Whooping Cough

Key points about whooping cough

• whooping cough causes episodes of coughing - each episode may last for 2 or 3 minutes
• young pēpi can go blue and stop breathing when coughing
• the cough may go on for 3 months
• whooping cough spreads very easily from person to person
• it can cause serious illness and sometimes death in pēpi

Having whooping cough immunisation in pregnancy protects pēpi in their first weeks of life. Start immunising pēpi the day they turn 6 weeks old to keep protecting them.

What is whooping cough?

Whooping cough is caused by a bacteria called Bordetella pertussis. This is why the illness is sometimes called pertussis. This bacteria damages the lining of the nose, throat and breathing passages (trachea and bronchi) and causes the coughing. The cough can go on for weeks or months. 'Whoop' describes the sound that some tamariki make after coughing.

Listen to the sounds of tamariki with whooping cough

Whooping cough can cause very serious illness in pēpi and young tamariki. Older tamariki usually get a less severe disease but the cough and vomiting can be very distressing. Adults may just have an irritating cough that goes on much longer than usual.

Watch some videos to see just how severe the disease can be.

Watch videos of young pēpi affected by whooping cough

How do you catch whooping cough?

Whooping cough is very easy to catch. It spreads through the air in droplets, so coughing, sneezing and contact with spit (saliva) pass it on. On average, each person with whooping cough passes the infection on to 12 other people.

Whooping cough is not under control in Aotearoa New Zealand and it is still a problem worldwide. Every 3 to 5 years there are outbreaks with several thousand people (mostly young children) affected. A significant number of pēpi in Aotearoa end up in hospital. Whooping cough in teenagers and adults often goes unrecognised and is often under reported. Up to a third of teenagers and young adults with a long-lasting cough have evidence of recent whooping cough infection.

Parents or older children in the family with whooping cough can easily pass it on to pēpi who are too young to have fully completed their immunisation course.

What are the signs and symptoms of whooping cough?

Whooping cough affects tamariki differently depending on their age. The younger your child, the greater the risk of getting very sick from whooping cough.

Pēpi under 6 months

Pēpi aged less than 6 months old do not usually whoop.

They may:

• stop breathing
• go blue with bad coughing spasms
• appear to have a cold, then cough and have difficulty breathing
• get exhausted from coughing
• not be able to feed because of coughing
• lose weight because of difficulty feeding and because the cough causes vomiting

Older pēpi and young tamariki

In older pēpi and young tamariki, the illness has 3 stages.

The early stage of whooping cough

It starts with a runny nose and eyes, mild fever and sneezing - just like with a cold. This lasts 1 or 2 weeks.

The second stage

Next, there is an irritating cough. Over a week or two, the cough gets worse and your child will have bouts of coughing. They gasp for air between each bout of coughing. They get very red in the face. These spells last many minutes and they may vomit food or spit (phlegm) after the coughing. The cough often gets worse with swallowing or eating. It is very distressing for both parent and child.

The final stage

The final stage is the long recovery stage. The symptoms get less severe, but the cough continues for weeks.

Watch 2 videos of young children with whooping cough

You can also hear audio of what whooping cough can sound like in a child at the Babycentre website.

Older tamariki and adults

Older tamariki and adults may get a less severe illness, particularly if they have had whooping cough before. But, most have a long-lasting irritating cough and some will still get a severe illness.

Whooping cough may cause a range of other problems.

How long does whooping cough last?

Whooping cough can last for weeks or months.

If your child gets an ordinary cold in the weeks after they have recovered from whooping cough, episodes of coughing sometimes come back for a while.

Whooping cough usually lasts for a shorter time:

• in adults
• in tamariki who are partially immunised 
• in older tamariki if the effect of their infant immunisations is beginning to wear off

What puts tamariki at risk of getting whooping cough?

You can get whooping cough at any age. Severe disease and complications are most likely in:

• pēpi who are too young for their first immunisation 
• pēpi who have not had all their immunisations 
• tamariki who have a heart or lung condition, or another medical problem

How is whooping cough diagnosed?

