Whooping cough
Whooping cough, also called pertussis, is very easy to catch (infectious). It is a bacterial infection of the lungs and airways. It is spread in the droplets of the coughs or sneezes of someone with the infection.
It causes repeated coughing bouts. The cough can last for 2 to 3 months or more and can make babies and young children very ill.
Immunisations can help protect your child. It is really important that children receive these and that you get a whopping cough vaccine if you are pregnant.
Symptoms of whooping cough
- The first symptoms of whooping cough are like those of a cold, such as a runny nose, red and watery eyes, a sore throat, and a high 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 appear blue – this often looks worse than it is and their colour should return to normal 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 6 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 6 days after they were infected – when they just have cold-like symptoms – until three weeks after the coughing bouts start.
Antibiotic treatment does not stop the cough but can reduce the length of time someone is infectious and stop the spread.
Please see Red-Amber-Green tables for advice on when and where to seek care for your child.
When should you worry?
If your child has any of the following:
- Breathing very fast, too breathless to talk, eat or drink
- Breathing that stops or pauses
- Working hard to breathe, drawing in of the muscles below the rib or noisy breathing (grunting)
- Is pale, blue, mottled or feels unusually cold to touch
- Difficult to wake up, very sleepy or confused
- Weak, high-pitched cry or can’t be settled
- Has a fit (seizure)
- Has a rash that does not disappear with pressure (the glass test)
- Is under 3 months old with temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red features)
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999 - consider using ‘What 3 words’ to best describe location to ambulance service
If your child has any of the following:
- Have a cough that is particularly severe or is getting worse
- Breathing a bit faster than normal or working a bit harder to breathe
- Dry skin, lips or tongue
- Not had a wee or wet nappy in last 8 hours
- Poor feeding in babies (less than half of their usual amount)
- Irritable (unable to settle them with toys, TV, food or hugs even after their fever has come down)
- Is 3-6 months old with temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
- Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
- Temperature less than 36°C in those over 3 months
- Getting worse and I am still worried
You need to contact a doctor or nurse today.
Please contact your GP surgery or call NHS 111 - dial 111.
If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features.
If none of the above features are present
Watch them closely for any change and look out for any red or amber symptoms.
- If your child has any other symptoms associated with their fever, you may want to look at the information on sore throat, cough, earache, diarrhoea and vomiting or tummy ache or our other pathways
- Additional advice is also available to young families for coping with crying of well babies
Self care
Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111.
Advice and Guidance
Self care and Prevention
Treatment for whooping cough
- Treatment for whooping cough depends on your age and how long you’ve had the infection.
- Children under 6 months who are very ill and people with severe symptoms will usually be admitted to hospital for treatment.
- People diagnosed during the first 3 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 3 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
- Stay away from nursery, school or work until 48 hours after starting antibiotic treatment or, if not taking antibiotics 21 days from the start of symptoms.
- 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 3 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 16th week of your pregnancy
- the 6-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 6 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.
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