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Whooping cough


Expert reviewer, Dr Adrian Raby, General Practitioner
Next review due October 2023

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

The infection is highly contagious – it is easily spread between people. You can reduce your baby’s chance of catching it by making sure they are vaccinated against whooping cough.

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 airways. 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 to 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 still less common than it used to be, cases of whooping cough have increased over the last few years. There tends to be an outbreak of whooping cough every few years, when more people than usual become infected. The highest peak of cases in recent years was in 2012.

You can still catch whooping cough, even if you’ve had it before or have been vaccinated against it. This is because the immunity you get from previous infection and vaccination wears off over time. If you do catch it for a second time though, your symptoms tend to not be so severe. There is more information about when vaccinations are offered in the section on prevention of whooping cough.

Symptoms of whooping cough

Whooping cough symptoms usually begin between seven and 10 days after you’ve been infected (known as the catarrhal phase). 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. Because the symptoms are similar to a cold, whooping cough isn’t often diagnosed at this stage unless you’re known to have been in contact with someone who has it.

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 – it tends to be more common in young children.
  • The coughing may be worse at night or there might be a particular thing that sets it off. This might be, for example, cold temperatures or being suddenly startled by something such as an unexpected noise.
  • You might cough up thick mucus.
  • After a bad fit of coughing, you might be sick.
  • Coughing may cause your face to become flushed and you might start sweating.
  • Children might have a bluish-purplish tinge to their lips and skin, caused by lack of oxygen during 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 contact your GP as soon as possible to get the treatment you need. At the same time, whooping cough is a ‘notifiable disease’ so your GP has to tell the health protection team in the local health authority. This is so that the health protection team can let other people know if they’ve come into contact with the infection.

Diagnosis of whooping cough

Your GP will ask about your symptoms and examine you. They’ll want to know if you’ve been vaccinated 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.

  • 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 used if you are over 16 and have 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. Even if the infection is not yet confirmed, you’ll need to keep children off school or nursery until they’ve completed at least 48 hours of treatment with antibiotics. Adults should stay away from work too. There is more information about this in the section on frequently asked questions.

Treating the symptoms

There isn’t any treatment you can take that can stop your cough but it will gradually get better on its own. 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. Contact your GP if your symptoms get worse or if you think you’ve developed a complication.

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 if they become very unwell. If your baby or young child develops blueish lips or nails or appears to be struggling to breathe, phone for an ambulance and tell them it’s whooping cough.

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 of complications. These 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 to you what signs to look out for. 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 making sure they are vaccinated against 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 also protects against the following diseases: 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 be offered a pre-school booster of the whooping cough vaccine, when they’re around three years and four months old.

The vaccine is very effective at protecting against whooping cough when you first have it, but this protection gradually wears off as you get older. So, 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 between 16 and 32 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, and these antibodies 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.

Children over 10 years old and adults aren’t normally vaccinated as the disease tends to be milder when you’re older. But if your child has missed out on vaccination in babyhood, they can have the course up to the age of 10.

Antibiotics for prevention

To help prevent the spread of whooping cough, your doctor may ask people who’ve been in contact with whooping cough to take antibiotics even if they don’t have symptoms. This is most likely for:

  • babies who haven’t had all their vaccinations yet
  • older children and adults who had their vaccination more than five years ago
  • women who are more than 32 weeks pregnant and haven’t had vaccination in the last five years

Frequently asked questions

  • No, they can’t. If you think that your child has whooping cough, you should keep them home from school or nursery and speak to your GP. They’ll need to be off 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.

    Whooping cough is easily spread through droplets when an infected person coughs or sneezes. It can have serious complications for young children. Keeping your child at home prevents them spreading the infection to other children who haven’t been vaccinated.

  • 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.

    The whooping cough vaccine contains bacteria that have been killed off, so they can’t multiply and give you the disease. When you’re injected, your body starts to make antibodies to fight off the bacteria, even though they’re not alive. Young children may need several injections to produce this response. When your child is given their booster jab, their body recognises the whooping cough bacteria and makes more antibodies more quickly. If they come into contact with the whooping cough infection later, their immune system is already primed to respond.

    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 possible time.



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Related information

    • Pertussis. BMJ Best Practice. bestpractice.bmj.com, last reviewed September 2020
    • Whooping cough. Patient. patient.info, last updated September 2020
    • Whooping cough. NICE Clinical Knowledge Summary. cks.nice.org.uk, last updated June 2018
    • Pertussis (whooping cough): information for healthcare professionals. Public Health England. gov.uk, last updated December 2018
    • Pertussis: guidelines for public health management. Public Health England. gov.uk, last updated May 2018
    • Pertussis. The Green Book. Public Health England. gov.uk, last updated April 2016
    • Immunity and how vaccines work. The Green Book. Public Health England. gov.uk, last updated December 2018
    • 6-in-1 vaccine overview. NHS.UK. nhs.uk, last updated June 2019

  • Reviewed by Liz Woolf, Freelance Health Editor and Marcella McEvoy, Bupa Health Content Team, October 2020
    Expert reviewer, Dr Adrian Raby, General Practitioner
    Next review due October 2023

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