Whooping Cough

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Whooping Cough
Whooping cough, or pertussis, is a serious infectious disease which can be fatal to young babies.

It occurs when the lining of the breathing airways is infected, causing the airways swell and produce excess mucus.

Whooping cough is very rare in the UK now because all children are routinely vaccinated against it 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. Although it hasn't been completely eradicated there are much less cases of whooping cough nowadays.

Whooping cough is caused by a bacterium called bordetella pertussis which is carried in airborne droplets in the saliva of infected people. When an infected person coughs or sneezes they send out hundreds of infected droplets into the air, which is why whooping cough is so contagious. Although older people are not often harmed by the infection they can easily pass it on to young babies who might die as a result. For this reason it is important to immunise babies at the correct age to prevent them getting the infection.

Symptoms

In most cases you will start to notice symptoms about 7-10 days after being exposed to the infection. However, it can take up to three weeks to develop symptoms.

The early symptoms of whooping cough might be confused with a cold:
BulletRunny nose,
BulletDry cough
BulletHigh temperature
BulletMucus and phlegm in the nose and mouth.

A child with these symptoms is very infectious so they should be kept away from other children, especially young babies. Once they have been given antibiotics, they will infectious for five days, but after five days they can have contact with others.

Coughing attacks usually follow the cold symptoms. Often the coughing is worse during the night. The child's eyes might water and their face might go red or blue due to the coughing fits. It can become very difficult for the child to breathe and they make a whooping sound at the end of a cough as they gasp for air. This can sometimes make the child vomit. Young babies often do not make the whooping noise but are sick. You should seek medical help if your child experiences these bouts of coughing. The attacks of coughing usually last for 6-8 weeks even when antibiotics are prescribed.

Diagnosis

The best way for a GP to diagnose whooping cough in young children is to listen to their cough. Diagnosis is adults is not so easy. The doctor will probably take a swab or cells from your nose or throat to see if the pertussis bacteria is present.

A GP must inform the local authorities about any suspected case of whooping cough.

Treatment

Whooping cough can be treated with antibiotics which kill the bacteria. Coughing attacks still carry on after antibiotics are prescribed and they usually last for 6-8 weeks. You should continue to take the medication even if you still have bouts of coughing. After five days of taking the antibiotics, you won't be infection any more.

To aid the recovery process, you should ensure your child has plenty of rest, drinks lots of fluids to stay hydrated, and you should wipe away excess mucus or vomit to prevent your child from choking.

In severe cases, your child may need hospital treatment.
h2>ComplicationsGenerally, older children and adults don't experience any complications with whooping cough. Babies, especially those younger than six months, are much more likely to suffer complications.

About two thirds of babies with whooping cough have to go to hospital for treatment. Some are seriously ill and have to go into intensive care. One in 500 babies with whooping cough dies. The risk of death decreases with age.

Most babies that die as a result of whooping cough die from pneumonia or apnoea, when they temporarily stop breathing. Whooping cough can also lead to complications such as bronchiectasis (infection in the airways of the lungs) or a collapsed lung.

Extremely severe coughing can lead to bruises, nose bleeds, bleeding into the whites of the eyes (subconjunctival haemorrhage), or a hernia (when part of an organ is pushed out of position).

Coughing can prevent oxygen reaching the brain or cause parts of the brain to bleed. This can cause damage to the nervous system, and may lead to seizures, convulsions or brain damage.

Prevention

The most effective way of preventing your child from getting whooping cough is to make sure they are vaccinated when they are a baby. The jab (DtaP/IPV/Hib) is a combined injection which protects your baby against diptheria, tetanus, polio and haemophilus influenzae type b, as well as whooping cough. It is given when your baby is 2, 3 and 4 months old. A booster jab is given when they are 3-5 years old because immunity wears off after a while.

It is unlikely that your baby will suffer any side effects as a result of the vaccination, but they might have a slight fever and swelling where the needle was inserted. Babies must get immunised at such a young age because it is at this young age they are most vulnerable to whooping cough.

June 2011

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