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What is whooping cough?Whooping cough, also known as pertussis, is a bacterial infection that inflames the lungs and airways. The pertussis bacteria also infect the windpipe, where they bring on a persistent, violent cough.
The name comes from the birdlike "whooping" sounds that children who have the illness typically make when they try to take a deep breath between coughs.
Babies younger than 6 months and adults may not make the typical whooping noise (VDHS 2005). It can often be hard in young babies to tell the difference between whooping cough and a regular cough from a respiratory infection.
In Australia there is an epidemic of whooping cough every three or four years and the disease is more common in spring and summer. It is estimated that 7 per cent of all cough illnesses in adults are whooping cough (VDHS 2005).
What are the symptoms of whooping cough?Whooping cough often starts with cold or flulike symptoms – sneezing, runny nose, and a mild cough, which may last up to two weeks before the more severe coughing spells begin. Your child may also have a fever, though not always.
A child with whooping cough will typically cough for 20 or 30 seconds nonstop and then struggle to breathe before the next coughing spell starts.
Listen to whooping cough with whoop:
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Listen to whooping cough without whoop:
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During coughing episodes, which seem to happen more often at night, your child's lips and nails may turn bluish from lack of oxygen. She may cough up or vomit a thick mucus.
Babies can develop apnoea as a complication of whooping cough, which means she may stop breathing for long periods. While your baby is unwell with whooping cough it is a good idea to keep her close by and watch her carefully in case she stops breathing. If your baby has any trouble breathing, call 000. If she has persistent vomiting, seizures, or signs of dehydration see your doctor or take her to your local emergency department.
This illness can be very dangerous for babies under a year old, who are especially susceptible to complications. Complications can include pneumonia, convulsions and brain damage. Pneumonia is the most common cause of death related to whooping cough and is most likely in babies. Although there were only 18 deaths caused by whooping cough between 1993-2005 in Australia, 16 of these were infants. (VDHS 2005).
If you think your baby may have whooping cough or if she has been in contact with someone with whooping cough you should see your doctor. It is possible to reduce the risks of giving whooping cough to other people by taking an early course of antibiotics.
How could my baby catch whooping cough?Whooping cough is very contagious. Your child could have gotten it from direct contact with someone infected with the bacteria or by simply breathing air infected with the germs. The bacteria usually enter the nose or throat.
It is estimated that if someone has whooping cough, 80 per cent of susceptible people who live with them will also catch the disease (ATAGI 2008). In a school or childcare centre it is likely that 50-80% of susceptible contacts will also catch the disease. Your baby is susceptible if she has not had the full course of three doses of the vaccine. You may be susceptible if your childhood vaccinations have worn off.
The incubation rate is most commonly 14 days and it is advised that children stay away from school or childcare until 21 days has passed from the first onset of coughing, or 5 days after they start taking a course of antibiotics (VDHS 2005).
How can I prevent whooping cough?Most children receive several vaccinations against whooping cough (pertussis) when they are 2 months, 4 months and 6 months old. There is a whooping cough booster vaccine given as part of the scheduled 4 year old immunisation and since 2004 it is also included in the 15 year old booster vaccination program.
Your child's protection against the disease increases with each shot she receives, so her risk of getting it will be at its lowest after she receives the forth shot of the series, at 4 years old. Even then she has a small chance of coming down with whooping cough, because the vaccine isn't 100 percent effective.
Unfortunately, it's possible for someone who's had whooping cough to get it again, although any later infection is usually much milder than the first. It is recommended that if your baby has whooping cough before she has had the full course of vaccinations, she continues the course of vaccinations.
Because babies are at risk of catching the disease before they get the full three doses of the vaccine, the government recommends that parents of newborns, grandparents and close caregivers are all vaccinated. Check with your doctor as some states and territories are offering the vaccine free for parents of newborns.
How can I treat my baby with whooping cough?It is difficult to get an accurate diagnosis of whooping cough. Your doctor will listen to your child's cough, and perhaps swab her nose to test the cells for the pertussis bacteria. If he suspects that your child has whooping cough, he won't wait for test results, though, as these can take some time. He will probably recommend an antibiotic to fight the infection and to reduce the chance that she can give the disease to other people. He may recommend that all of the child's close contacts will need to be treated with antibiotics as well.
Antibiotics can help relieve symptoms if given very early on. If given later, they may not shorten the course of the illness, but they can still remove the bacteria from your child's secretions, preventing her from spreading the infection to others. The cough typically takes six to ten weeks to subside and unfortunately there is no way to make the recovery quicker.
While your baby is recovering from whooping cough it is important to give her plenty of fluids, so she doesn't become dehydrated. Smaller more regular feeds can be helpful when babies are tired from coughing and not able to take their full feeds. If you are worried that your baby is not getting enough fluids or is lethargic you should see your doctor.
Don't give your child a cough suppressant unless your doctor recommends it. Coughing is what the body naturally does when it needs to clear the lungs of mucus. If you suppress that reaction, you may be hindering your child's ability to heal.
Cough and cold medicines are not recommended for any child younger than six years old. Cough and cold medicines that contain antihistimines, antitussives, expectorants, mucolytics or decongestents have not been proven to help children. They may actually cause harm and side effects including allergic reactions, increased heart rate, convulsions, nausea and constipation (TGA 2012).
Of course, if the cough gets worse even with antibiotics, call your doctor immediately. In serious cases, children have to be hospitalised, put on oxygen, and given intravenous fluids to avoid dehydration.
ATAGI. 2008. The Australian Immunisation Handbook 9th Edition Australian Technical Advisory Group on Immunisation. [Accessed April 2010]
TGA. 2012. Children's cough and cold medicines – TGA advice, Therapeutic Goods Administration. www.tga.gov.au
VDHS. 2005.The blue book – Guidelines for the control of infectious diseases. Victorian Department of Human Services, Communicable Diseases Section, Public Health Group. www.health.vic.gov.au [Accessed April 2010].