Whooping cough (Pertussis)is a highly infectious disease that is usually caused by Bordetella pertussis. This primarily affects infants and young children although it may also affect older children and adults. It can be life-threatening especially for babies.
SymptomsCoughing fits occur due to pertussis infection can last for up to 10 weeks or more; some people know this disease as the “100 day cough.”
There is an initial catarrhal stage, followed by an irritating cough that gradually becomes paroxysmal, usually within one to two weeks. The paroxysms are often followed by a characteristic ‘whoop’ or by vomiting. In young infants, the typical ‘whoop’ may never develop and coughing spasms may be followed by periods of apnoea. The illness often lasts for two to three months. In older children and adults, the disease may present as persistent cough without these classic symptoms and therefore could not be easily recognised as whooping cough.
Pertussis may be complicated by bronchopneumonia, repeated vomiting leading to weight loss, and cerebral hypoxia (inadequate supply of oxygen on the brain) with a resulting risk of brain damage. It can also lead to weight loss, incontinence, and rib fractures. Other minor complications include subconjunctival haemorrhages, epistaxis (nosebleeds), facial oedema, ulceration of the tongue or surrounding area, and suppurative otitis media.
TransmissionTransmission of the infection is by respiratory droplet, and cases are most infectious during the early catarrhal phase. The incubation period is between 6 and 20 days and cases are infectious from six days after exposure to three weeks after the onset of typical paroxysms. If the carer or parent contracts the whooping cough, it can put the infant at greater risk.
PrevalenceApproximately half of babies less than 1 year old who get pertussis need treatment in the hospital.
Severe complications and deaths occur most commonly in infants under six months of age. Pertussis in the very young is a significant cause of illness and death. The majority of hospitalisations occur in infants under six months of age, some of whom are seriously ill and require admission to paediatric intensive care units (Crowcroft et al., 2003 PHE).
VaccinationThe most effective way to prevent pertussis is through vaccination.
All vaccines containing pertussis antigens are available only as part of combined products and supplied as a single dose. The acellular vaccines are made from highly purified selected components of the Bordetella pertussis organism. They are inactivated, do not contain live organisms and cannot cause the diseases against which they protect. The vaccine is thiomersal-free.
In the UK, vaccine containing pertussis is a part of routine childhood immunisation in the UK via intramuscular followed by boosters in the pre-school years. Vaccination should be offered between gestational weeks 16 and 32 to maximise the likelihood that the baby will be protected from birth.
Due to the ongoing cases of whooping cough, it remains a threat in many places and can cause serious illness in people of all ages. In other countries such as Australia and the USA, whooping cough (pertussis) booster vaccination is generally required especially to people visiting friends and family with a newborn.