Whooping cough

Symptoms of whooping cough 

Whooping cough can affect people of any age, but usually it affects babies and young children. It can make babies and young children very ill. 

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

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
• 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. 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 (see section on complications below)
• 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 GP out of hours service 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 emergency department if you or your child:

• have significant difficulty breathing, 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 (see section below), 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 or your child are 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
• take medication such as paracetamol or ibuprofen for a fever

 Aspirin should not be given to children under 16 years old.

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. This includes:

• staying away from nursery, school or work until five days  from the start of antibiotic treatment or three weeks after the coughing bouts started if not on antibiotics (whichever is sooner)
• covering your or your child's mouth and nose with a tissue when coughing and sneezing
• disposing of used tissues immediately
• washing 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. This is to stop them becoming infected.

Vaccinations for whooping cough 

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

Though rates have increased in recent years, whooping cough is rare in Northern Ireland (when compared to the time before the vaccine was developed) due to an effective vaccination programme.

High uptake rates of the vaccination programme are essential to keep whooping cough cases down.

These vaccines don't offer lifelong protection from whooping cough. 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.

• Immunisation for children
• Whooping cough vaccination for pregnant women

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
• difficulty breathing
• 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 not common

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.

More useful links

• How to use your health services
• Immunisation for babies up to a year old
• Immunisation for babies just after their first birthday
• Whooping cough vaccination for pregnant women