Whooping cough

Also known as pertussis

Whooping cough is an infectious disease that causes coughing, choking and difficulty breathing. The bacteria are easily spread by coughing and sneezing. Complications can be serious, including pneumonia and seizures. Vaccination with the pertussis vaccine is the best way to protect yourself or your child against whooping cough. It also reduces the number of people in the community who can pass on the bacteria.

Key points

  1. Anyone can get whooping cough, but it causes the most severe, sometimes life-threatening, symptoms in babies, young children and older adults.
  2. Whooping cough can still be severe in older children and other adults. Coughing can continue for months.
  3. Vaccination with the pertussis vaccine is the best way to protect against whooping cough. In New Zealand it is part of the immunisation schedule for infants at 6 weeks, 3 months and 5 months of age. Booster vaccinations are funded for children at 4 years and 11 years and for women who are between 28 to 38 weeks pregnant.
  4. If your child gets whooping cough and they have not been vaccinated, they are more likely to develop pneumonia and other serious complications.
  5. If you think your child has whooping cough or if you are worried about your child's health, call your doctor or practice nurse. You can also free phone Healthline 0800 611 116.

Whooping cough NZKidsHealth, NZ

How contagious is whooping cough?

Whooping cough is very contagious. It is easily passed from person to person by coughing and sneezing. A person with whooping cough is likely to be infectious from the week before they start coughing to 3 weeks after the cough begins.

Why is whooping cough a concern?

In New Zealand, epidemics of whooping cough occur about every 3 to 5 years. Infants and children are most at risk:

  • Around 5 in 10 babies who catch whooping cough before the age of 12 months need to go to hospital. Of those that do go to hospital, 1 to 2 in every 100 die from whooping cough infection. Severe coughing can stop the oxygen supply to the brain (hypoxia).
  • In around 2 in 1000 children, whooping cough leads to brain damage, paralysis, deafness or blindness.
  • Having whooping cough can lead to other infections such as pneumonia and ear infections.

The disease is usually milder in adolescents and adults, with a persistent cough that can last for weeks to months. Some adults may collapse or fracture a rib from violent coughing.

Who is most at risk of complications?

Babies under 12 months of age or infants who do not receive their doses of pertussis vaccine at 6 weeks, 3 months, and 5 months are most at risk of serious disease. They are 5 times more likely to go to hospital with whooping cough than babies who are vaccinated on time. Babies often catch pertussis from their older brothers and sisters or parents, usually before they are fully immunised.

Whooping cough and pregnancy

The best protection for infants is for their mother to be vaccinated during pregnancy and then on-time vaccinations for the infant at 6 weeks, 3 months and 5 months. A booster dose of a pertussis vaccine is recommended for every pregnancy and is free for women between 28 to 38 weeks of pregnancy.
When a pregnant woman is vaccinated against whooping cough, her body develops antibodies (disease-specific protective proteins) which pass through the placenta. This helps protect the newborn from severe whooping cough for the first few months of life, until they have had their own 3 doses of vaccine and can make their own longer-term protection.
Breastfeeding does not provide direct effective protection against whooping cough.

What are the symptoms of whooping cough?

Symptoms of whooping cough develop about 5 to 10 days after you are exposed to the bacteria (up to 3 weeks in some people). Whooping cough can last up to 3 months and usually runs in 3 stages.

Stages of the illness Description
Stage 1 Usually starts like a cold
  • It produces an irritating cough, sneezing, runny nose and possibly a slight fever.
  • It is highly contagious at this stage but difficult to diagnose.
  • This stage usually lasts 1 to 2 weeks.
Stage 2 Begins after 1 or 2 weeks when the coughing gets worse
  • The coughing bouts often end in a high-pitched whooping sound as you take a breath.
  • Coughing spells may produce plenty of mucus, and choking on the mucus can cause vomiting.
  • The typical 'whoop' sound may not happen in very young children or adults with whooping cough. The coughing spells can cause a child to stop breathing, or turn blue.
  • Complications such as pneumonia or middle ear infections (glue ear) are more likely to happen at this stage.
Stage 3 The recovery stage
  • Recovery is slow. The cough can last for months, especially in adults, before it starts getting better.
  • Coughing lessens but may still happen at times.  
  • Sometimes, the coughing can start again months later if the child develops an upper respiratory tract infection.

