Whooping cough (suspected)

Infectious diseases · Symptom or situation · updated 2026-11-08

BioMG follows French guidelines. Adapt it to the guidelines and the tests available where you practise.

Frequency: In 2024, the incidence of confirmed whooping cough seen in general practice was estimated at 134 639 cases (Sentinelles network, update of 16 September 2024, a year of high circulation of the bacterium) ^[1].

Cough < 21 days, paroxysmal with apnoea in an unvaccinated child

Laboratory tests

Bordetella NAAT (PCR) on nasopharyngeal sample (pertussis PCR) + culture if symptoms for less than 15 days
State on the prescription the vaccination status (date of the last dose) and how long the cough has lasted: information required by the French laboratory fee schedule for the PCR.

Detailed explanation and international comparison (in French): read it in English (machine translation)

Cough < 21 days, lasting more than 7 days (or pertussis contact); nocturnal paroxysms and/or whoop and/or post-tussive vomiting and/or cyanosis, apnoea

Laboratory tests

Bordetella NAAT (PCR) on nasopharyngeal sample (pertussis PCR) + culture if symptoms for less than 15 days
State on the prescription the vaccination status (date of the last dose) and how long the cough has lasted: information required by the French laboratory fee schedule for the PCR.

Detailed explanation and international comparison (in French): read it in English (machine translation)

Cough > 21 days

No further tests after 21 days of symptoms.

Detailed explanation and international comparison (in French): read it in English (machine translation)

Whooping cough contact

Laboratory tests

Bordetella NAAT (PCR) on nasopharyngeal sample (pertussis PCR) if symptomatic
State on the prescription the vaccination status (date of the last dose) and how long the cough has lasted: information required by the French laboratory fee schedule for the PCR.

Detailed explanation and international comparison (in French): read it in English (machine translation)

Prolonged cough in adults (more than 3 weeks, chronic beyond 8 weeks): no laboratory tests

No routine laboratory tests. Initial work-up of a chronic cough: recent chest X-ray and spirometry.

Detailed explanation and international comparison (in French): read it in English (machine translation)

Do not order

Pertussis PCR in an adult coughing for more than 3 weeks: not indicated as first line, as it is very likely to be already negative; rather sample a recent secondary case among contacts ^[6]; the NABM excludes it beyond 3 weeks ^[2].
Pertussis serology: removed from the NABM since 15 February 2011, it should no longer be used for routine diagnosis ^[6].
Routine FBC “for eosinophils”: no solid evidence justifies measuring blood eosinophils routinely in chronic cough, or to predict the response to corticosteroids ^[7].

Sources (15)