Whooping cough

Whooping cough (also known as pertussis) is a highly infectious disease that causes bouts of coughing, and can be very serious in babies and children, especially those under 1 year old or with heart or lung conditions.

It is caused by a type of bacteria called Bordetella pertussis, which damages the lining of the nose, throat and breathing tubes and causes coughing. Pertussis is called whooping cough because of the ‘whoop’ noise some children make after coughing.

The bacteria is spread from person to person through saliva contamination (droplets of saliva being shared through talking, coughing, sneezing etc).

Whooping cough can be very serious for babies and children – especially those under 1 year old. In babies, whooping cough is very serious and may require hospitalisation.

For babies under 6 months of age (whose mother did not have the whooping cough booster vaccine during pregnancy, and who have not yet completed their first three whooping cough immunisations on the NZ Immunisation Schedule at 6 weeks, 3 months and 5 months of age), they are most likely to catch whooping cough from their mother.

Babies under 6 months old do not usually ‘whoop’. They may be unable to feed because of coughing, vomit after coughing bouts, and get exhausted. In severe cases, they may stop breathing, go blue, or become very sleepy and difficult to rouse, in which case you must dial 111 for an ambulance.

In older babies and young children, whooping cough starts with cold-like symptoms for 7-10 days before coughing begins.

Next, there is an irritating cough, which starts as a dry cough, then worsens to bouts of coughing and bringing up thick mucus (sputum/phlegm). They might gasp for air between each bout of coughing and get red in the face. These spells may last many minutes, and they may vomit afterwards. The cough often gets worse with swallowing or eating.

The final stage is the recovery period. While symptoms get less severe, the coughing and whooping sound can last for four weeks or longer.

Symptoms can include:

• not being able to feed or breathe properly
• having a runny nose
• sneezing
• a slight fever
• a mild irritating cough
• feeling generally unwell
• intense bouts of coughing, which bring up thick mucus (sputum/phlegm)
• making a ‘whoop’ sound with each sharp intake of breath after coughing
• vomiting after coughing, especially in infants and young children
• tiredness and redness in the face from the effort of coughing
• prolonged coughing spasms
• turning blue while coughing

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

People with whooping cough are most likely to be contagious (infectious), and therefore pass the infection on to others, from the week before they start coughing, up until three weeks after they start coughing.

Whooping cough is highly contagious, especially among those living in the same household who are not protected by the whooping cough vaccination.

School children and teenagers are likely to be infected by other students or friends.

Whooping cough is normally treated with antibiotics at home.

Try to keep away from other people during this time – keep your child home from daycare/kindy/preschool, school and other public places for three weeks after they have started coughing, or five days after starting antibiotics.

Adults should stay away from work or public places for the same period of time.

Without antibiotics, you may still be infectious until three weeks after your intense bouts of coughing start.

Young babies (less than 1 year old) with whooping cough may need hospital treatment to avoid developing complications, such as seizures (fits), pneumonia (an infection that causes inflammation of the tissues in your lungs), or brain damage.

Vaccination against whooping cough reduces your child’s risk of catching the disease and makes it less severe if they do catch it.

The vaccine is part of the NZ Immunisation Schedule and is given at 6 weeks, 3 months and 5 months. Two booster doses are given at ages 4 and 11.

Most cases of whooping cough in babies are passed on by family members, who can be infectious without realising. People who are around pregnant mums and babies should have a whooping cough vaccination. The protection from vaccination wanes over time, so check with your healthcare provider whether you need a booster injection.

If you have questions about the whooping cough vaccine, talk to your healthcare practitioner or call the free helpline 0800 IMMUNE (0800 466 863).