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Whooping Cough



Whooping cough (also known as pertussis) is a bacterial infection that causes bouts of coughing in children. It is of particular concern in very young babies who have not been immunised. Typically the child will present with bouts of coughing where there is a run of several sustained coughs followed by a large intake of air during which the characteristic “whoop” can be heard. Very young babies may not have this whoop and may instead present with spells of not breathing where a colour change may be noticed on their lips and face. Sometimes babies will be seen to vomit at the end of a bout of coughing.

Is it infectious?

Yes, whooping cough is an infectious disease which is on the increase. There has been a five fold increase in cases since 2000.

Whooping cough is divided into 3 stages:

  1. Catarrhal stage – The catarrhal stage appears similar to a viral upper respiratory infection with mild cough and coryza. Fever is uncommon,if present, it is usually low grade. The cough in whooping cough gradually increases instead of improving and the nasal secretions remains watery. This stage lasts up to 2 weeks.

2. Paroxysmal stage – During the paroxysmal stage, coughing spells increase in severity. The paroxysmal cough is distinctive: a long series of coughs one after another. The child may become blue , and appear to be struggling for breath. Sweating episodes may occur between bouts of coughing. The coughing is usually worse at night.

The whoop, or noise made by the forced inspiratory effort that follows the coughing attack , is not always present but in combination with other clinical symptoms a presumed diagnosis can usually be made before laboratory tests are available.

Even immunised children can get whooping cough although currently we are seeing children around 3 months of age who may have received only their first vaccinations presenting with whooping cough.

The paroxysmal stage may last for two to eight weeks. The coughing spells increase in frequency during the first one to two weeks, remain at the same intensity for two to three weeks, and decrease gradually thereafter.

3. Convalescent stage – During the convalescent stage, the cough subsides over several weeks to months. Studies have shown that the median duration of coughing can be over 100 days (around 4 months).

How can I prevent my child from getting whooping cough?

Immunisation is the only way of protecting your child from getting whooping cough. Immunisations are offered at 2,3 & 4 months of age. Immunisations are now also recommended for pregnant women between 28 and 38 weeks of pregnancy.

The following link gives the advice that is offered to parents from the NHS and also discusses the vaccination that is offered to pregnant women.

NHS advice

How long does the cough last?

Whooping cough used to be called the 100 day cough because of the length of time that symptoms can persist.

Is there any treatment?

Patients are usually prescribed a course of antibiotics (eg erythromycin). This serves to reduce the infectivity of the illness and therefore help reduce transmission to other children.

Please click on the symptoms and sign section to see a video of a typical baby with this condition.

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Author: Dr Tim Ubhi

Review date: December 2018