PERTUSSIS: THE WHOOPING COUGH
Whooping cough, also known as pertussis, is a highly contagious bacterial infection of the lungs and airways that causes a characteristic cough. The most obvious symptom are attacks, or paroxysms, of intense, uncontrollable coughing followed by a large gasp of air that makes a ‘whooping’ noise. While this is relatively uncommon in the UK, thanks to the availability of the pertussis vaccine, it is still a long-lasting and potentially life-threatening infection. In this post, our doctors at LDC will teach you how to spot the signs of whooping cough, as well as some of the potential complications of the disease.
What Is Whooping Cough?
Whooping cough can affect anyone, from infants to adults. While it is more severe in young infants, who are at a higher risk of complications, it is still an extremely unpleasant condition for teenagers and adults!
Can You Catch Pertussis Twice?
You can catch the disease even if you have been had it before, although usually it isn’t as bad the second time around. You can also catch it if you have been vaccinated in the past, as it does wear off after some years.
Whooping Cough Symptoms
Whooping cough has 4 stages of infection, each with different symptoms to look out for:
Pertussis Stage 1: The Incubation Period
This is the time between the moment the disease was first caught and the start of symptoms. This is usually between 1-3 weeks, but can be over a month!
Pertussis Stage 2: The Catarrhal Stage
This follows the incubation period, and just refers to a period of early symptoms of pertussis which are very similar to the common cold:
• Sore throat
• Runny nose
• Mild fever
• Red, watery eyes
• Mild cough
These symptoms last for 1-2 weeks. As the infection is passed through the air, by coughing and sneezing, people are infectious in this period.
Pertussis Stage 3: The Paroxysmal Stage
This stage is characterised by the intense coughing fits that give the disease its name. These bouts can be very severe and quite exhausting, lasting several minutes and often bringing up thick mucus. They tend to be more frequent in the night-time.
While people with pertussis can seem healthy between the coughing attacks, the strain of such intense coughing can have a debilitating effect. During a paroxysm, the face can redden and even start bleeding slightly in the eyes or under the skin.
In adults and older children, the force of coughing is enough to break ribs in 4%. Often, the bouts are followed by vomiting. In infants below 12 months, there may not be much of a cough but instead the child may have brief periods of not breathing at all. This is called apnoea, and is an important sign that the infant should be taken to A&E.
Pertussis Stage 4: The Convalescent Stage
The paroxysmal stage can last up to 6 weeks and is followed by a convalescent stage, where the patient recovers. The coughing fits gradually lessen in severity, but there is still a higher risk than usual of contracting a separate respiratory (lung or airway) infection. This is because the pertussis infection can dampen down the body’s immune system. The recovery period will usually take a couple of weeks.
My Child Has Whooping Cough: What Should I Do?
If you are concerned that you or your child may have the signs and symptoms of whooping cough, you should make an appointment at your doctors surgery right away.
Doctors can prescribe antibiotics, which can lessen symptoms and reduce contagiousness in the first 3 weeks of the infection. If you or your child has any of the following 'red flag' symptoms, you should call 999 or go straight to A&E:
- Severe breathing difficulties
- Periods of apnoea
- The temporary stopping of breathing
- Shortness of breath
- Turning blue
- Especially seen in the lips and in the face
That said, it is important to keep in mind that most cases are not quite as severe, and can be managed by the GP with care at home.
Staying at home is an important and effective way of reducing the spread of the disease. It is especially important to keep children with whooping cough from going to nursery or school. Also, encourage them to wash their hands frequently and throw away any used tissues straightaway – the same goes for adults too!
It is important to encourage frequent hand washing
As with the cold or flu, rest and drinking lots of fluids can help, as can taking paracetamol or ibuprofen. If you have any concerns about taking care of yourself or a child with pertussis at home, you can always contact your GP for advice.
Is Pertussis Dangerous?
This disease can have some severe, even deadly, complications that particularly affect infants under the age of 1 year. About half of these children will require a hospital stay due to pertussis. The infection can spread deep into the lungs and cause pneumonia to the ears and even to the brain.
Complications are less severe and less likely in older children and adults.
Whooping Cough Vaccination
Because of the potentially life-threatening nature of this disease, it is important that children are vaccinated against the bacteria which causes whooping cough. The NHS strongly recommends a pertussis jab as part of the 5-in-1 vaccine, given at 8 weeks of age.
As children are still at risk of catching whooping cough under this age, it also recommended that mums-to-be are vaccinated against pertussis with each pregnancy. This has been shown to decrease the risk of catching the disease as a baby in the first few weeks of life by 91%.
Immunising your child against pertussis not only protects them from the risk of pneumonia or brain damage that whooping cough carries, but also prevents them from spreading it to other people who are either too young to have been vaccinated or in those old enough for the effect of the vaccine to have worn off.
The NHS strongly recommends a pertussis jab
You can find more information about the symptoms and complications of whooping cough, as well as advice on looking after a sick child, on the NHS choices website. You can also book in for an appointment with a private doctor at any of our 12 London clinics. And with the opening of our ninth private GP in Paddington this month, we hope to be even closer to you when you need to find a GP.
By Ankit Mishra