Whooping cough

Also known as: Pertussis

• Whooping cough is a very contagious bacterial disease that causes intense coughing fits and difficulty breathing.
  
• The disease gets its name because it causes people to make a “whoop” sound between bouts of coughing as they gasp for breath.
  
• Each coughing fit can last around 2–3 minutes. A patient may have whooping cough for weeks or months.
  
• Whooping cough can be dangerous in elderly adults, young children and babies. Around 50% of babies who get whooping cough will need to go to hospital. Of those hospitalised babies, 1–2 out of 100 will die.
  
• Adults and older children can also get whooping cough but it is usually much more mild.
  
• Severe cases of whooping cough can lead to further complications like pneumonia, seizures, paralysis, deafness and blindness.
  
• The best defence against whooping cough is the pertussis vaccine, which is part of the NZ Immunisation Schedule and is free.
  
• If you are going to be around young babies, be sure to check with your doctor that your vaccines are up to date.
  
• Whooping cough can have similar symptoms to COVID-19. If you have a cough, sore throat, a head cold, loss of smell or are experiencing shortness of breath, stay home and test for COVID. You can also call Healthline’s COVID-19 number: 0800 358 5453 for further advice.

• A type of bacteria known as Bordetella pertussis causes whooping cough.
  
• It attacks the lining of the nose, throat and breathing tubes (trachea and bronchi), which leads to intense coughing fits.

In adults

• Whooping cough tends to be more mild in adults and older kids, especially if they’ve had whooping cough before.
  
• Most people will experience a long-lasting cough and cold-like symptoms.

In children

Babies who are younger than 6 months won’t necessarily whoop when they cough. Their symptoms are less predictable and can worsen quickly. Look out for any of the following:

• They have a cough and are having trouble breathing properly
• They stop breathing
• They turn blue with coughing fits
• They get fatigued or floppy from coughing
• They have cold-like symptoms
• They vomit after coughing
• They aren’t feeding because they’re coughing too much
• They lose weight because of the vomiting and/or difficulty feeding
  
  

Whooping cough has 3 stages in older babies and young kids:

1. Runny nose, mild fever and sneezing – this will last 1–2 weeks.
2. A cough which gets worse over 1–2 weeks. Eventually the coughing turns into fits, where they gasp for air in-between bouts. These coughing fits may last for minutes at a time, during which their face may turn red, and they may vomit or cough up phlegm. Coughing may get worse with eating or drinking.
3. Symptoms improve during the third stage but the cough may stick around for a few weeks.

• If caught early—normally within the first 3 weeks—antibiotics may be prescribed to reduce the severity of whooping cough.
• Antibiotics can cut down the amount of time a patient is infectious. Without antibiotics a person may be contagious for 3 weeks, with them it’s more like 5 days.
• Once the cough has started, there isn’t any medicine that will stop it. Most people’s immune systems will clear out the bacteria after 3–4 weeks.
• Rest is vital to help the body fight off the infection and recover.
• Drinking plenty of water is important to help a patient to stay hydrated.
• Eating small, healthy meals is recommended.
• It’s best to avoid things that will trigger coughing like smoke, cooking spicy food, perfumes and pollutants.

Some babies, younger kids and elderly adults may need to be hospitalised if they’re having trouble breathing or drinking. They may need:

• A nasal tube to assist with oxygen
• An intravenous drip (into a vein) or nasogastric tube (through the nose or mouth into the stomach) to increase their fluid intake

Medication

• Antibiotics can be used to reduce the severity and the amount of time a person is contagious, but only if they’re taken within the first 3 weeks.
  
• Cough medicines won’t stop the coughing unfortunately, and they shouldn’t be given to kids.

Home remedies

• Sipping warm drinks may help to ease the coughing.
  
• Dry air tends to make coughing worse, so some people may find it helpful to use a humidifier which adds more moisture to the air.
  
• Saline nose drops can be helpful to clear mucous—these can be purchased from a pharmacy.

Common over-the-counter medications

• Paracetamol can be purchased over-the-counter and may provide relief if the coughing is causing pain. Always be careful to follow the dosage instructions.

Proactive protection

• The pertussis vaccine is the best defence against whooping cough. It’s part of New Zealand’s Immunisation Schedule, which requires 3 injections—1 at 6 weeks old, another at 3 months old and then the last at 5 months old. Kids will be given 2 booster injections when they are aged 4 and 11 years old.  Every one of these vaccinations is free.
  
• Over time, the protection from the vaccine lessens, so check with your doctor to see if you need a top up.
  
• It’s a good idea to get a pertussis vaccine if you are around pregnant people and babies—often whooping cough is passed on without people realising they have it.
  
• It’s perfectly safe for pregnant people to get the pertussis vaccine, in fact it can help protect your baby. Your body can pass the antibodies onto your baby through your placenta. This should prevent your baby from getting serious whooping cough until they have their vaccine
  
• Other than the vaccine, the best way to protect yourself and/or your child against whooping cough is to wash your hands thoroughly and regularly, and stay away from people who are sick

• If you or your child has symptoms of whooping cough, you should see a doctor. If it’s caught early enough, they may prescribe antibiotics.
  

Babies and young kids are most at risk of complications occurring as a result of whooping cough.

You should see a doctor if:

• Your child been in contact with someone who has whooping cough and:
  - is under 12 months old
  - was born prematurely
  - has a heart or lung condition
• Their cough lasts for a long time without breaks, or ends with them throwing up
• They’ve had a cough for longer than 2 weeks
• They’re younger than 3 months old and have a cough
  

If your child experiences any of the following, call an ambulance by dialling 111:

• They turn blue while coughing
• They stop breathing
• They have a seizure
• They become difficult to wake up
• They are floppy and lethargic
  

Whooping cough is very contagious—if you suspect you or your child have whooping cough, call ahead before going to the doctor as you will need to be separated from other patients.

Which specialist should I visit?

Paediatrician

Whooping cough can last anywhere from a few weeks to a few months. If a patient gets a cold while recovering from whooping cough, they may continue to have coughing fits for longer.