Whooping cough (pertussis)

Whooping cough, also called pertussis, is very easy to catch (infectious). It is a bacterial infection of the lungs and airways. It is spread in the droplets of the coughs or sneezes of someone with the infection.

It causes repeated coughing bouts.  The cough can last for 2 to 3 months or more, and can make babies and young children in particular very ill.

Immunisations can help protect your child.

Symptoms of whooping cough

The first symptoms of whooping cough are similar to those of a cold, such as a runny nose, red and watery eyes, a sore throat, and a slightly raised temperature.

Intense coughing bouts start about a week later.

The bouts usually last a few minutes at a time and tend to be more common at night.

Coughing usually brings up thick mucus and may be followed by vomiting.

Between coughs, you or your child may gasp for breath – this may cause a ‘whoop’ sound, although not everyone has this.

The strain of coughing can cause the face to become very red, and there may be some slight bleeding under the skin or in the eyes.

Young children can sometimes briefly appear blue – this often looks worse than it is and their colour should return to normal quickly. 

In very young babies, the cough may not be particularly noticeable, but there may be brief periods where they stop breathing.

The bouts will eventually start to become less severe and less frequent over time, but it may be a few months before they stop completely.

Who’s at risk of whooping cough

Whooping cough can affect people of any age, including:

  • babies and young children – young babies under 6 months of age are at a particularly increased risk of complications of whooping cough
  • older children and adults – it tends to be less serious in these cases, but can still be unpleasant and frustrating
  • people who’ve had whooping cough before – you’re not immune to whooping cough if you’ve had it before, although it tends to be less severe the second time around
  • people vaccinated against whooping cough as a child – protection from the whooping cough vaccine tends to wear off after a few years

You can get whooping cough if you come into close contact with someone with the infection.

A person with whooping cough is infectious from about 6 days after they were infected – when they just have cold-like symptoms – until three weeks after the coughing bouts start.

Antibiotic treatment does not stop the cough but can reduce the length of time someone is infectious and stop the spread.

If your child has any of the following:

  • Is under 3 months of age with a temperature more than 38°C or under 36°C  (unless fever in the 48 hours following vaccinations and no other red or amber features)
  • Breathing very fast, too breathless to talk, eat or drink
  • Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
  • Breathing that stops or pauses
  • Is pale, blue, mottled or feels unusually cold to touch
  • Difficult to wake up, very sleepy or confused
  • Weak, high-pitched cry or can’t be settled
  • Has a fit (seizure)
  • Has a rash that does not disappear with pressure (the ‘Glass Test’)

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Is 3-6 months old with a temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
  • Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
  • Temperature less than 36°C in those over 3 months
  • Breathing a bit faster than normal or working a bit harder to breathe
  • Has a cough that is particularly severe or is getting worse 
  • Dry skin, lips or tongue
  • Not had a wee or wet nappy in last 8 hours
  • Poor feeding in babies (less than half of their usual amount)
  • Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)
  • Swelling of a limb or joint
  • Not using or putting weight on an arm, leg, hand or foot
  • Complaining of severe pain that is not improving with painkillers
  • Has had chickenpox in the past few days and is now getting worse with a high fever or spreading red rash
  • Getting worse or you are worried about them

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

If your child has none of the above:

  • Watch them closely for any change and look out for any red or amber symptoms
  • If your child has any other symptoms associated with their fever, you may want to look at the information on sore throatcoughearachediarrhoea and vomiting or tummy ache or our other pathways
  • Additional advice is also available to young families for coping with crying of well babies – click here
  • If your child has a long term condition or disability and you are worried please contact your regular team or follow any plans that they have given you

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

Treatment for whooping cough

Treatment for whooping cough depends on your age and how long you’ve had the infection.

Children under 6 months who are very ill and people with severe symptoms will usually be admitted to hospital for treatment.

People diagnosed during the first 3 weeks of infection may be prescribed antibiotics to take at home. These will help stop the infection spreading to others, but may not reduce the symptoms.

People who’ve had whooping cough for more than 3 weeks won’t normally need any specific treatment, as they’re no longer contagious and antibiotics are unlikely to help.

While you’re recovering at home, it can help to get plenty of rest, drink lots of fluids, clean away mucus and sick from your or your child’s mouth, and take painkillers such as paracetamol or ibuprofen for a fever.

Avoid using cough medicines, as they’re not suitable for young children and are unlikely to be of much help.

Stopping the infection spreading

If you or your child are taking antibiotics for whooping cough, you need to be careful not to spread the infection to others.

Do

  • stay away from nursery, school or work until 48 hours after starting antibiotic treatment or, if not taking antibiotics 21 days from the start of symptoms
  • cover your or your child’s mouth and nose with a tissue when coughing and sneezing
  • dispose of used tissues immediately
  • wash your and your child’s hands regularly with soap and water

Other members of your household may also be given antibiotics and a dose of the whooping cough vaccine to stop them becoming infected.

Vaccinations for whooping cough

There are 3 routine vaccinations that can protect babies and children from whooping cough:

  • the whooping cough vaccine in pregnancy – this can protect your baby during the first few weeks of life; the best time to have it is soon after the 16th week of your pregnancy
  • the 6-in-1 vaccine – offered to babies at 8, 12 and 16 weeks of age
  • the 4-in-1 pre-school booster – offered to children by 3 years and 4 months

These vaccines don’t offer lifelong protection from whooping cough, but they can help stop children getting it when they’re young and more vulnerable to the effects of the infection.

Older children and adults aren’t routinely vaccinated, except during pregnancy or a whooping cough outbreak.

Complications of whooping cough

Babies and young children under 6 months are usually most severely affected by whooping cough.

They’re at an increased risk of:

  • dehydration
  • breathing difficulties
  • weight loss
  • pneumonia – an infection of the lungs
  • fits (seizures)
  • kidney problems
  • brain damage caused by a lack of oxygen reaching the brain
  • death – although this is very rare

Older children and adults tend to be less severely affected, although they may experience problems caused by repeated coughing, such as nosebleeds, bruised ribs or a hernia.

Where should you seek help?

Accident and Emergency

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance

NHS 111

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

GP (General Practitioner)

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

School Nurses

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

Health Visitors

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

Local Pharmacist

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Self Care

For wear and tear, minor trips and everything in between.

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

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