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Whooping cough (pertussis) is a serious, contagious, respiratory infection caused by the bacterium Bordetella pertussis.
The disease begins like a cold and then the characteristic cough develops.
This cough may last up to three months, even after antibiotic treatment is completed and the person is no longer infectious.
The ‘whoop’ (which is not always obvious) is due to a deep breath at the end of a bout of coughing.
Vomiting after coughing is common.
Whooping cough is particularly dangerous for babies less than six months of age.
They are affected more seriously by the disease than older children or adults, and are more likely to develop complications.
Symptoms of whooping cough
Whooping cough begins with symptoms similar to those of a cold.
These can rapidly progress to include:
severe cough – occurs in bouts
characteristic ‘whooping’ sound on inhalation
vomiting at the end of a bout of coughing
apnoea – the child stops breathing for periods of time and may go blue.
These symptoms may be associated with poor appetite, fatigue and dehydration.
The person may appear normal between bouts of coughing.
During the recovery, the cough gradually decreases, but can last up to three months.
Complications of whooping cough
Whooping cough is most serious in babies under 12 months of age.
In young babies less than six months of age, the symptoms can be severe or life threatening.
Seek urgent medical attention if your child’s lips or skin go blue (cyanosis) or if they are having breathing difficulties associated with the coughing.
Some of the complications of whooping cough in young babies include:
apnoea (stopping breathing for periods of time)
inflammation of the brain
convulsions (fits) and coma
permanent brain damage
Causes of whooping cough
The Bordetella pertussis bacterium is spread by airborne droplets from the upper respiratory tract (when the infected person coughs or sneezes) and is highly infectious.
The time from infection to appearance of symptoms (incubation period) is between six and 20 days.
A person is infectious for the first 21 days of their cough or until they have had five days of a 10-day course of antibiotics.
In countries where immunisation rates are high, the risk of catching whooping cough is low.
In Victoria, most reports of whooping cough currently occur in adults over 20 years of age.
Recent research has shown that family members, household contacts and carers are the main source of whooping cough infection in babies.
Diagnosis of whooping cough
Whooping cough should be diagnosed and treated immediately.
There are a number of tests for whooping cough, but they are not always reliable and the results may take some time.
Treatment should not be withheld while waiting for these results.
Tests used to diagnose whooping cough may include:
medical history including immunisation status
swabs of the nose and throat for laboratory testing.
Treatment for whooping cough
In its early stages, the symptoms of whooping cough can be reduced by taking antibiotics.
If treatment is given in the first 21 days of the illness, the risk of passing the infection to others might be reduced.
Members of the infected person’s household are at increased risk of acquiring the disease and are usually prescribed a strong antibiotic as a preventative measure, even if they are fully immunised.
Immunisation against whooping cough
In Victoria, the whooping cough vaccine is only available in a number of combined vaccines that also contain protection against other serious and potentially fatal diseases.
The type of combined vaccine used for immunisation will depend on the person’s age group.
Children need to follow the full schedule of vaccines to be fully protected.
In Victoria, immunisation against whooping cough is free for:
children at two (from six weeks), four and six months of age – in the form of a diphtheria, tetanus, whooping cough, hepatitis B, polio and Haemophilus influenzae type b (Hib) vaccine (six-in-one vaccine)
children at 18 months of age – in the form of a diphtheria, tetanus and whooping cough vaccine (three-in-one vaccine)
children at four years of age – in the form of a diphtheria, tetanus, whooping cough and polio vaccine (four-in-one vaccine)
adolescents in Year 7 at secondary school (or age equivalent) – adolescents receive a booster dose of diphtheria, tetanus and whooping cough vaccine (three-in-one vaccine).
The dose can also be given by a doctor or at a council community immunisation session
pregnant women from 28 weeks gestation during every pregnancy
partners of women who are at least 28 weeks pregnant if the partner has not received a pertussis booster in the last ten years
parents or guardians of babies born on or after 1 June 2015, if their baby is under six months of age and they have not received a pertussis booster in the last ten years
children up to and including nine years – catch-up immunisations are available for children who have not been fully vaccinated
vulnerable eligible people aged ten years and over – catch-up immunisations are available for people who have not been fully vaccinated.
If you are not sure whether you are eligible for immunisation against whooping cough that is free of charge, ask your doctor.
What is whooping cough?
