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Whooping cough


Expert reviewer Dr Adrian Raby, General Practitioner
Next review due May 2021

Whooping cough (also known as pertussis) is a bacterial infection that causes severe bouts of coughing, which can last for several weeks or months. It gets its name from the fact that some people, particularly young children, make a ‘whoop’ sound as they draw in breath between coughing.

The infection is highly contagious – it can be easily spread between people.

A dad having a cuddle with his baby

About whooping cough

Whooping cough is an infection caused by the bacterium, Bordetella pertussis, which affects your upper respiratory tract (your nose and throat). It’s spread through droplets in the air when an infected person coughs. You can get whooping cough at any age, but young babies and children are more likely to have severe symptoms and develop complications. A vaccination is available that can prevent this.

Whooping cough used to be very common in the UK. But since vaccinations against the disease were introduced in the 1950s, the number of people getting it each year has been much lower.

Although it’s less common these days, the number of people getting whooping cough has been higher over the last few years. In 2017, there were around 4,000 confirmed cases in the UK. There tends to be an outbreak of whooping cough every few years, when many more people than normal become infected. The most recent one was in 2012.

You can still catch whooping cough, even if you’ve had it before or you’ve been vaccinated against it. This is because the immunity you get from previous infection and vaccination can wear off over time. If you do catch it for a second time though, your symptoms tend to not be so severe. See Prevention of whooping cough to find out more.

Symptoms of whooping cough

Symptoms of whooping cough usually begin between seven and 10 days after you’ve been infected (known as the incubation period). The first symptoms are similar to a common cold. You may feel generally unwell with a runny nose, sneezing, sore throat, a slight fever and, a few days later, a dry cough. These symptoms usually last for about a week or two.

After about a week, your cough will get worse, and you’ll probably have regular bouts of severe coughing. In between the coughing fits, you might feel quite well. You may have some of the following symptoms associated with your cough.

  • At the end of a bout of coughing, you may make a ‘whoop’ sound as you draw in breath. Many adults and babies don’t have this symptom of whooping cough – it tends to be more common in young children.
  • The coughing may be worse at night, or there might be particular things that set if off – like cold temperatures or a sudden noise.
  • You might cough up thick mucus.
  • You might feel like you need to be sick after a bout of coughing.
  • Your face may be flushed and you might suddenly start sweating.
  • Children might have a blueish-purplish tinge to their lips and skin, caused by lack of oxygen after a coughing fit.
  • The cough tends to last for one to six weeks, although it can carry on for up to three months. You should start to gradually feel better during this time, with the coughing becoming less frequent and less severe.
  • If you’ve been vaccinated against whooping cough, or you’ve had it in the past, you may have some immunity against it. You may still get some symptoms, but they will probably be milder and not last as long.

If you or your child has symptoms of whooping cough, you should see your GP.

Diagnosis of whooping cough

Your GP will ask about your symptoms and examine you. They’ll want to know if you’ve been immunised against whooping cough, and if you’ve recently been in contact with anyone who has the infection. In the early stages of the disease, your symptoms may be similar to other respiratory tract infections, like the common cold. But if your symptoms begin to get worse, your GP will usually be able to tell that it’s whooping cough. They may want to confirm the diagnosis by doing some tests. These may include the following.

  • Taking a sample from your nose or throat with a swab (like a small round cotton bud).
  • Testing a sample of fluid from your mouth. You can get kits to do this test yourself at home, and your GP may arrange for one to be sent to you.
  • A blood test. This is mainly for people over 16, and if you’ve had a cough for over two weeks.

It can take a while to get the results back from any tests. So if your GP suspects you have whooping cough, they will probably recommend you start treatment straightaway. Sometimes the tests can give a negative result, even if you do have whooping cough. This is because the cough can last even after the bacteria that cause it have cleared from your body.

