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Whooping cough

NHS Direct Online Health Encyclopaedia

 

Introduction

Whooping cough, also known as pertussis is a very infectious disease that can cause death in babies, especially those under six months old. For older children and adults, whooping cough is not usually serious.

Children are vaccinated against whooping cough at 2, 3 and 4 months, and again before they start school. Before the vaccine was introduced there were often over 100,000 cases per year in England and Wales, but after it was introduced in the 1950s the rate fell dramatically to about 2,000 cases a year.

However, people still get whooping cough and babies still die from it so, it is very important that children are immunised. If people do not get their babies immunised it could lead to an epidemic.

Symptoms

Symptoms can take 5-21 days to appear after infection, but in most cases they appear after 7-10 days. This is called the incubation period.

The early symptoms of whooping cough are often like a cold:

  • runny nose, 
  • dry, irritating cough, and
  • raised temperature.

There may be lots of mucus or catarrh in the nose and mouth.

After these symptoms begin, the child is very infectious for approximately two weeks and should be kept away from other children, especially babies, to stop the disease spreading. Once they have been given antibiotics they will only be infectious for five days.

As the cold symptoms start to improve, coughing attacks begin, and may be particularly bad at night. These bouts of coughing can cause the child’s face to go red and their eyes to water. Seek medical attention if your child seems very unwell or goes blue in the face.

Coughing can make it difficult for the child to breathe. They may make a ‘whooping’ sound at the end of a bout of coughing as they gasp for air - the disease gets its name from this sound. Sometimes the child will whoop then be sick (vomit) at the end of a bout of coughing. Young babies are often sick but may not whoop. If your child is repeatedly being sick they will be losing a lot of weight and may have to go into hospital for a few days.

Younger babies, particularly those under 6 months old, are most seriously affected. Older babies and children do not have such severe symptoms.In adults, the symptoms of whooping cough are normally only a dry, irritating cough that lasts for a few months.

Usually the bouts of coughing last for 6-8 weeks, even with antibiotic treatment.

Causes

Whooping cough is caused by an infection of the lining of the breathing airways.  The infection causes inflammation and swelling of these airways and makes them produce too much mucus.

The bacterium that causes whooping cough is called bordetella pertussis. It is carried in droplets of moisture in the air. When a child with the disease coughs or sneezes, they send out hundreds of infected water droplets into the air.  This is why whooping cough is so infectious.

Older children are usually not seriously affected by whooping cough, but they can spread the infection to younger babies.

Diagnosis

Your GP will usually be able to diagnose whooping cough by listening to your child’s cough. Symptoms can take 5-21 days to appear after infection (incubation period), but in most cases they appear after 7-10 days.

In adults, diagnosis is more difficult. The doctor may take a swab of cells from your throat or nose to find out whether the pertussis bacteria have caused the infection.

Your GP has to tell the local authorities about any suspected case of whooping cough.

Treatment

People with whooping cough are usually given antibiotics to kill the bacteria. Even with antibiotics, the bouts of coughing will probably last for 6-8 weeks. After about 5 days of taking antibiotics you will no longer be infectious.

If your child has mild whooping cough they should get lots of rest, drink lots of fluids and stay away from other children while they are infectious (for two weeks after the symptoms begin). Clear away any excess mucus or vomit so your child does not inhale it and choke.

If the whooping cough is more severe, your baby might have to go into hospital (see complications).

Complications

Complications of whooping cough mostly only affect babies.

About two thirds of babies with whooping cough have to go into hospital. Some are seriously ill and have to go into intensive care. One in 500 babies with whooping cough die. The risk of death is highest in younger babies.

Babies with whooping cough can develop pneumonia, bronchiectasis (pockets of infection form in the small airways of the lungs) and/or collapsed lung.  Most babies that die as a result of whooping cough die from pneumonia or apnoea (when they temporarily stop breathing).

Very severe coughing may lead to nosebleeds, bleeding into the whites of the eyes (subconjunctival heamorrage) bruises or a hernia (part of an organ is pushed out of position). The nervous system may also be affected. This is thought to be because of a lack of oxygen to the brain or small amounts of bleeding to the brain, caused by coughing. This can lead to convulsions, seizures and permanent brain damage in some.

Prevention

It is very important that babies get immunised against whooping cough.

The whooping cough vaccine is given as part of the DtaP/IPV/Hib jab that babies have at 2 months, 3 months and 4 months old. This jab protects against diptheria, tetanus, whooping cough (pertussis), polio and Hib (haemophilus influenzae type b).

A booster vaccine is given before the child starts school (between 3 years 4 months, and 5 years). This is called dTaP/IPV or DtaP/IPV.

This is an inactive version of the infection and the body produces antibodies to fight it so that you are then immune to it. Immunity wears off after a while, so children have a booster jab before they start school.

The reason that babies are given these jabs when they are so young is because young babies are most seriously affected by diseases such as whooping cough. The jabs are very safe and it is unlikely your baby will have any side effects. If they do have side effects they may include irritability, a fever and slight swelling where the needle went in.

Speak to your GP for advice if your child immunised has a problem with their immune system. Babies with mild coughs or colds can still have the jab.

© Queen's Printer and Controller of HMSO, 2005

Crown copyright material is reproduced with the permission of the controller of HMSO and the Queens Printer for Scotland

 

 

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