Whooping cough is an infection that causes a cough that can go on for weeks or months.
Its medical name is pertussis.
‘Whoop’ describes the sound that some children make after coughing.
Whooping cough is very easy to catch.
Every 3 to 5 years a significant number of young New Zealand children end up in hospital with whooping cough.
These outbreaks are called epidemics.
Whooping cough can cause very serious illness in babies and young children.
Older children usually get a less severe disease but the cough and vomiting can be very distressing.
Adults may just have an irritating cough that goes on much longer than usual.
Parents or older children in the family with whooping cough can easily pass it on to babies who are too young to have fully completed their immunisation course.
What are the signs and symptoms of whooping cough?
Whooping cough affects children differently depending on their age.
Babies under 6 months
Babies aged less than 6 months old do not usually whoop.
appear to have a cold, then cough and have difficulty breathing
get exhausted from coughing
not be able to feed because of coughing
lose weight because of difficulty feeding and because the cough causes vomiting
Older babies and young children
In older babies and young children, the illness has 3 stages:
The early stage of whooping cough
It starts with a runny nose and eyes, mild fever and sneezing – just like a virus cold.
This lasts 1 or 2 weeks.
The second stage
Next there is an irritating cough. Over a week or 2, the cough gets worse and your child will have bouts of coughing.
They gasp for air between each bout of coughing.
They get very red in the face.
These spells last many minutes and they may vomit food or spit (phlegm) after the coughing.
The cough often gets worse with swallowing or eating.
It is very distressing for both parent and child.
The final stage
The final stage is the long recovery stage.
The symptoms get less severe, but the cough continues for weeks.
How long does whooping cough last?
Whooping cough can last for weeks or months.
If your child gets an ordinary viral cold in the weeks after they have recovered from whooping cough, bouts of coughing sometimes come back for a while.
Whooping cough usually lasts for a shorter time:
in children who are partially immunised
in older children if the effect of their infant immunisations is beginning to wear off
How easy is it to catch whooping cough?
It’s very easy to catch whooping cough – it spreads very easily.
On average, each person with whooping cough passes the infection on to 12 other people.
Whooping cough most easily spreads from one person to another in the first stage (before the typical cough starts).
People can still pass it on to others 3 or 4 weeks after the cough starts.
Antibiotics have very little effect on the severity of the coughing illness.
However, if started early, antibiotics can reduce the amount of time your child is infectious to others from about 3 weeks to 5 days.
You should keep your child away from others, especially babies, children and elderly people until your child is no longer infectious.
What puts my child at risk of getting whooping cough?
You can get whooping cough at any age.
Severe disease and complications are most likely in:
in children who have a heart, lung or another chronic medical problem
The younger your child, the greater the risk of getting very sick from whooping cough.
The best protection is to have your child fully immunised and for you to be immunised against whooping cough if you are pregnant.
Getting immunised during pregnancy means you can pass on your immunity to your baby when they’re most vulnerable.
It helps to protect baby until their first immunisations.
How is whooping cough diagnosed?
Whooping cough is usually diagnosed on your description of your child’s symptoms.
Your family doctor will ask some questions and examine your child.
Sometimes whooping cough can be hard to diagnose.
Your doctor may take a sample of mucus (‘snot’) from your child’s nose.
Your doctor will send this to a laboratory.
It can take days for a result to come back.
Your doctor may also ask for a blood test.
How is whooping cough treated?
Whooping cough is caused by bacteria, but antibiotics are not effective in stopping the cough once it has started.
Antibiotics may help reduce the severity of the illness but only if your child has them very early in the illness.
Your child needs to have them before the cough starts and, even then, may make only a small difference.
They do, however, reduce the chance of passing the illness to others.
Your child’s infection-fighting (immune) system will help get rid of the bacteria after 3 or 4 weeks without any treatment but the damage caused to the breathing tubes takes longer to repair.
There is no medicine that will stop the cough once it has started.
Cough medicines (cough suppressants) are not effective and may have side-effects so they are not recommended.
If your child is very young or very unwell with whooping cough, or they have any complications, they may need to stay in hospital.
Sometimes whooping cough may make it hard for a young child to get enough oxygen.
If your child has any signs of this, they will need to have oxygen in hospital.
Children usually have this through nasal prongs (small soft plastic tubes).
These fit into your child’s nose and carry a flow of oxygen.