Treatment of whooping cough

Antibiotics

If you’ve had your cough for less than three weeks, your GP may prescribe a course of antibiotics for you. Antibiotics won’t usually help with your symptoms – you’re still likely to have a cough for several weeks. But they may help to prevent the infection spreading to other people. You’ll need to keep children off school or nursery until they’ve completed at least 48 hours of treatment with antibiotics. See FAQ: Can my child go to school if they have whooping cough? for more information.

Treating the symptoms

There isn’t any treatment you can take that can stop your cough. This will gradually get better on its own with time. While you’re feeling unwell, the best thing you can do is rest and make sure you’re drinking enough fluids to keep hydrated. You can take over-the-counter painkillers, such as paracetamol or ibuprofen to help with symptoms such as a fever and sore throat.

Treatment for severe symptoms

Some people with whooping cough may need to be admitted to hospital for treatment. This might be if you’re having difficulty breathing due to the cough, or if you develop a complication such as pneumonia. Babies under six months with whooping cough may need to be treated in hospital too, if they become very unwell.

Complications of whooping cough

There are several possible complications of whooping cough, some of which can be serious and life-threatening. Most people aren’t affected, but babies under six months are at the greatest risk. Complications can include:

  • infection in your middle ear – caused by spread of the bacterium that’s caused your whooping cough
  • infection of your lung (pneumonia) – caused by spread of the bacterium that’s caused your whooping cough
  • temporary pauses in your breathing (apnoea)
  • seizures (fits)
  • inflammation of your brain (encephalitis)
  • severe dehydration, if you’re frequently being sick after coughing fits

You may develop other complications that are directly related to the strain of constant, severe coughing. These include:

  • bursting of the tiny blood vessels in your eye, causing red eyes
  • red spots under the skin of your face and chest, caused by small blood vessels bursting during coughing
  • trapped air in the space between your lungs and the wall of your chest (a pneumothorax)
  • a hernia – this is when the contents from your abdomen, such as your intestines, push through a weakness in the muscle of your abdominal wall
  • a rectal prolapse – when part of your rectum or the lining of your rectum drops through your anus
  • fracture of a rib
  • urinary incontinence (passing urine unintentionally)

If your baby has whooping cough, your GP will check for any signs of complications when they examine them. They can explain what to look out for too. If you’re at all worried that your baby is becoming more unwell, seek medical attention straightaway.

Prevention of whooping cough

Whooping cough is highly contagious – it spreads very easily from person to person. Up to eight in 10 people, who aren’t immune to it, will catch it if they’re in contact with an infected person. You can reduce your baby’s chance of catching it by giving them the vaccination for whooping cough.

Vaccination

The whooping cough vaccine is offered to all babies in the UK as part of the routine vaccination schedule.

The vaccine is given in a series of injections when your baby is eight, 12 and 16 weeks old. The vaccination protects against the following diseases too: diphtheria, tetanus, polio and Hib (Haemophilus influenzae type b) and hepatitis B. The combination of vaccines is called DTaP/IPV/Hib/HepB. Your child will then be offered a pre-school booster of the whooping cough vaccine too, when they’re around three years and four months.

The vaccine is very effective at protecting against whooping cough when you first have it, but it gradually wears off as you get older. That means you may still get the disease, especially as an adult – although it’s likely to be milder.

In the UK, all pregnant women are also offered a booster vaccine for whooping cough. You’ll be offered it any time from 16 weeks of pregnancy, but it’s usually timed to coincide with your 20-week scan. Having the vaccination when you’re pregnant will boost levels of antibodies against whooping cough in your blood, which will then be passed on to your baby. This helps to protect them from whooping cough as soon as they’re born, until they are old enough to have the vaccination themselves.

Antibiotics for prevention

Your GP may offer you antibiotics if you, or your baby has been in close contact with someone who has whooping cough. These can help prevent you catching or spreading the disease. Normally only the following people are offered antibiotics for prevention of whooping cough.

