Young babies with whooping cough can become very ill and end up in hospital. They can catch whooping cough from family members so make sure you, your older children and extended family are up-to-date with immunisations.
Key points to remember about whooping cough
Watch videos of young babies affected by whooping cough. They show just how severe the disease can be.
- whooping cough causes bouts of coughing - each bout may last for 2 or 3 minutes
- young babies can go blue and stop breathing with bad coughing bouts
- the cough may go on for 3 months
- whooping cough spreads very easily from person to person
- it can cause serious illness and sometimes death in babies
- it is usually less severe in older children and adults but is still distressing for them
- immunisation reduces the risk of getting whooping cough and makes the illness less severe in those who get it
What is whooping cough?
Whooping cough is caused by a type of bacteria called Bordetella pertussis (this is why the illness is sometimes called pertussis). This bacteria damages the lining of the nose, throat and breathing tubes (trachea and bronchi) and causes the coughing. The cough can go on for weeks or months. 'Whoop' describes the sound that some children make after coughing.
Whooping cough can cause very serious illness in babies and young children. Older children usually get a less severe disease but the cough and vomiting can be very distressing. Adults may just have an irritating cough that goes on much longer than usual.
Watch a baby with whooping cough.
How do you catch whooping cough?
Whooping cough is very easy to catch. It spreads through the air in droplets, so coughing and contact with spit (saliva) pass it on. On average, each person with whooping cough passes the infection on to 12 other people.
Whooping cough is not under control in New Zealand and it is still a problem worldwide. Every 3 to 5 years there are outbreaks with several thousand people (mostly young children) affected. A significant number of babies in New Zealand end up in hospital. Whooping cough in teenagers and adults often goes unrecognised and is often under reported. Up to a third of teenagers and young adults with a long-lasting cough have evidence of recent whooping cough infection.
Parents or older children in the family with whooping cough can easily pass it on to babies who are too young to have fully completed their immunisation course.
What are the signs and symptoms of whooping cough?
Whooping cough affects children differently depending on their age. The younger your child, the greater the risk of getting very sick from whooping cough.
Babies under 6 months
Babies aged less than 6 months old do not usually whoop.
- stop breathing
- go blue with bad coughing bouts
- appear to have a cold, then cough and have difficulty breathing
- get exhausted from coughing
- not be able to feed because of coughing
- lose weight because of difficulty feeding and because the cough causes vomiting
Older babies and young children
In older babies and young children, the illness has 3 stages:
The early stage of whooping cough
It starts with a runny nose and eyes, mild fever and sneezing - just like a virus cold. This lasts 1 or 2 weeks.
The second stage
Next, there is an irritating cough. Over a week or two, the cough gets worse and your child will have bouts of coughing. They gasp for air between each bout of coughing. They get very red in the face. These spells last many minutes and they may vomit food or spit (phlegm) after the coughing. The cough often gets worse with swallowing or eating. It is very distressing for both parent and child.
The final stage
The final stage is the long recovery stage. The symptoms get less severe, but the cough continues for weeks.
Older children and adults
Older children and adults may get a less severe illness, particularly if they have had whooping cough before. But, most have a long-lasting irritating cough and some will still get a severe illness.
Whooping cough may cause a range of other problems.
How long does whooping cough last?
Whooping cough can last for weeks or months.
If your child gets an ordinary viral cold in the weeks after they have recovered from whooping cough, bouts of coughing sometimes come back for a while.
Whooping cough usually lasts for a shorter time:
- in adults
- in children who are partially immunised
- in older children if the effect of their infant immunisations is beginning to wear off
What puts my child at risk of getting whooping cough?
You can get whooping cough at any age. Severe disease and complications are most likely in:
- babies who are too young for their first immunisation
- babies who have not had all their immunisations
- in children who have a heart or lung condition, or another medical problem
How is whooping cough diagnosed?
Your family doctor will ask some questions and examine your child. Your doctor may be able to diagnose whooping cough after listening to you explain your child's symptoms. Sometimes whooping cough can be hard to diagnose.
Your doctor may take a sample of mucus ('snot') from your child's nose. Your doctor will send this to a laboratory. It can take days for a result to come back. Your doctor may also ask for a blood test.
How is whooping cough treated?
Antibiotics may help reduce the severity of the illness if started very early
Whooping cough is caused by bacteria, but antibiotics are not effective in stopping the cough once it has started. Antibiotics may help reduce the severity of the illness but only if your child has them very early in the illness. Your child needs to have them before the cough starts and, even then, may make only a small difference. If started early, antibiotics can reduce the amount of time your child is infectious to others from about 3 weeks to 5 days.
There is no medicine that will stop the cough once it has started
Your child's infection-fighting (immune) system will help get rid of the bacteria after 3 or 4 weeks without any treatment but the damage caused to the breathing tubes takes longer to repair. There is no medicine that will stop the cough once it has started. Cough medicines (cough suppressants) are not effective and may have side-effects so they are not recommended.
Sometimes your child may need to go to hospital
If your child is very young or very unwell with whooping cough, or they have any complications, they may need to stay in hospital. Sometimes whooping cough may make it hard for a young child to get enough oxygen. If your child has any signs of this, they may need to have oxygen during or after the coughing bouts.
If your young child is not drinking enough, they may need to have fluid by:
- an intravenous drip (into a vein), or
- by nasogastric feeding (feeding through a tube passed through the nose or mouth into the stomach)
How can whooping cough be prevented?
See the whooping cough immunisation page.
Close contact with whooping cough
See your doctor if your baby has had contact with whooping cough. Your child can have antibiotics if they have had close contact with someone with whooping cough (like their brother or sister). This may help prevent your child catching it.
It's very important to see your doctor if your baby has been in contact with whooping cough and they:
- are less than 1 year old
- were premature
- have a heart or lung condition
How can I care for my child with whooping cough at home?
Your child with whooping cough should stay away from people outside of the family (especially other children) for 3 weeks. This is to stop the infection spreading. If your child is taking antibiotics, this time goes down to 5 days.
If your child is taking antibiotics, make sure they take all the doses.
If the coughing is hurting your child, you can give paracetamol to make them more comfortable. You must follow the dosage instructions on the bottle. It is dangerous to give more than the recommended dose.
Your child will need rest at the beginning when the bouts of coughing are causing the most trouble.
Encourage them to drink fluids and eat healthy small meals.
What are the complications of whooping cough?
Complications of whooping cough are most likely to happen in babies and young children. Complications are less likely in older children and adults.
Serious complications include:
- stopping breathing
- lack of oxygen
- bleeding into the brain, which can cause brain damage
- weight loss as babies and young children cannot keep enough food down
Whooping cough in very young babies is unpredictable and can get worse very quickly.
Babies under 1 year of age, in hospital with whooping cough, have a 1 in 10 chance of ending up in the paediatric intensive care unit. If they end up there, they have a 1 in 6 chance of either dying or being left with brain damage or lung damage.
When should I seek help for whooping cough?
When do I need to see a doctor?
You should see your family doctor if your child:
- is less than 1 year old and they have had contact with someone with whooping cough
- has a cough that goes on for a long time without any pauses, or has a cough that ends in vomiting
- has had a daily cough that lasts longer than 2 weeks
- is less than 3 months old and has a cough
When do I need to see a doctor urgently?
You should see a doctor urgently if your child of any age:
- has breathing difficulty
- looks unwell and you are worried
When should I dial 111?
Dial 111 within New Zealand for urgent medical help (use the appropriate emergency number in other countries) if your baby:
- goes blue when coughing
- stops breathing
- has a seizure
- is becoming very sleepy and not easy to rouse