Q: Are pertussis symptoms similar to bronchiolitis, and could my older child expose my newborn?
Medically reviewed by Sang Hyun Ahn, MD
Content edited by Myeongchan Kim, MD
This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
Question:
Hello, doctor. I currently have a 21-day-old newborn at home. Today, my older child was diagnosed with bronchiolitis, and the doctor recommended hospitalization. With all the recent news about pertussis (whooping cough) outbreaks, I am extremely anxious. Are the symptoms of pertussis similar to bronchiolitis, and could my older child actually have pertussis instead? While I trust the pediatrician who examined my child in person, having a newborn makes me terrified of potential risks. What should I do?
Answer:
It is completely understandable to feel anxious given the recent news about pertussis, especially with a 21-day-old newborn at home.
In their early stages, pertussis and bronchiolitis can look quite similar, often beginning with mild upper respiratory symptoms like a runny nose and mild cough. However, as the illnesses progress, key differences emerge:
Key Characteristics of Pertussis (Whooping Cough):
Paroxysmal coughing fits: Severe, uncontrollable bursts of coughing.
Whooping sound: A high-pitched "whoop" noise when breathing in after a coughing fit (though this sound may be absent in infants).
Post-tussive vomiting: Vomiting triggered by coughing episodes.
Apnea: Pauses in breathing, which are particularly dangerous and common in young infants.
Vaccine status: Severe disease is far more likely in individuals who are unimmunized or under-immunized.
Key Characteristics of Bronchiolitis:
Wheezing and tachypnea: Audible wheezing or whistling sounds and rapid, shallow breathing.
Abundant congestion: Significant nasal discharge and thick mucus in the airways.
Viral etiology: Most commonly caused by viruses such as Respiratory Syncytial Virus (RSV).
Urgent Steps to Protect Your Newborn:
Immediate Isolation: Strictly isolate your older child from the newborn. Do not allow them to share the same room, and ensure caregivers practice thorough hand hygiene and wear masks when caring for the newborn after handling the older child.
Request Pertussis Testing: Inform your older child's attending physician about the newborn at home and ask whether pertussis testing (such as a PCR nasal swab) is warranted to rule it out conclusively.
Monitor the Newborn Closely: Newborns are extremely vulnerable to respiratory infections. If your baby develops any symptoms—such as pauses in breathing (apnea), coughing, difficulty feeding, extreme sleepiness, or a bluish tint around the lips—go to the nearest emergency department immediately.
While you should follow the guidance of the physician currently treating your older child, maintaining strict physical separation and consulting them regarding pertussis testing are essential steps to keep your newborn safe.
For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.