If your young child is not drinking enough, they may need to have fluid by:
an intravenous drip (into a vein), or
by nasogastric feeding (feeding through a tube passed through the nose or mouth into the stomach)
How can whooping cough be prevented?
Immunisation is the best way to prevent whooping cough
If your child has had immunisation against whooping cough, they are much less likely to catch it.
If they do catch it, they are less likely to be severely affected.
Immunisation is effective at preventing your child dying from whooping cough, or needing to go to hospital.
Young infants are most at risk of getting very sick from whooping cough.
The following steps will help protect them.
Immunise your baby on time
Thumbnail image of a poster ‘Protecting baby starts in pregnancy’
begin immunisation at 6 weeks of age
complete the first 3 doses on time to build the maximum protection
Have immunisation against whooping cough during pregnancy
This helps protect young infants against whooping cough until they are old enough to have their own immunisations.
The vaccine itself doesn’t pass on to your baby, but your immunity to whooping cough does.
Have a booster dose to help protect young babies
Immunity from both the disease and the vaccine lessens over time.
That’s why people need booster doses for longer-term protection, and to minimise the spread to vulnerable babies who are too young to have had all their immunisations.
Children can have booster doses when they are:
4 years old and
11 years old
There is also a whooping cough vaccine available for older children and adults who are at higher risk of catching the disease or in contact with young infants or other children at high risk.
Ask your family doctor about this.
See your doctor if your baby has had contact with whooping cough
Your child can have antibiotics if they have had close contact with someone with whooping cough (like their brother or sister).
This may help prevent your child catching it.
See your doctor for advice about antibiotic treatment if your baby has been in contact with whooping cough and they:
are less than 1 year old
have a heart or lung condition
How can I care for my child with whooping cough at home?
Your child with whooping cough should stay away from people outside of the family (especially other children) for 3 weeks.
This is to stop the infection spreading.
If your child is taking antibiotics, this time goes down to 5 days.
If your child is taking antibiotics, make sure they take all the doses.
If the coughing is hurting your child, you can give paracetamol to make them more comfortable.
You must follow the dosage instructions on the bottle.
It is dangerous to give more than the recommended dose.
Your child will need rest at the beginning when the bouts of coughing are causing the most trouble.
Encourage them to drink fluids and eat healthy small meals.
What are the complications of whooping cough?
Complications of whooping cough are most likely to happen in babies and young children.
Complications are less likely in older children and adults.
Serious complications include:
lack of oxygen
bleeding into the brain, which can cause brain damage
weight loss as babies and young children cannot keep enough food down
Whooping cough in very young babies is unpredictable and can get worse very quickly.
Babies under 1 year of age, in hospital with whooping cough, have a 1 in 10 chance of ending up in the paediatric intensive care unit.
If they end up there, they have a 1 in 6 chance of either dying or being left with brain damage or lung damage.
When should I seek help for whooping cough?
When do I need to see a doctor?
You should see your family doctor if your child:
is less than 1 year old and they have had contact with someone with whooping cough
has a cough that goes on for a long time without any pauses, or has a cough that ends in vomiting
has had a daily cough that lasts longer than 2 weeks
is less than 3 months old and has a cough
When do I need to see a doctor urgently?
You should see a doctor urgently if your child of any age:
goes blue when coughing, or stops breathing at the end of the cough, or appears frightened by the cough
has breathing difficulty
looks unwell and you are worried
Food and Nutrition for whooping cough
- Fresh fruit juices and fresh fruits
- Nursing babies continue on breast milk only, plus vitamins, especially C
- Bread, butter, oat flour- porridge, milk puddings, eggs, and minced meat
- Grape juice mixed with honey is also very useful in treatment of this condition
- A glass of hot ginger tea will help to loosen thickened mucus and phlegm within the respiratory system
- Add a small amount of chopped garlic to a glass of hot water and drink this liquid
- Almond oil blended with the juice of white onion and ginger can be a good remedy for whooping cough
- Foods to be avoided
- Processed and refined foods, pickles, condiments, coffee, tea, sugar and meats
- The patient should also avoid all products made from white flour and sugar, ice-cream, candies and soft drinks
Yoga exercises to reduce whooping cough
Exercise that is more vigorous than everyday activity will aggravate pertussis and delay your recovery from the illness. Get sufficient rest.