Whooping cough- why is it such a serious illness?
What is whooping cough?
Whooping cough is a highly contagious lung infection caused by the bacteria Bordetella Pertussis. It is common, and can have serious complications, particularly in smaller babies for whom it can be life-threatening. Cases have been steadily rising in recent years. This is because the whooping cough vaccine does not give long-lasting protection, and wears off over time. It is also probably being picked up more often, as healthcare professionals and the wider community are more aware of it, and we have better and quicker ways to test for it.
What are the symptoms of whooping cough?
It usually starts with a dry cough. Runny nose and fever may occur in the first week. Many people develop spasms of uncontrolled coughing- the force of the cough may even cause vomiting. One of the classic symptoms of whooping cough is a distinctive “whoop” at the end of a coughing spasm, cause by a sharp intake of breath. This is more common in children- not all kids get this “whooping” sound. Some people just complain of a dry hacking cough that goes on for weeks. Small babies may have difficulty catching their breath after a coughing fit, which can be very distressing. Apnoeic spells may also occur in babies- this means they stop breathing for a few seconds. Some babies don’t get the cough at all, they just develop apnoeic episodes. Serious complications may occur, and include pneumonia, ear infections, seizures and encephalopathy (brain damage).
How is whooping cough spread?
You catch whooping cough by breathing in droplets that an infected person has coughed or sneezed into the air. It can also catch it by touching something an infected person has coughed or sneezed on, and then putting your hand to your face. If you live with someone who has whooping cough, you are very likely to get it too- usually everyone in the same household will catch it, as it is very contagious.
How long does it take symptoms to show after exposure to whooping cough?
It takes between 7 and 20 days after catching whooping cough infection for the first symptoms to occur.
How long is whooping cough contagious for?
An infected person is contagious to others from the time of the first symptoms, until about 3 weeks after the start of the cough.
How long does whooping cough last?
The initial phase of fever and runny nose may last about a week. The cough can last for 10 weeks or more. Sometimes it’s called the “100 day cough” as many people will have a cough for about three months.
How is whooping cough diagnosed?
The symptoms may be enough for the doctor to diagnose it, for example if the distinctive “whoop” is present. Sometimes a nasal swab will be performed by the doctor to confirm the diagnosis. However a swab may come back saying there is no infection if the infected person has already had a course of antibiotics, or if the cough has already been there for more than 2 weeks. If you think your child could have whooping cough, it is really important to seek medical advice as soon as you can- it is worth trying to call the clinic or emergency department before you arrive, so they can make arrangements to reduce spread to others.
What is the treatment for whooping cough?
Appropriate antibiotic treatment will shorten the amount of time a person is infectious to others, though it does not the stop cough any sooner. About 5 days after starting an antibiotic there is little or no risk of being contagious. Without treatment a person will spread whooping cough for around 3 weeks!
It is advised that people who live in the same house, or have been in regular close contact with a case of whooping cough should be treated, particularly pregnant women and babies. Small babies who have whooping cough often need admission to hospital for treatment as they can become extremely ill.
If a child is struggling to breathe, or they look blue around the lips, call an ambulance immediately (Triple ooo).
Why is whooping cough so serious in babies?
It is a frightening statistic, but 1 in every 200 babies who contract whooping cough will die. Babies under the age of 6 months are particularly vulnerable because their immunity is not fully developed. They also have softer airways, which means they can develop more severe breathing problems. Pneumonia, seizures, inflammation of the brain and long term brain damage are also some of the possible devastating complications that can affect babies who contract whooping cough.
Who should get the whooping cough vaccine?
All children get the whooping cough vaccine as part of their childhood immunisations, at 2, 4 and 6 months, with further boosters scheduled throughout childhood. Pregnant women are advised to get receive a whooping cough vaccine to boost their immunity during their third trimester, usually around 28 weeks. This works in two ways: it allows immunity to pass to the unborn baby through the mum’s bloodstream. Also, if a mum contracted whooping cough around the time of delivery, she could pass it on to her newborn- so the vaccine reduces the risk of this happening. It’s also advised that fathers, grandparents and anyone else likely to spend time with a newborn baby should get a whooping cough vaccine at least 2 weeks before the baby is born.
Is the whooping cough vaccine safe? Are there any side effects?
The whooping cough vaccine is very safe and reactions to it are rare. It is now routinely recommended in pregnancy. Some people may get muscle aches, low grade fever and soreness at the injection site. Nausea, vomiting and diarrhoea can also occur, but are uncommon. As with all vaccines, there is an extremely small risk of anaphylaxis (which is treatable)- this risk is about 1 in a million. Anyone getting a vaccine will usually be monitored for a few minutes after the injection, to be on the safe side.
Is it possible for a child to catch whooping cough even if they have been vaccinated?
Sometimes, children can catch whooping cough even if they have been vaccinated. But the illness will be less severe and tends to get better more quickly. This also means the child is contagious for less time, so spread to others is reduced.
Is it whooping cough or croup? How can I tell?
Children with croup can have a harsh barking cough (like a sea-lion!), and may make a squeaky, high-pitched or rasping noise in their throat (called stridor) when they breath in. The name ‘whooping cough’ is a bit misleading, because the cough itself doesn’t sound like a “whoop”. The cough is actually a “normal” sounding cough, but occurs in long spells or spasms. Then, when there is a break in the coughing, the child will suddenly make a quick breath in- this is what makes the ‘whoop’ sound. If you are not sure (it can be tricky to tell the difference), it is really important to speak to a doctor.
If you have more questions about whooping cough or the whooping cough vaccine, speak to your doctor.
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