The first stage of whooping cough is known as the catarrhal stage. In the catarrhal stage, which typically lasts from one to two weeks, an infected person has symptoms characteristic of an upper respiratory infection, including:

• runny nose,
• sneezing,
• low-grade fever,
• mild, occasional cough, similar to the common cold.

The cough gradually becomes more severe, and after one to two weeks, the second stage begins. It is during the second stage (the paroxysmal stage) that the diagnosis of whooping cough usually is suspected. The following characteristics describe the second stage:

• There are bursts (paroxysms) of coughing, or numerous rapid coughs, apparently due to difficulty expelling thick mucus from the airways in the lungs. Bursts of coughing increase in frequency during the first one to two weeks, remain constant for two to three weeks, and then gradually begin to decrease in frequency.
• At the end of the bursts of rapid coughs, a long inspiratory effort (breathing in) is usually accompanied by a characteristic high-pitched "whoop" sound.
• During an attack, the individual may become cyanotic (turn blue) from lack of oxygen.
• Children and young infants appear especially ill and distressed.
• Vomiting (referred to by doctors as post-tussive vomiting) and exhaustion commonly follow the episodes of coughing.
• The person usually appears normal between episodes.
• Paroxysmal attacks occur more frequently at night, with an average of 15-24 attacks per 24 hours.
• The paroxysmal stage usually lasts from one to six weeks but may persist for up to 10 weeks.
• Infants under 6 months of age may not have the strength to have a whoop, but they do have paroxysms of coughing.

The third stage of whooping cough is the recovery or convalescent stage. In the convalescent stage, recovery is gradual. The cough becomes less paroxysmal and usually disappears over two to three weeks; however, paroxysms often recur with subsequent respiratory infections for many months.

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