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Whooping cough

Whooping cough is an infection that causes a cough that can go on for weeks or months. Its medical name is pertussis. 'Whoop' describes the sound that some children make after coughing.

Whooping cough can cause very serious illness in babies and young children. Older children 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.

Parents or older children in the family with whooping cough can easily pass it on to babies who are too young to have fully completed their immunisation course. Immunisation with the pertussis vaccine is the best way to protect against whooping cough.

Who is most at risk?

Young children who have not yet completed the National Immunisation Schedule (see Whooping Cough Prevention) and children who are not immunised, or only partially immunised, are most at risk from pertussis.

On-time vaccination is the best way to protect at-risk individuals, as it:

  • protects against infection
  • reduces the number of people in the community that can transmit the bacteria.

Booster vaccinations are recommended for adults in regular contact with infants, for the following reasons:

  • The immunity given by the pertussis vaccine to whooping cough decreases with time.
  • This means that you can catch whooping cough some years later, even if you have been immunised in the past or have previously had the disease.
  • Many babies often catch it from their older siblings or parents, often before they are old enough to be fully immunised.
  • To protect children during their first year of their life, when they are most at-risk, it is recommended that adults caring for babies and older siblings are up to date with their immunisations.  

What to look for

Whooping cough affects children differently depending on their age.

Babies aged less than 6 months old do not usually whoop. They may:

  • stop breathing
  • 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.

In older babies and young children, the illness has 3 stages:

  1. It starts with a runny nose and eyes, mild fever and sneezing – just like a virus cold. This lasts 1 or 2 weeks.
  2. 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.
  3. The final stage is the long recovery stage. The symptoms get less severe, but the cough continues for weeks.

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

Whooping cough may also cause a range of other problems. 

If you think you or your child may have whooping cough, see your doctor or practice nurse as soon as possible. Usually the history and sound of the cough will make diagnosis fairly easy, but your doctor will take a nose and throat swab and send it to the laboratory to make sure of the diagnosis. The tests that detect the pertussis bacteria will only show up in the early stages of the disease.

How long is whooping cough infectious?

You may be infectious to others for up to a month after the start of the cough, but if an antibiotic has been prescribed the infectious period is reduced to less than a week. To reduce the risk of infection:

  • keep your child away from others during the infectious period to prevent infection spreading
  • take extra precautions with hygiene measures
  • if there is an outbreak of whooping cough and your child is not immunised, keep them away from their early childhood centre until the outbreak is over.

How can you look after a child with whooping cough?

Mild cases of whooping cough can be treated at home.

  • Comfort and plenty of cuddles for young children will aid in recovery.
  • Small healthy meals and fluids can be given to your child.
  • Steam in the bedroom or sitting the child on your knee in a steamy bathroom may give some temporary relief.

Make sure you and your child get as much rest as you can. Caring for your child with whooping cough is hard work, especially as the cough is often worse at night.

Prevention of whooping cough – pertussis vaccine

Immunisation is the best way of preventing whooping cough. The NZ Immunisation Schedule offers vaccination against whooping cough (pertussis vaccine) to children. The schedule consists of a course of 5 injections combined with others (for tetanus and diphtheria). It is given at ages 6 weeks, 3 months and 5 months. Booster doses are then given at ages 4 years and 11 years.

If your child is immunised against whooping cough, they are much less likely to catch it, and if they do catch it, they are less likely to be severely affected. Immunisation is effective at preventing your child dying from whooping cough, or needing to go to hospital.

Young infants are most at risk of getting very sick from whooping cough so it is important to:

  • begin immunisation at 6 weeks of age, and
  • complete the first 3 doses on time to build the maximum protection
  • be immunised during pregnancy - this helps protect young infants against whooping cough until they are old enough to be immunised themselves. The vaccine itself doesn't get passed on to your baby, but your immunity to whooping cough does

Babies are at the greatest risk until they have had their first 3 immunisations. It is important to immunise babies on time, every time and to keep them away from or people who have a cough.

Pregnant or have young children?

If you are pregnant or have young children and have not been vaccinated, ask your doctor or practice nurse about being vaccinated. This is for mothers, pregnant mothers, fathers, older children, grandparents and everyone having contact with children.

See the kidshealth.org.nz website for links to other online whooping cough resources.

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