Whooping cough is a respiratory infection (infection of the lungs) which causes long bursts of coughing. The infection is caused by a bacteria calledBordetella pertussis. Pertussis is another name for whooping cough.

Whooping cough infection is widespread in the community and in some years can occur at an epidemic rate. Since late 2008 the number of notifications and hospitalisations of infants with whooping cough has continued to rise.

Whooping cough is very easy to catch. It is spread by tiny drops of fluid when coughing and sneezing. It can also be spread on hands to the nose if the hands have come in contact with the bacteria.

Seventy percent to 100% of people living in the same house as a person with whooping cough are usually infected.

It is particularly serious in babies under 6 months of age. They will usually need to be admitted to hospital. Children and adults can also get it. Most children and adults do not need to be hospitalised with whooping cough, but may cough for many weeks.

There is an immunisation for whooping cough. Children who have been immunised can still get whooping cough but it is usually not so serious.

Signs and symptoms

• Whooping cough usually starts with symptoms like a cold, such as a runny nose and dry cough, which last for about one week.
• After that, a more definite cough develops, which may last for many weeks. The cough comes in long spells and often ends with a high pitched ‘whoop’ sound when they breathe in.
• Some children cough so much they vomit afterwards.
• Children are usually well between coughing spells.
• In more severe cases, babies and children may have problems catching their breath after a coughing spasm.
• Other infections such as pneumonia (chest infection) and middle ear infections are common.
• Very young babies under six months of age may have pauses in breathing (called apnoeas) instead of a cough.

How is it diagnosed?

• Your doctor will often decide if your child has whooping cough by asking you questions about their cough or by actually seeing one of the coughing spasms.
• Tests of secretions from the nose and blood tests can sometimes be helpful in confirming the diagnosis. However, the germ (organism) may not be detected if your child has had a cough for 3 weeks or more, or if they were started on antibiotics before the sample was taken.

Treatment

The type of treatment depends on many things including:

• the age of your child
• how severe the symptoms are
• how long your child has had the symptoms

As whooping cough is most severe in young babies, they are more likely to be admitted to hospital to be watched closely. Older children who are quite unwell also usually need to stay in hospital. The time it takes to get better is different for each child.

Antibiotics

Your doctor may prescribe antibiotics for your child, but these are not always necessary. Treatment with antibiotics reduces the amount of time your child is infectious (to 5 days or less). If your child has been coughing for more than 3 weeks, they are no longer infectious. In these cases, antibiotics are not usually needed.

Going to school

Your child should not attend school or day-care:

• for 3 weeks from the start of the cough, if no antibiotics are given
• until they have had at least five days of their course of antibiotics.

If there is an outbreak of whooping cough and your child is not immunised, then they will have to stay away from kindergarten or school for three weeks or until the outbreak settles.

Treatment of contacts

• Whooping cough is easily spread. Often other family members or close contacts also have the infection.
• Whooping cough is infectious just before and for three weeks after the start of the cough. If your child is given antibiotics, they can still spread the infection until they have had five days of antibiotics.
• Antibiotics should be given to anyone living in the same house or who has had very close contact with your child while your child was infectious. These include women in the last month of pregnancy and babies less than a month of age.

Prevention

• Previous infection with whooping cough does not provide lifelong immunity.
• Immunisation is the best way to control whooping cough.
• Whooping cough vaccine is recommended to all children at 2, 4, 6 months and at 4 years. An adult pertussis booster dose is then given at 15-16years (Year 10 at high school).
• All infants less than 6 months are at-risk of catching life threatening pertussis because they have not completed the 3 dose primary vaccine course. This risk period is prolonged if the 6 month vaccines are not given on time or the child is not immunised.
• Vaccination is effective after the primary schedule but the protection stops five years after the booster doses.
• A booster dose of adult whooping cough vaccine is recommended for all parents of infants, however it is not funded.  Grandparents and other carers in contact with children less than 6 months old should also have and buy an adult pertussis booster. The vaccine costs approximately $40.  Every adult is susceptible to whooping cough infection unless they have had a recent pertussis booster or proven pertussis infection. They are also the ones most likely to spread infection to the vulnerable population under 6 months who are not yet fully vaccinated.
• Mothers should have an adult pertussis booster very soon after their baby is born. It is safe to have it while breastfeeding.
• To further protect young babies, the 2 month vaccines can be given from 6 weeks and the 4 year old booster can be given from 3 ½ years.
• All parents with children aged under 8 years should check their child’s immunisations are up to date and ask their doctor to catch up on any missed doses.
• If your child has been in contact with whooping cough they may need an antibiotic to protect them. You should talk to your doctor about this.
• By law, doctors treating patients with suspected or confirmed whooping cough must notify the Department of Human Services (The Health Department). The Health Department keeps a record of how many children have the infection each year.

Care at Home

• Give your child small frequent meals and fluids often (such as sips of water or smaller feeds but more often).
• Taking care of a child with whooping cough can be stressful. Ask for help from family and friends so that you can catch up with sleep.
• Try to keep your home free of irritants such as cigarette smoke.

Key points to remember

• Whooping cough is especially dangerous in babies under 6 months of age. If a child aged under six months gets whooping cough, they will usually need to be admitted to hospital.
• Whooping cough is easily spread and often other family members or close contacts are infected.
• Whooping cough can be prevented by the routine childhood vaccination course and by vaccinating adults who are in contact with young babies.