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Whooping cough

Published by Bupa's health information team, February 2008.

This factsheet is for parents of children with whooping cough, or for people who would like information about it.

Whooping cough (also known as pertussis) is a contagious bacterial infection which causes a severe, uncontrollable cough. Although thought of as a childhood disease, it can affect people of all ages. Children can be given a vaccine to prevent whooping cough.

• About whooping cough
• Symptoms
• Complications
• Causes
• Diagnosis
• Treatment
• Prevention
• Further Information
• Questions and answers
• Related topics
• Sources

About whooping cough

Whooping cough is a highly contagious bacterial infection. The most prominent feature of whooping cough is a violent cough. In children, the coughing may end with a "whoop" noise as they draw in breath.

Historically, whooping cough was common among infants and young children, but it's not as common nowadays as most children are vaccinated against it. The vaccination doesn't give you life-long protection, so you may get the infection as an adolescent or adult. However, symptoms in adults are typically milder than those in infants.

Symptoms

After your child is infected it can take between five and 21 days (most commonly between seven and 14 days) before symptoms appear. This is known as the incubation period.

Initially, the symptoms are similar to a common cold. Your child may feel generally unwell with a runny nose, a slight fever and have a mild, irritating cough.

After a week or two, the mild cough can get progressively worse and your child will start to have episodes of violent coughing which may end with a "whoop" noise as he/she breathes in. Although "whooping" is one of the most well known features of whooping cough, adults and infants younger than six months are not as likely to have this symptom. Coughing may be worse at night, making it difficult for your child to sleep.

In addition to spells of coughing, infants and children may also:

• be sick at the end of a coughing episode
• have episodes of choking due to thick mucus in the throat and chest
• stop breathing for short periods of time (known as apnoea) and turn blue in colour from the lack of oxygen
• have difficulty feeding which can lead to weight loss and dehydration

Babies, particularly those younger than six months old, are most seriously affected by whooping cough. Serious illness is less common in older children. If you catch whooping cough as an adult, symptoms are usually mild and you may have a dry, irritating cough that lasts a few months.

Although not necessarily due to whooping cough, if you or your child have any of these symptoms you should visit your GP.

Complications

Complications are more common in young infants than in older children and adults. Complications can include:

• pneumonia (inflammation of the lungs)
• weight loss and dehydration
• slow or stopped breathing (called apnoea)
• a lack of oxygen to the brain which can cause seizures and, rarely, brain damage
• a collapsed lung
• an abdominal or inguinal hernia - a lump in the groin or abdomen (tummy) that occurs when part of the intestine pushes through a weakness in the muscles of the abdominal wall
• little red spots on your child's face or trunk (chest, abdomen and back) caused by tiny blood vessels bursting from coughing
• bleeding into the whites of the eyes, nosebleeds and bruises
• an ear infection

Causes

Whooping cough is caused by a bacterium called Bortedella pertussis. It's highly contagious and is spread from person to person when tiny droplets containing the bacteria are released into the air when an infected person coughs or sneezes.

Diagnosis

The doctor will ask about your child's symptoms and medical history. He or she will usually be able to diagnose whooping cough based on your child's symptoms, but may also take a sample of mucus or saliva from your child's nose or throat using a swab stick which will then be sent to a laboratory to be tested.

Treatment

Your child will be given a course of antibiotics. However, even when treated with antibiotics, whooping cough commonly lasts for between six and eight weeks. The sooner your child is given antibiotics after catching whooping cough, the more effective they will be in fighting the infection and reducing his/her symptoms. Cough medicines are usually ineffective in reducing coughing and are not recommended.

If your child has severe whooping cough, he/she may have to go to hospital to be monitored and treated by doctors, particularly if he/she is younger than 18 months. Around half of infants under the age of one with whooping cough will need to go to hospital. Excess mucus may need to be removed from the throat by suction.

Prevention

Vaccination

Your child can have a vaccination to prevent them getting whooping cough. The vaccine is called the acellular pertussis vaccine and is given over a series of injections when your child is aged two, three and four months old. It's given along with diphtheria, tetanus, polio and Hib (Haemophilus influenzae type b) vaccines. A pre-school booster is given to your child when he/she is between three and five years old. There is a national immunisation programme in the UK.

Even if vaccinated in infancy, immunity decreases over time, so older children and adults can get whooping cough.

Medicines

If you have been in close contact with someone who has whooping cough, you may be given a course of antibiotics to help prevent them catching it, particularly if you have never been vaccinated or you haven't had all your vaccination injections. Children who are under five years old may also be given antibiotics.

Further information

• Health Protection Agency (HPA)
  www.hpa.org.uk
• NHS Immunisation Information
  www.immunisation.org.uk

Related topics

• Childhood immunisation
• Pneumonia

Sources

• Whooping cough (Pertussis). Health Protection Agency. www.hpa.org.uk, accessed 22 June 2007
• Pertussis (Whooping cough). Guidelines on the management of cases and household contacts. Health Protection Agency, December 2004. www.hpa.org.uk
• Gregory, D. Pertussis: A disease affecting all ages. American Family Physician 2006; 74(3):420-426. www.aafp.org
• Kumar, P and Clark, M. Clinical medicine. 6th edition ed. London: Elsevier Saunders, 2005
• Kasper et al. Principles of internal medicine. 16th edition. New York: McGraw-Hill 2005
• Pertussis. Medline Plus. www.medlineplus.gov, accessed 14 November 2007
• British Medical Association, Royal Pharmaceutical Society of Great Britain. British National Formulary for children. London: BMJ Publishing Group Ltd, RPS Publishing, 2007
• Pertussis. Immunisation (NHS). www.immunisation.org.uk, accessed 14 November 2007

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: February 2008.