What is pertussis?
Pertussis, or whooping cough, is a serious and contagious bacterial infection of the lungs and airways. It is spread easily by coughs, sneezes and close contact.
It causes serious long bursts of continuous coughing and choking, which makes it difficult to breathe. This sometimes causes a ‘whoop’ noise where there is an attempt to gasp for breath between coughing.
It is one of the most common, vaccine preventable illnesses and is extremely serious in small babies as it can cause them to stop breathing. This can be fatal.
Why is it important now?
There has been a sharp increase in the number of pertussis cases in England, Wales and Northern Ireland since the start of 2024 and cases are expected to continue to rise across the UK and Ireland.
Due to the reduction in vaccine uptake, there is a significant risk of pertussis causing serious illness in Northern Ireland.
In 2012 there was a big rise in pertussis and among those, a number of babies died. A significant proportion of those babies were infected before being old enough to receive their vaccinations, which is why vaccination in pregnancy is so important.
How do you prevent your child from getting pertussis?
The whooping cough vaccine protects babies and children from getting whooping cough. That’s why it’s important to have all the routine NHS vaccinations.
The whooping cough vaccine is routinely given as part of the 6 in 1 vaccine given to babies at 8, 12 and 16 weeks, and part of the 4 in 1 pre-school booster for children aged 3 years 4 months.
Pregnant women will also be offered the whooping cough vaccine between 16 and 32 weeks of pregnancy. This maximises the chance that your baby will be protected from birth due to the transfer of your antibodies.
The vaccines will not give lifelong protection, however they do prevent children getting it when they are younger and more susceptible to the effects of the illness.
What are the signs and symptoms?
The first symptoms of whooping cough are similar to those of a cold:
- Runny nose
- Red, watery eyes
- Sore throat
- Temperatures/ fever
Around 7 days later, intense bouts of coughing start:
- The bouts usually last a few minutes at a time and are often worse at night
- Coughing usually brings up thick mucus and can cause the child to vomit
- Between coughing bouts your child may gasp for air giving the characteristic “whoop” sound, however, not everyone will have this
- The strain of the cough may cause your child’s face to turn red and they might develop small petechiae (small bleeding points) under the skin and in the eyes
- Young children can turn blue when they have trouble breathing, this should resolve when they start breathing again
- In very small babies, the cough may not be noticeable but they may have periods where they stop breathing (apnoeas)
The bouts will eventually become less frequent and severe but may take several months to completely resolve.
What harm can pertussis cause to young babies?
People of any age can catch pertussis, however it is much more severe in small babies. This is because they have a poorly developed immune system and it is much harder to fight infections.
Whooping cough can cause:
- Temporary pauses in breathing and difficulty breathing
- Weight loss due to excessive vomiting
- Pneumonia
- Seizures and brain damage
- Encephalitis (swelling of the brain)
- Hospitalisation
- Death
What should you do if you think your child has pertussis?
Contact your GP or GP out of hours for advice if your child has:
- Symptoms of whooping cough
- A cough for longer than 3 weeks
- A cough that is particularly severe or not getting better
**Given the infective nature of pertussis it is advised to phone ahead before attending appointments to reduce the spread to other vulnerable groups.
Call 999 or attend your nearest emergency department if your child has:
- Significant difficulty breathing such as long periods of breathlessness/ choking/ shallow breathing/ periods where breathing stops or dusky blue skin
- Develops significant complications of whooping cough such as fits/ seizures/ pneumonia
What can you do to help your child if they have pertussis?
Treatment for whooping cough depends on your child’s age and how long they have had the symptoms for:
- Children under 6 months who are very ill or children with severe symptoms may be admitted to hospital for observation or breathing support
- Children within the first 3 weeks of infection will often be commenced on a course of antibiotics to be taken at home. These may not reduce the severity of symptoms, but will help to stop it spreading to others.
- Children who have had whooping cough longer than 3 weeks often won’t require antibiotics as they’re no longer contagious and antibiotics are unlikely to help
General supportive treatment for your child includes:
- Encouraging them to rest
- Encourage your child to drink lots of fluids- this should not be limited to plain water as they will require salts and sugars. Ice lollies can be a helpful way to increase this fluid intake.
- If your child has a fever, you can give them paracetamol and/ or ibuprofen to reduce their temperature and help them feel better. Ensure you check the dose for your child’s age and do not exceed the maximum daily dose of either. It can be useful to stagger the doses of paracetamol and ibuprofen 2 hours apart
- Aspirin should not be used in children
- Clean away mucous and vomit from your child’s mouth
- Avoid using cough medicines as they are not suitable in small children and are unlikely to be of any benefit
Stopping the spread of infection
If your child has been diagnosed with whooping cough, it is important not to spread this infection to others. This includes:
- Staying away from school/ nursery until 5 days from the start of antibiotic treatment or 3 weeks after the bouts of coughing started if not on antibiotics
- Covering your child’s mouth and nose with a tissue while coughing and sneezing
- Dispose of used tissues immediately
- Wash your child’s hands frequently with soap and water
Other members of the household may require antibiotics or be offered a dose of the whooping cough vaccine if they are at risk and exposed, this is to stop them becoming infected.
For further information and advice, visit the NHS website.