Whooping cough

Whooping cough, also called pertussis, is a highly contagious bacterial infection of the lungs and airways.

It causes repeated coughing bouts that can last for two to three months or more, and can make babies and young children in particular very ill.

Whooping cough is spread in the droplets of the coughs or sneezes of someone with the infection.

Symptoms of whooping cough

The first symptoms of whooping cough are similar to those of a cold, such as a runny nose, red and watery eyes, a sore throat, and a slightly raised temperature.

Intense coughing bouts start about a week later.

• The bouts usually last a few minutes at a time and tend to be more common at night.
• Coughing usually brings up thick mucus and may be followed by vomiting.
• Between coughs, you or your child may gasp for breath – this may cause a "whoop" sound, although not everyone has this.
• The strain of coughing can cause the face to become very red, and there may be some slight bleeding under the skin or in the eyes.
• Young children can sometimes briefly turn blue (cyanosis) if they have trouble breathing – this often looks worse than it is and their breathing should start again quickly.
• In very young babies, the cough may not be particularly noticeable, but there may be brief periods where they stop breathing.

The bouts will eventually start to become less severe and less frequent over time, but it may be a few months before they stop completely.

Who's at risk of whooping cough

Whooping cough can affect people of any age, including:

• babies and young children – young babies under six months of age are at a particularly increased risk of complications of whooping cough
• older children and adults – it tends to be less serious in these cases, but can still be unpleasant and frustrating
• people who've had whooping cough before – you're not immune to whooping cough if you've had it before, although it tends to be less severe the second time around
• people vaccinated against whooping cough as a child – protection from the whooping cough vaccine tends to wear off after a few years

You can get whooping cough if you come into close contact with someone with the infection.

A person with whooping cough is infectious from about six days after they were infected – when they just have cold-like symptoms – until three weeks after the coughing bouts start.

Antibiotic treatment can reduce the length of time someone is infectious.

When to get medical advice

See your GP or call NHS 111 if you or your child:

• have symptoms of whooping cough
• have had a cough for more than three weeks
• have a cough that is particularly severe or is getting worse

Call 999 or go to your nearest accident and emergency (A&E) department if you or your child:

• have significant breathing difficulties, such as long periods of breathlessness or choking, shallow breathing, periods where breathing stops, or dusky, blue skin 
• develop signs of serious complications of whooping cough, such as fits (seizures) or pneumonia

Treatment for whooping cough

Treatment for whooping cough depends on your age and how long you've had the infection.

• Children under six months who are very ill and people with severe symptoms will usually be admitted to hospital for treatment.
• People diagnosed during the first three weeks of infection may be prescribed antibiotics to take at home – these will help stop the infection spreading to others, but may not reduce the symptoms.
• People who've had whooping cough for more than three weeks won't normally need any specific treatment, as they're no longer contagious and antibiotics are unlikely to help.

While you're recovering at home, it can help to get plenty of rest, drink lots of fluids, clean away mucus and sick from your or your child's mouth, and take painkillers such as paracetamol or ibuprofen for a fever.

Avoid using cough medicines, as they're not suitable for young children and are unlikely to be of much help.

Stopping the infection spreading

If you or your child are taking antibiotics for whooping cough, you need to be careful not to spread the infection to others.

• Stay away from nursery, school or work until 48 hours from the start of antibiotic treatment or three weeks after the coughing bouts started (whichever is sooner).
• Cover your or your child's mouth and nose with a tissue when coughing and sneezing.
• Dispose of used tissues immediately.
• Wash your and your child's hands regularly with soap and water.

Other members of your household may also be given antibiotics and a dose of the whooping cough vaccine to stop them becoming infected.

Vaccinations for whooping cough

There are three routine vaccinations that can protect babies and children from whooping cough:

• the whooping cough vaccine in pregnancy – this can protect your baby during the first few weeks of life; the best time to have it is soon after the 20th week of your pregnancy
• the 5-in-1 vaccine – offered to babies at 8, 12 and 16 weeks of age
• the 4-in-1 pre-school booster – offered to children by 3 years and 4 months

These vaccines don't offer lifelong protection from whooping cough, but they can help stop children getting it when they're young and more vulnerable to the effects of the infection.

Older children and adults aren't routinely vaccinated, except during pregnancy or a whooping cough outbreak.

Complications of whooping cough

Babies and young children under six months are usually most severely affected by whooping cough.

They're at an increased risk of:

• dehydration
• breathing difficulties
• weight loss
• pneumonia – an infection of the lungs
• fits (seizures)
• kidney problems
• brain damage caused by a lack of oxygen reaching the brain
• death – although this is very rare

Older children and adults tend to be less severely affected, although they may experience problems caused by repeated coughing, such as nosebleeds, bruised ribs or a hernia.