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11 July 2009
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Doctor examining a child

Whooping cough

Dr Trisha Macnair

Routine immunisation has made whooping cough much less common.


What is Whooping cough?

Whooping cough, or pertussis, is a highly contagious bacterial infection of the lungs caused by the bacteria Bordetella pertussis. It is also known as the ‘100 day cough’.

Infection can occur at any age, but it's more common in those under five years old

It's spread from person to person through the air in tiny droplets of fluid when someone with the infection coughs, sneezes or talks. Infection can occur at any age, but it's more common in those under five years old.

In England and Wales, GPs handle an estimated 35,000 consultations for pertussis infection and it's responsible for more than nine deaths a year.

Symptoms

The incubation period between exposure and symptoms is about seven days. Initial symptoms are similar to a cold, with a runny nose, mild fever and dry night-time cough.

A pattern of coughing spasms develops, with a series of short coughs followed by a sudden drawing-in of breath that makes the characteristic whooping sound (the whoop may not be heard in small babies). The bouts of coughing, which tend to occur at night, often end in vomiting.

In babies, the spasms of coughing may occur after feeding. During the coughing spasm, the child may go red or blue in the face and copious amounts of mucus may be produced from the nose or mouth.

Nosebleeds and subconjunctival haemorrhages (bleeding into the white of the eye) may occur with intense coughing.

Complications are uncommon, but include pneumonia, seizures and bronchiectasis - a lung condition where the small airways become enlarged.

In babies, whooping cough can cause apnoea (when breathing stops) and sudden death.

Causes and risk factors

Whooping cough is fairly easily diagnosed by observing the symptoms and examining a swab taken from the throat or nose for traces of the bacteria.

If you suspect whooping cough, or if your child develops an unusual cough that causes vomiting or doesn't improve after a couple of days, see a doctor.

Get urgent medical advice if your child seems particularly unwell, goes blue during coughing or has other worrying symptoms.

Treatment and recovery

Mild whooping cough can be treated at home with plenty of rest and fluids, but in some cases hospital treatment may be needed.

TThe benefit of antibiotics is debatable. They don't appear to shorten the course of the illness, but may prevent whooping cough in people who've been exposed to it and it spreading to other people.

It's not unusual for the cough to persist for two to three month.

The number of cases of pertussis has been greatly reduced since the introduction of immunisation. Babies are routinely immunised to prevent whooping cough when they are two, three and four months old.

Since November 2001, children in the UK have been routinely offered a preschool booster between the ages of three and five.

This article was last medically reviewed by Dr Orlena Kerek in March 2009


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