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Whooping cough (pertussis)

Whooping cough is also known as pertussis after the bacterium called Bordetella pertussis that causes it.

medref_whooping_cough_bacteria.jpg

Whooping cough is an infection of the lining of the airways, which causes a persistent hacking cough with a characteristic "whoop" noise as a child gets their breath after coughing.

The rod-shaped Bordetella pertussis bacteria (shown above in green) lodge themselves in the cilia (small hair-like structures) of the respiratory tract.

Whooping cough can spread easily to people nearby such as family members through coughing and sneezing. However, modern (acellular) vaccine is effective in preventing 80 to 85% of cases and is included in routine childhood vaccinations.

The number of cases each year is usually low. However, in the first eight months of 2012, 302 cases were reported in infants under 12 weeks of age – more than double the 115 cases reported in the same period the previous year. There were nine deaths of young children in January to August 2012 compared with seven in the whole of 2011.

Whooping cough symptoms

The initial symptoms of whooping cough may include sore throat, runny nose, raised temperature and generally feeling unwell.

These may take between six and 20 days to develop after someone is infected.

The initial symptoms can last one or two weeks before the second or paroxysmal stage sets in.

Symptoms in this stage include intensive bouts of coughing producing thick phlegm, the 'whoop' sound and vomiting (being sick) after coughing. The paroxysms may be exhausting and cause fatigue. This phase of the illness typically lasts around two weeks or longer.

Full recovery can take around three months or longer.

Whooping cough prevention

Unvaccinated babies and young children are most at risk of whooping cough, but older children, teenagers and adults can develop the condition.

Children are given vaccination against whooping cough when they are two, three and four months old, and again before they start school. It is given as part of the 5-in-1 vaccine (DTaP/IPV/Hib), which also protects against diphtheria, tetanus, polio and Hib (haemophilus influenzae type b).

Vaccination is less effective in children under four months and this age group has the highest risk of severe complications and even death.

In October 2012, women between 28 and 38 weeks of pregnancy started to be offered vaccination. The temporary programme aimed to boost the short-term immunity passed on by pregnant women to protect their unborn babies. This gives protection from birth rather than waiting for the first dose of vaccine at two months. Vaccination will be offered during routine antenatal appointments with a nurse, midwife or GP. Even if women have been vaccinated before, they are being encouraged to be vaccinated again.

In older people, whooping cough can be an unpleasant illness but doesn't usually lead to any serious complications.

Whooping cough treatment

Antibiotics are used to treat whooping cough if it is diagnosed early enough. Infants may need hospital care because of the risk of severe complications.

Corticosteroids may be given to reduce inflammation in a child's airways to help them breathe easier.

Doctors will usually recommend drinking plenty of fluids and rest.

Where possible, the person with whooping cough should be kept away from others until they are no longer infectious.

This is after they have completed a 5-day course of antibiotics or once they have had three weeks of intense bouts of coughing, whichever is sooner.

Anyone showing symptoms of whooping cough should seek medical advice.

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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on September 27, 2012

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