Whooping cough (Pertussis)

Whooping cough, also known as pertussis, is a serious and highly contagious respiratory infection caused by the bacterium Bordetella pertussis. The cough can last up to 3 months, even after antibiotic treatment is finished and the person is no longer infectious. The name “whooping cough” comes from the sound a person sometimes makes when gasping for a deep breath at the end of a bout of coughing. Vomiting after coughing is common.

Whooping cough is most dangerous in babies under 6 months of age. They are too young to be fully immunized, become more seriously ill, and are more likely to develop complications. Older children and adults who have not had a recent whooping cough vaccination can also become infected. Because their symptoms may be mild, they can unknowingly pass the infection on to infants.

Cases of whooping cough tend to rise every few years. During these times there is an increased risk of spread to infants and other people in the community. Immunization is the best way to reduce that risk.

Symptoms#

Whooping cough begins with symptoms similar to a cold, such as a cough, tiredness, a blocked or runny nose and a mild fever. These may last for one to 2 weeks. After this, the cough usually worsens and can include:

• Severe bouts of coughing, often followed by a “whooping” sound as the person breathes in
• Vomiting at the end of a coughing bout
• Apnea, where the child stops breathing for periods of time and may turn blue
• Dehydration

People may appear well between bouts of coughing. During recovery, the cough gradually decreases but can last up to 3 months. Babies under 6 months may not cough at all; instead they may stop breathing and turn blue, or have trouble feeding and may choke or gag. In adolescents and adults, whooping cough may appear simply as a persistent cough.

Complications#

Whooping cough is most serious in babies. Young babies under 6 months of age can become severely or even critically ill. Complications can include:

• Apnea (stopping breathing for periods of time)
• Dehydration from poor feeding
• Middle-ear infections
• Pneumonia (chest infection)
• Inflammation of the brain
• Seizures (fits) and coma
• Permanent brain damage
• Death

How whooping cough spreads#

Whooping cough is highly contagious. It spreads when a person breathes in bacteria that an infectious person has coughed or sneezed into the air.

People usually develop symptoms between 4 and 21 days after being exposed. They are infectious from the onset of their first cold-like symptoms until 21 days after the cough begins, or until they have completed 5 days of appropriate antibiotic treatment.

Who is at risk#

Anyone can get whooping cough. People living in the same household as someone with the infection are at risk. Babies under 6 months of age are at greatest risk of severe disease, hospitalization and death, because they are too young to be fully immunized. Many babies catch whooping cough from older children and adults who may not even know they are infected.

Prevention and immunization#

Immunization is a safe and effective way to protect against serious disease caused by whooping cough. Whooping cough vaccines give good protection, but immunity fades over time, which is why additional doses (boosters) are recommended.

Whooping cough vaccines are given as combination vaccines that also protect against other diseases, such as diphtheria and tetanus. Childhood immunization is usually given as a series of doses in infancy and early childhood, with booster doses later in childhood and adulthood. Catch-up doses may be available for people who have not been fully vaccinated.

Booster doses are particularly recommended for:

• Adults who are in close contact with young children, including parents, guardians and carers of infants under 6 months of age
• Healthcare workers
• Travelers, depending on their destination

Exact schedules and eligibility vary from place to place. If you are not sure what is recommended for you, or whether you qualify for a funded vaccine, ask your doctor or immunization provider.

Whooping cough vaccination in pregnancy#

Pregnant women are recommended to have a whooping cough vaccine during every pregnancy, ideally between about 20 and 32 weeks of gestation. If a woman is not vaccinated within this window, she should receive the vaccine as soon as possible, at any time up to delivery. If the vaccine is given within 2 weeks of delivery, the newborn may not be adequately protected.

Vaccinating pregnant women before delivery has been reported to reduce whooping cough in infants by around 80% to 91%.

Working out what you need#

The immunizations you may need depend on your health, age, lifestyle and occupation. Talk to your doctor or immunization provider if you think you or someone in your care has factors that could make immunization important.

Diagnosis#

People with symptoms of whooping cough should seek prompt medical care from their doctor or a hospital. Call an ambulance immediately if you or your child have difficulty breathing or if the lips start turning blue.

Whooping cough is diagnosed based on symptoms, a physical examination and medical history (including immunization status). The diagnosis is confirmed by tests such as a nose and throat swab or blood tests.

Treatment#

Antibiotic treatment can help prevent the spread of infection and reduce the severity of symptoms if started early in the illness. Some babies may need treatment in hospital.

People with whooping cough should:

• Get plenty of rest
• Drink plenty of water or other fluids to stay hydrated; small sips may be easier to manage between bouts of coughing
• Avoid cigarette smoke

Protecting others#

People with whooping cough should limit their contact with others while they are infectious, particularly infants and women in the last month of pregnancy. They are usually infectious from the onset of the first cold-like symptoms until 21 days after the cough begins, or until they have completed 5 days of appropriate antibiotic treatment.

Infants and children diagnosed with whooping cough should not attend childcare or school for 21 days after the cough begins, or until they have received 5 days of appropriate antibiotic treatment.

Preventive antibiotics may be recommended for some people who have been exposed to whooping cough and are in close contact with babies under 6 months of age or women in the last month of pregnancy. This can apply in household, childcare and healthcare settings, and is usually recommended even if the exposed person is fully immunized.

Children under 7 years of age who are not vaccinated against whooping cough and were in the same room as an infectious person should not attend childcare or school. They should stay away for 14 days from their last contact with the case, or until they have received 5 days of appropriate antibiotic treatment.

Key points#

• Whooping cough (pertussis) is a serious, highly contagious respiratory infection that can cause a cough lasting up to 3 months.
• It is most dangerous for babies under 6 months of age, who can become critically ill.
• It spreads easily through coughing and sneezing, and people are infectious for several weeks unless treated with antibiotics.
• Immunization is the best protection, and vaccination during pregnancy helps protect newborns.
• Seek prompt medical care for symptoms, and call an ambulance if breathing is difficult or the lips turn blue.

Where to get help#