Whooping cough is a highly contagious disease caused by a small bacterial bug. This bug enters the air passages and damages the lining of the windpipe and the main air passages in the lungs. The inflamed airways produce mucus, which starts the irritating cough.
It is spread by sick people coughing onto other people, and it is highly infectious.
A few generations ago, many children used to die from whooping cough. Now, fortunately, because of vaccinations, very few children do. Although, we continue to experience epidemics of whooping cough every three to five years.
symptoms of whooping cough
Symptoms develop about 7-10 days after being exposed to the bacteria. Whooping cough usually runs in a six-week cycle in three stages, each lasting about two weeks, but it can last for up to three months.
The first stage usually produces an irritating hacking cough (worse at night), loss of appetite, sneezing and possibly a slight fever. It is highly contagious at this stage.
When the second stage begins, there are coughing spells where the sufferer has sudden attacks of an irritating cough which often ends in a 'whooping' sound as the child takes a breath in. Many young children diagnosed with whooping cough may not necessarily have the typical 'whoop'. There may be lots of mucus. Choking on the mucus can cause vomiting.
The third stage is when the coughing and vomiting starts to subside.
complications of whooping cough
Complications include ear infections and pneumonia. If your child gets whooping cough and they have not been vaccinated against it, they are more likely to develop pneumonia. Sometimes, in severe cases of whooping cough, not enough oxygen gets to the brain and can cause permanent brain damage, paralysis, deafness or blindness (this occurs in 0.1% to 0.3% of cases).
treatment of whooping cough
If you think you or your child has whooping cough symptoms, you should see your doctor as soon as possible. Some cases of whooping cough can be treated at home. Others will need to be treated at a hospital. The diagnosis is made based on the patient’s history, a doctor’s examination and special swabs taken from the back of the nostrils.
An antibiotic called erythromycin can reduce symptoms if given early enough in the illness. It also stops the patient spreading the illness.
If your child has whooping cough, they should not go to daycare, kindergarten or school until your doctor says it is safe. A child may be infectious for up to a month after the start of the cough, but if an antibiotic has been prescribed, the infectious period can be reduced to less than a week.
Caring for your child with whooping cough is hard work. Small healthy meals, fluids and steam inhalations may be useful.
prevention of whooping cough
Immunisation is the best way to prevent whooping cough. In New Zealand, all children are offered free immunisations given at six weeks old, three months, five months, fifteen months and at four to five years. The vaccine gives protection after three injections in 85% of children.
The immunisation is not normally given to children over seven years of age because whooping cough is a milder illness in older children. The vaccine can wear off later in life, which is why some adults can get whooping cough despite immunisation as a child.
Whooping cough is most severe in babies, which is why the immunisation schedule starts as young as six weeks of age. Maternal antibodies, such as those from breastfeeding, do not protect your baby from whooping cough.
The vaccine is usually given as part of a single injection that combines the vaccines against diphtheria, tetanus, and polio. A new acellular vaccine for whooping cough, which has fewer side effects than the older vaccine, has been part of the New Zealand immunisation schedule since 2000. This acellular vaccine contains only small parts of the Pertussis bacteria instead of the whole bacteria.
There can be some side-effects after immunisation. These are considered far less dangerous than the complications from whooping cough and studies show all children recover from them. Children’s pain relief medication can help reduce the side effect symptoms from the vaccine.
There are only a few groups of children, such as those with neurological problems, who should not have the vaccine. Your doctor will be able to advise you.
vaccination side effects
- local redness 1-6%
- local swelling 1-8%
- local tenderness 1-13%
- fretfulness 12-30%
- fever more than 38 deg. C 1-7%
- vomiting 7-21%
- drowsiness 20-48%
for further information
0800 immune or visit www.imac.auckland.ac.nz
Dr Catherine Cearns, General Practitioner
