Is It Croup or Whooping Cough?

It can be frightening to hear your child coughing or struggling to breathe. Both croup and whooping cough can cause these symptoms, but one of these childhood illnesses is much more serious than the other. Determining the cause can be confusing, and waiting too long to seek medical care can cause additional complications.

These two respiratory ailments are identified by unusual coughing sounds and share other symptoms. They can start out looking like typical colds, with sneezing, low grade fevers and runny noses. Both also are very contagious and primarily affect infants and children under 6 years old.

But there are distinct differences between them.

Bacteria or Virus?

The parainfluenza virus causes croup, which leads to inflammation and swelling in the throat, narrowing the airway and making breathing more labored. This causes your child's cough to take on a loud “barking” sound, along with hoarseness. Croup normally lasts three to five days and responds well to at-home treatments such as cool-mist vaporizers and fever reducers. 

Whooping cough is the result of a bacterial infection that attacks the lungs and breathing tubes. It progresses more slowly than croup and is far more dangerous — with 50 percent of infant cases requiring hospitalization. Whooping cough’s early coldlike symptoms will last one to two weeks, with a signature cough that sounds like a “whoop” and then vomiting as the infection worsens. Apnea, when breathing repeatedly starts and stops, is especially concerning in infants. Whooping cough, also known as pertussis, is much more likely than croup to cause additional complications such as pneumonia, ear infections and seizures. It’s easily transferable to older children and adults, so treatment often will involve the whole family.

Don’t Pass It On

Transmission of both whooping cough and croup is through person-to-person contact and shared breathing spaces. These simple preventive steps can help you and your family avoid getting sick:

• Wash your hands often. Viruses can stay on doorknobs, shared toys and grocery carts.

• Cover your mouth when you sneeze or cough. Use a tissue or cough into your elbow.

• Don’t share dishes, cups and eating utensils.

• Regularly wipe down toys and mats shared by other children.

• Treat any minor cuts or scrapes and keep them covered until they are healed.

• Wear a protective face mask. COVID-19 restrictions already have resulted in a decrease in many airborne illnesses.

Two highly effective vaccines for whooping cough are available and recommended as part of routine childhood vaccination schedules: 

DTaP (diphtheria, tetanus and pertussis) — administered to children under the age of 7 in multiple doses beginning at 2 months of age. 

Tdap (tetanus, diphtheria and pertussis) — administered to preteens and teens as a booster to their DTaP and to adults who may have missed the booster shots. Tdap also is recommended for women early in their pregnancy.

Caring for Croup

For most cases of croup, your child’s discomfort and cough can be managed in the same way you’d treat a cold, with cool-mist humidifiers, cold drinks and pain relievers to help with the sore throat and cough. Should your child have trouble swallowing or have a prolonged fever, your doctor may prescribe a steroid or inhaler treatment to reduce inflammation. 

Extra Precautions for Whooping Cough

 With whooping cough, in addition to managing the discomfort, your doctor will order a lab test and prescribe one of several antibiotics available. Dehydration is a big concern with whooping cough, so ensure your child consumes plenty of fluids.  And keep them isolated from others to reduce the chance of spread throughout the household.