Whooping cough (Pertussis)

Whooping cough (Pertussis) is a respiratory infection which classically presents as a “100 day cough”.

Affected people have paroxysmal coughing bouts, a “whoop” on breathing in, and sometimes vomiting after coughing, particularly in infants.

There has been a recent rise in cases of whooping cough in the UK since November 2023. Whooping cough is a cyclical disease that regularly peaks every 3 to 5 years and unfortunately, it is anticipated that cases will continue to rise for several months.

Infants under 3 months of age are the most vulnerable.

Vaccination is highly effective at preventing whooping cough. All infants are offered vaccination at 8, 12 and 16 weeks. 3 doses of vaccine give 95% protection. A pre-school booster at age 3yrs 4 months boosts this protection further.

The best way to prevent whooping cough in babies is for the mother to be vaccinated during pregnancy. By receiving the vaccine during pregnancy, mothers pass on protective antibodies to their unborn babies, offering them crucial immunity during the vulnerable first few weeks of life when they are too young to receive the vaccine themselves.

For further information on vaccination in pregnancy, please follow this link:

Pregnancy: how to help protect you and your baby – GOV.UK (www.gov.uk)

Symptoms

  • Catarrhal stage – lasts 1-2 weeks: runny nose and sneezing with a low grade or no fever
  • Paroxysmal stage – lasts 3-5 weeks: coughing bouts, often worse at night, with or without whooping, and vomiting after coughing, especially in young infants
  • Convalescent stage – lasts weeks to months: gradual resolution of coughing bouts

Whooping cough can be complicated by other problems such as ear infections, pneumonia or seizures, and can occasionally cause death in infants.

Cause

Whooping cough is caused by a bacterial infection called Bordetella pertussis. It is spread by sneezing and coughing.

Diagnosis

Whooping cough can be diagnosed by taking a swab from the back of the throat or nose. This needs to be done within the first 21 days of starting the infection.

A swab from the inside of the mouth can be taken in people between the ages of 2 and 17. This needs to be done after the first 14 days of illness.

Your GP can arrange these tests.

Treatment

Antibiotics given in the first 7 days of the illness can reduce the symptoms.

Apart from this, unfortunately there is no proven effective treatment for the cough.

Sometimes, people with whooping cough need to be admitted to hospital.

When to contact your GP

You should contact your GP if you think you or your child may have whooping cough.

Ask for an urgent GP appointment or get help from 111 if:

  • your baby is under 6 months old and has symptoms of whooping cough
  • you or your child have a very bad cough that is getting worse
  • you’ve been in contact with someone with whooping cough and you’re pregnant
  • you or your child has been in contact with someone with whooping cough and have a weakened immune system

Whooping cough can spread very easily. It’s best to call the GP before you go in. They might suggest talking over the phone.

Check symptoms on 111 online (for children aged 5 and over) or call 111 (for children under 5).

Parents or carers can see guidance on when to seek advice if your child is chesty, by using the free HANDi Paediatric app (developed by the NHS in Devon). Answer the quick questions in the ‘Chestiness’ section for clear simple guidance.

The app is also very useful for other common childhood conditions.

Call 999 or go to A&E if:

your or your child’s lips, tongue, face or skin suddenly turn blue or grey (on black or brown skin this may be easier to see on the palms of the hands or the soles of the feet)

you or your child are finding it hard to breathe properly (shallow breathing)

you or your child have chest pain that’s worse when breathing or coughing – this could be a sign of pneumonia

your child is having seizures (fits)

Prevention

Vaccination is the most effective way to protect against whooping cough.

The pertussis vaccine is safe in pregnancy and can be given from 16 weeks onwards.

For further information, please see Whooping cough vaccination in pregnancy – NHS (www.nhs.uk)

Pertussis vaccine is part of the 6-in-1 vaccine given to babies at 8, 12, and 16 weeks. It is important to have all 3 doses to be fully protected.

A pre-school booster at age 3 years and 4 months boosts the protection further.

For further information, please see NHS vaccinations and when to have them – NHS (www.nhs.uk)

Useful information about Whooping Cough

https://www.nhs.uk/conditions/whooping-cough/

 

Published: April 2024