  • Babies who aren’t fully immunised (eg they may be younger than two months, or they may not have completed their vaccinations).
  • Women who are more than 32 weeks pregnant and haven’t had the whooping cough vaccine in the last five years.
  • Adults who haven’t had the whooping cough vaccine in the last five years, and live or work with pregnant women or babies who may not be fully immunised.

Frequently asked questions

  • No, you’ll need to keep your child off school if they have whooping cough. They should be kept away from school until they’ve had at least 48 hours of treatment with antibiotics.

    If you choose not to give your child antibiotics, they’ll need to stay away from school for three weeks from when their symptoms started.

    More information

    Whooping cough is easily spread from person to person when an infected person coughs or sneezes. Tiny droplets containing the bacteria are released into the air, which can then be breathed in by other people.

    Whooping cough can have serious complications for some young children. Keeping your child at home will prevent them passing on the infection to other children who may not have been vaccinated. If you think that your child has whooping cough, you should keep them home from school or nursery and speak to your GP.

    If your child has whooping cough, your GP will prescribe antibiotics for them to take. Antibiotics might not make much difference to your child’s symptoms, but they will help to prevent the infection spreading to other people. One type of antibiotic commonly given to children needs to be taken for three days, and the other for seven. Your child will be able to go back to school or nursery once they have completed 48 hours of antibiotic treatment.

  • The routine immunisation schedule in the UK includes four separate doses of the pertussis (whooping cough) vaccination. The first three are given when your child is between two and four months, and the last booster dose is given three years later.

    More information

    When you’re injected with the pertussis vaccination, your body will start to make antibodies to fight off the bacteria. Young children may need several injections to produce this response. When your child is given their booster jab, it means their body is primed to give a greater and faster response to the whooping cough infection if they come into contact with it.

    Although your child may have some protection against whooping cough after one dose of the vaccine, each extra dose will offer greater protection. The four doses offer the best protection for your child for the longest amount of time.

  • Primary vaccination (when you’re first vaccinated against a disease) isn’t currently recommended for adults and children over the age of 10. Vaccination is aimed at preventing babies and young children from getting the disease, as they tend to be at greater risk of serious complications. Whooping cough tends to be a milder disease in adults. If you have the whooping cough vaccination as a child, it normally wears off as you get older anyway.

    If your child has missed doses of the whooping cough vaccine, it can be started or continued at any point up till the age of 10. The vaccines should still be given at least one month apart, and the final booster dose can be given a year after the first ‘primary’ doses.

    In adults, vaccinations are only recommended for women who are pregnant. This is to offer protection to their newborn babies once they are born.


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Related information

    • Pertussis. BMJ Best Practice. bestpractice.bmj.com, last reviewed April 2018
    • Whooping cough. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised April 2017
    • Whooping cough. PatientPlus. www.patient.info, last checked 23rd October 2015
    • Laboratory confirmed cases of pertussis (England): annual report for 2017. Public Health England, 27 April 2018. www.gov.uk
    • Pertussis factsheet for health professionals. Public Health England, October 2016. www.gov.uk
    • PHE guidelines for the public health management of pertussis incidents in healthcare settings. Public Health England, November 2016. www.gov.uk
    • The routine immunisation schedule. Public Health England, April 2018. www.gov.uk
    • Vaccination against pertussis (whooping cough) for pregnant women – 2016. Information for healthcare professionals. Public Health England, June 2016. www.gov.uk
    • Green book. Chapter 1. Immunity and how vaccines work. Public Health England, March 2013. www.gov.uk
    • Quinn HE, Snelling TL, Macartney KK, et al. Duration of protection after first dose of acellular pertussis vaccine in infants. Pediatrics 2014; 133(3):e513–19. doi: 10.1542/peds.2013-3181
    • Whooping cough vaccination. PatientPlus. www.patient.info, last checked 23 October 2015

  • Reviewed by Pippa Coulter, Freelance Health Editor, Bupa Health Content Team, May 2018
    Expert reviewer Dr Adrian Raby, General Practitioner
    Next review due May 2021



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