How is whooping cough diagnosed?

If you think you or your child may have whooping cough, see your doctor or practice nurse as soon as possible.

Usually the history and sound of the cough will make diagnosis fairly easy, but your doctor will take a nose and throat swab and send it to the laboratory to make sure. The pertussis bacteria will only show up in tests in the early stages of the disease.

How is whooping cough treated?

What self-care can I do if my child has whooping cough?

Mild cases of whooping cough can be treated at home.

  • Comfort, rest and plenty of cuddles for young children will help them recover.
  • Small healthy meals and fluids can be given to your child.
  • Steam in the bedroom or sitting your child on your knee in a steamy bathroom may give some temporary relief.

Make sure you and your child get as much rest as you can. Caring for your child with whooping cough is hard work, and the cough is often worse at night.

Treating the cough

There is no treatment for whooping cough. Cough medicine will not ease the coughing (and is not recommended in young children). The following may:

  • sipping warm drinks can be soothing and may help break the coughing spasm
  • reducing dry air, by using a humidifier in the bedroom may help (this must be cleaned every 2 or 3 days)
  • using saline nose drops to help remove thick mucus
  • drinking lots of clear fluids
  • avoiding coughing triggers, such as cigarette smoke, perfumes or pollutants.

Paracetamol may be helpful if your child is in pain from coughing. Ensure you follow directions and measure children's doses accurately. Never give more than the recommended dose. If unsure, ask your doctor or pharmacist for advice.

Antibiotics

If whooping cough is diagnosed during the first 3 weeks of the infection, your doctor may prescribe a course of antibiotics. This helps to prevent the bacteria from spreading to other people.

How can I prevent the spread of whooping cough?

If your child has whooping cough

  • When your child has whooping cough, they may be infectious to others for 3 weeks after the start of the cough, but if an antibiotic has been prescribed the infectious period is reduced.
  • To reduce the risk of infection keep them away from early childhood centres, school or community gatherings until they are well enough and have either received 5 days of antibiotics or it is 3 weeks since the start of coughing spasms.

Coming into contact with someone who has whooping cough

If your child is not fully vaccinated and comes into contact with someone who has whopping cough, or if there is an outbreak of whooping cough, keep them away from their early childhood centre until the outbreak is over.

Why is vaccination so important?

Vaccination is the best way to protect against whooping cough. In New Zealand, the pertussis vaccine is part of the immunisation schedule. It is a course of 5 injections which is given at ages 6 weeks, 3 months and 5 months. Booster doses are then given at ages 4 years and 11 years.

Most cases of whooping cough in infants are passed on by family members, as you can be infectious and pass it on without realising you have whooping cough. To protect pregnant mums and babies, all other people in your household, as well as other close family members, such as grandparents, should have a whooping cough vaccination, as they could be at risk of passing it onto your baby.

  • For dads, grandparents and other caregivers, see your family doctor or nurse to check you have had a pertussis vaccination within the past 10 years.
  • Check that older siblings are also up-to-date with their vaccinations.

Learn more

The following links provide more information on whooping cough.

Information for people with whooping cough (pertussis) Auckland Regional Public Health Service 
Whooping cough Ministry of Health, NZ, 2017
Immunise against whooping cough HealthEd, NZ, 2016
Pertussis The Immunisation Advisory Centre, NZ, 2017
Pertussis (whooping cough) The Immunisation Advisory Centre, NZ, 2013

References

  1. Pertussis (whooping cough) Immunisation Handbook 2017, NZ
  2. Pertussis: halting the epidemic by protecting infants BPAC, 2013, NZ
  3. News Update: Pertussis vaccine now subsidised for all pregnant women BPAC, 2015, NZ
Credits: Editorial team. Last reviewed: 22 Nov 2017