The Link Between Asthma and Pertussis (Whooping Cough)

Asthma is a chronic respiratory illness that causes hyper-reactivity of the airways and episodes of difficulty breathing. Pertussis (whooping cough) is a bacterial infection that can cause respiratory symptoms including violent coughing that makes it difficult to breathe.

Some studies have suggested that people with asthma might be at an increased risk of pertussis. Here's what you need to know about the two conditions and how they might be connected.

An illustration of a doctor holding a magnifying glass over a pair of lungs with two people looking at it—a woman with a tissue over her mouth and a man who is coughing.

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What Is Asthma?

Asthma is a common and long-term (chronic) respiratory illness that causes inflammation and constriction of the tubes (bronchi or bronchioles) that carry oxygen to the lungs.

Approximately 25 million people in the United States have asthma.

The exact cause of asthma is unknown, but it is common in people who also have allergies (allergic asthma). There might also be a hereditary (genetic) link. People who have had asthma for a long time may develop permanently thickened airways.

A substance or condition that brings on an asthma attack is called a trigger. Common triggers include allergens such as pollen, exercise, infections (such as a cold or the flu), and air pollutants.

Since the main component of asthma is inflammation of the airways, treating the condition typically includes anti-inflammatory agents such as inhaled corticosteroids and bronchodilators to help to relax and open the airways.

What Is Pertussis?

Pertussis is a bacterial infection. It can occur in people of any age but is especially dangerous for infants and children.

Approximately 24.1 million cases of whooping cough are reported each year around the world, and about 160,700 people die from it each year. Pertussis infections in the United States have been increasing in recent years.

The symptoms of whooping cough can initially be similar to those of a common cold or an upper respiratory infection. However, the symptoms typically progress to severe fits of coughing that are often described as making a barking or "whooping" sound.

Symptoms of pertussis include:

  • Runny nose
  • Fever
  • Coughing that may start out mild and progress to severe fits that can lead to exhaustion, vomiting, or, in extreme cases, apnea

Pertussis can be diagnosed with a sputum culture that grows the bacteria responsible for the illness. It can also be diagnosed by using PCR or serology testing.

Whooping cough is sometimes called the 100-day cough because it can last more than 10 weeks, especially if it goes untreated.

Pertussis is a bacterial infection that needs to be treated with antibiotics. A person is much more likely to get better if antibiotics are started within the first three weeks that they get sick. Treatment with antibiotics also helps prevent the disease from spreading.

The Pertussis Vaccine

There are two immunizations available in the United States for the prevention of pertussis: the DTaP vaccine and the Tdap vaccine. Both vaccines protect against pertussis, tetanus, and diphtheria.

Which vaccine you will receive depends on your age:

  • Children under the age of 7 years old can receive the DTaP vaccine
  • Older children and adults can get the Tdap vaccine

Adults have a very low risk of becoming seriously ill from pertussis, but they should get vaccinated to prevent them from passing the infection to infants and small children. Pregnant people and new parents should be vaccinated to protect their newborns.

Does the Vaccine Increase Asthma Risk?

While it has been theorized that the pertussis vaccine might play a role in increasing the incidence and severity of childhood asthma, research has not provided evidence to back the theory up.

An older study from 2004 looked at the incidence of wheezing disorders (including asthma) in over 13,000 children and looked for any possible link to the pertussis vaccine.

The children who got the pertussis vaccine as babies were not more likely to have asthma by the age of 7 years old than kids who had not been vaccinated.

How Are Pertussis and Asthma Linked?

It has been hypothesized that getting pertussis can increase your risk of developing asthma later in life. It's also been suggested that the reverse might be true: Having asthma can increase your risk of getting pertussis.

There have been few studies on either theory, but here is a brief overview of what researchers have found out.

Can Getting Pertussis Increase Your Risk of Getting Asthma?

The theory that getting sick with whooping cough increases asthma risk has not been studied extensively, and the research that has been done yielded mixed results.

For example, in the early 1990s, a study involving children in Germany showed only a very weak correlation between pertussis infections and allergic sensitization.

Animal studies have given different results. In 2004, a study in mice showed that pertussis infection increased bronchial hyper-reactivity and exacerbated allergic asthma response.

Most studies agree that a pertussis infection can increase the likelihood of allergic sensitization (which is often linked with asthma). However, studies disagree on the extent to which the effect occurs and whether or not it is significant.

Does Having Asthma Increase Your Risk of Getting Pertussis?

One study in 2012 found that children and teenagers with asthma appeared to be at an increased risk of getting whooping cough. While there might be a link, research has not determined why.

Since both conditions affect the airways and can cause difficulty breathing, it makes sense that if someone with asthma got a respiratory illness like pertussis, they might have a more severe case than someone who did not have asthma.

Steroid Medications

Asthma is often treated with steroid medications, which can inhibit the immune response and reduce the body's ability to fight infections like pertussis. This effect is more likely to happen when a person is taking high doses of steroids or taking them for a long time.

If you have questions about the medications that you take to treat your asthma and how they might be affecting your immune system, it's important to bring these concerns to your doctor.

Can Pertussis Be Misdiagnosed as Asthma?

Pertussis might be misdiagnosed as asthma because both conditions are causes of chronic coughing. The mistake is more likely to be made if a person does not produce the characteristic "whooping" sound when coughing. A misdiagnosis can also happen if someone waits to seek medical care until they have been experiencing episodes of coughing for several weeks.

If there is no current outbreak of pertussis in the community, medical professionals might not suspect that a person with a cough has the infection.

How to Protect Yourself

The most effective way to prevent whooping cough is to get the appropriate pertussis vaccination for your age. As with other illnesses, washing your hands frequently, staying home if you're sick, and avoiding other people who are sick can also help reduce your risk.

If you have asthma, it's important to stick with your treatment plan and manage your symptoms the best that you can. When your asthma is well controlled, it will reduce your risk of complications if you do get a respiratory illness like whooping cough.

If you think that you could have pertussis, call your doctor right away. Starting antibiotics as soon as possible will help you recover and also keep you from giving the infection to others.

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10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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