At a glance:
- Whooping cough, also known as pertussis or the 100-day cough is a bacterial infection of the upper respiratory tract
- It is caused by bordetella pertussis bacteria infecting the trachea (windpipe) and bronchi (the two large airways into the lungs)
- The disease has two major stages, a mild, common cold like stage and the paroxysmal stage typified by coughing fits
- The coughing is frequently followed by a high pitched “whoop” sound as the infected child draws in air
- Immunisation against bordetella pertussis bacteria is available to reduce the risk and severity of contracting whooping cough
What is Whooping Cough?
Whooping cough, also known as pertussis, is a highly contagious respiratory tract infection that is typified by a hacking cough followed by a “whoop” or high pitched sound while drawing breath. Although many types of infection may cause a cough, the cause of pertussis is a bacteria called Bordetella Pertussis.
The bordetella pertussis bacteria affects the airways and lungs, causing long-lasting coughing fits and difficulty breathing. The bacteria is spread through personal contact as well as when the person with whooping cough coughs or sneezes. In the past, whooping cough was a serious, life-threatening childhood disease but thankfully immunisations are now available.
Pertussis is now mostly seen in children under six months of age (too young to be immunised), unvaccinated people and adults whose immunisation has waned. People who have been immunised aren’t immune from contracting whooping cough but their chances are greatly reduced.
Whooping cough is most dangerous to small babies as their airways can be easily damaged by prolonged coughing fits. While not as serious in older children or adults it can still be quite distressing as the cough can last for a very long time. This longevity is the reason that another name for pertussis is the “100-day cough”.
If your child is having difficulty breathing or you suspect that your baby has whooping cough, seek medical attention immediately. If you’re unsure about your child’s cough, the Virtual Respiratory Clinic uses an AI diagnostic app that can help your doctor identify whether it is whooping cough.
Symptoms of Whooping Cough
Pertussis typically presents in a number of stages, getting worse before it gets better. Mild symptoms usually present around a week after initial infection and are often confused with those of the common cold. After a week or two of mild symptoms, there is typically a period of severe symptoms much more readily identifiable as whooping cough.
Early or mild whooping cough symptoms include:
- Blocked or runny nose
- Dry cough
- Fever - typically only slight
- Generally feeling sick
- Sore throat
- Watery eyes
The later stage of whooping cough is sometimes referred to as the paroxysmal stage due to the intense and prolonged bouts (paroxysms) of coughing. This coughing is often painful and uncontrollable, leaving children vomiting or gasping for air after a bout. It is at this stage that the “whoop” is often heard.
Each coughing paroxysm may last a minute or two and may occur in succession leading to a fit that lasts for a number of minutes. This coughing is often productive, bringing up thick phlegm and may be more severe at night. The paroxysmal stage of whooping cough typically lasts around 10 days to two weeks, but the cough itself may last for a longer period, even after treatment has eradicated the bacteria in the lungs.
Babies with a pertussis infection may not necessarily develop a cough at all but may experience other symptoms such as apnea (a pause in breathing), rapid breathing, difficulty feeding (due to rapid breathing or coughing) and cyanosis (a blue tinge due to lack of adequate blood oxygen).
Babies under six months of age may be at risk of severe complications from pertussis, including:
- Bacterial pneumonia
- Brain damage
- Dehydration due to difficulty drinking
- Severe breathing difficulties
- Seizures
- Weight loss due to difficulty feeding
These complications may be potentially life threatening for small babies, so hospital care should be sought.
While not life threatening, older children and adults may experience debilitating complications from whooping cough as well. These complications almost invariably come as a consequence of coughing fits and may include broken or cracked ribs, abdominal hernias, pulled back and neck muscles and burst blood vessels in the eyes.
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What Causes Whooping Cough?
Whooping cough is caused by the Bordetella pertussis bacteria entering someone's airways. The upper respiratory system is covered with tiny hair like fibres called cilia to which the bacteria attach themselves by secreting chemicals referred to as adhesins. The Bordetella pertussis bacteria then releases toxins, causing the infection and inflammation of the affected tissue.
This inflammation causes the airways to constrict, making breathing difficult and also prompts the production of mucus. The coughing fits caused by whooping cough are caused by the body trying to expel the mucus and irritants causing illness.
Bordetella pertussis is part of a family of bacteria that may cause respiratory infections, but B. pertussis is the only one that is specifically virulent to humans.
Treatment for Whooping Cough
If your child is having difficulty breathing or you suspect your baby may have whooping cough, you should seek medical attention immediately or call an ambulance on 000.
A nasal or throat swab is used to diagnose pertussis, but in some cases a chest x-ray may also be recommended to see if they also have pneumonia. Once a diagnosis has been made, treatment may begin.
If caught in the mild stage, a course of antibiotics may prevent the infection from moving into the paroxysmal stage. Antibiotics will also be prescribed if the whooping cough is treated during the paroxysmal stage. Family members of a child with whooping cough may also be prescribed prophylactic antibiotics to prevent further infection. Unfortunately there is little that can be done to medically treat the cough, as over the counter cough medicine has little to no effect and is generally advised against.
There are some steps you can take to either alleviating coughing fits or reducing the likelihood of them being frequent and protracted through basic lifestyle changes such as:
- Avoid irritants - eliminating irritants from the home that may trigger a coughing fit may help reduce symptoms during recovery from whooping cough. Irritants include tobacco smoke, wood smoke, incense, strong perfumes.
- Drink plenty of fluids - staying hydrated may soothe the throat as well as loosen the mucus in the airways making it easier to cough up. Water, soup and juice are all excellent options. Abiding dehydration is very important, so more frequent drinks of small amounts of liquid may help hydrate a child having trouble drinking due to coughing fits.
- Eat smaller meals - smaller meals may reduce the likelihood of vomiting after a coughing fit, and more frequent smaller meals may make feeding easier for a child having trouble eating due to coughing fits.
- Get plenty of rest - rest is always good for recovery.
While it’s impossible to entirely avoid possible infection, there are a number of seps a parent can take to reduce the risk of their child contracting pertussis.
- Cover your mouth and nose - covering up when you cough or sneeze can drastically reduce the chance of spreading an infection.
- Hand hygiene - washing your hands frequently and well can help stop the spread of infection.
- Immunisation - children can be immunised against pertussis. The whooping cough vaccine schedule is quite long and requires booster shots every 10 or so years after the initial schedule is complete, but it’s the most effective way to reduce the risk and severity of infection. Pregnant women are recommended to get a pertussis vaccine booster somewhere between 20 and 32 weeks pregnant