed for longer. There is a useful sign however. Asthmatics with whooping cough are usually aware that although the cough is a bit familiar, their chest is not tight as they would expect if it were asthma doing it. They usually recognize this but do not think it important enough to mention.

Fully blown whooping cough cannot be official diagnosed until there has been at least 2 weeks of severe paroxysmal coughing. That is usually about 4 weeks from the start. Meantime it has been passed to others. That is why immunisation is the only answer.


This page has been reviewed and updated by Dr Douglas Jenkinson 22 May 2020