Your family doctor will ask some questions and examine your child. Your doctor may be able to diagnose whooping cough after listening to you explain your child's symptoms. Sometimes whooping cough can be hard to diagnose.

Your doctor may take a sample of mucus ('snot') from your child's nose. Your doctor will send this to a laboratory. It can take days for a result to come back. Your doctor may also ask for a blood test.

How is whooping cough treated?

Antibiotics may help reduce the severity of the illness if started very early 

Whooping cough is caused by bacteria, but antibiotics are not effective in stopping the cough once it has started. Antibiotics may help reduce the severity of the illness but only if your child has them very early in the illness. Your child needs to have them before the cough starts and, even then, may make only a small difference. If started early, antibiotics can reduce the amount of time your child is infectious to others from about 3 weeks to 5 days.

There is no medicine that will stop the cough once it has started

Your child's infection-fighting (immune) system will help get rid of the bacteria after 3 or 4 weeks without any treatment but the damage caused to the breathing tubes takes longer to repair. There is no medicine that will stop the cough once it has started. Cough medicines (cough suppressants) are not effective and may have side-effects so they are not recommended.

Sometimes your child may need to go to hospital

If your child is very young or very unwell with whooping cough, or they have any complications, they may need to stay in hospital. Sometimes whooping cough may make it hard for a young child to get enough oxygen. If your child has any signs of this, they may need to have oxygen during or after the coughing bouts. 

If your young child is not drinking enough, they may need to have fluid by:

• an intravenous drip (into a vein), or
• by nasogastric feeding (feeding through a tube passed through the nose or mouth into the stomach)

How can whooping cough be prevented?

Immunisation

Find out about whooping cough immunisation

What to do if pēpi has had close contact with whooping cough

See your doctor if pēpi has had contact with whooping cough. Your child can have antibiotics if they have had close contact with someone with whooping cough (like their brother or sister). This may help prevent your child catching it.

It's very important to see your doctor if pēpi has been in contact with whooping cough and they:

• are less than 1 year old
• were premature
• have a heart or lung condition

How can I care for my child with whooping cough at home?

Your child with whooping cough should stay away from people outside of the family (especially other children) for 3 weeks. This is to stop the infection spreading. If your child is taking antibiotics, this time goes down to 5 days.

If your child is taking antibiotics, make sure they take all the doses.

If the coughing is hurting your child, you can give paracetamol to make them more comfortable. You must follow the dosage instructions on the bottle. It is dangerous to give more than the recommended dose.

Your child will need rest at the beginning when the bouts of coughing are causing the most trouble.

Encourage them to drink fluids and eat healthy small meals.

When should I seek help for whooping cough?

When do I need to see a doctor?

You should see your family doctor if your child:

• is less than 1 year old and they have had contact with someone with whooping cough
• has a cough that goes on for a long time without any pauses, or has a cough that ends in vomiting
• has had a daily cough that lasts longer than 2 weeks
• is less than 3 months old and has a cough

When do I need to see a doctor urgently?

You should see a doctor urgently if your child of any age:

• has breathing difficulty
• looks unwell and you are worried

When should I dial 111?

Dial 111 within New Zealand for urgent medical help (use the appropriate emergency number in other countries) if your baby:

• goes blue when coughing
• stops breathing
• has a seizure
• is becoming very sleepy and not easy to rouse

What are the complications of whooping cough?

Complications of whooping cough are most likely to happen in babies and young children. Complications are less likely in older children and adults.

Serious complications include:

• stopping breathing
• lack of oxygen
• pneumonia
• seizures
• bleeding into the brain, which can cause brain damage
• weight loss as babies and young children cannot keep enough food down

Whooping cough in very young babies is unpredictable and can get worse very quickly.

Babies under 1 year of age, in hospital with whooping cough, have a 1 in 10 chance of ending up in the paediatric intensive care unit. If they end up there, they have a 1 in 6 chance of either dying or being left with brain damage or lung damage.