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8 October, 2008

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Whooping cough

Whooping cough (pertussis) is a serious, contagious respiratory infection caused by the bacterium Bordetella pertussis. The disease begins like a cold and then the characteristic cough develops. This cough may last for months, even after antibiotic treatment when the patient is no longer infectious. The ‘whoop’ - which is not always obvious - is due to a deep breath at the end of a bout of coughing. Vomiting after coughing is common.

Whooping cough is particularly dangerous for babies aged less than six months. They are affected more seriously by the disease and are more likely to develop complications. One in every 200 babies who contract whooping cough will die. Immunisation is the best way to prevent whooping cough.

Symptoms
Whooping cough begins like a cold. The symptoms can rapidly progress to include:

Severe cough, which occurs in bouts of coughing
Characteristic ‘whooping’ sound on inhalation
Vomiting at the end of a bout of coughing
Apnoea - the child stops breathing for periods of time and may go blue.

These symptoms may be associated with poor appetite, fatigue and dehydration. The person may appear normal between bouts of coughing. During the convalescent phase, the cough gradually decreases, but it often takes weeks to disappear.

Babies are at increased risk
In young babies less than six months of age, the symptoms can be severe or life threatening. Seek urgent medical attention if your child’s lips or skin go blue (cyanosis), or if they are having breathing difficulties associated with the coughing. Some of the complications of whooping cough in young babies include:

Haemorrhage (bleeding)
Apnoea (stopping breathing for long periods of time)
Pneumonia
Inflammation of the brain
Convulsions and coma
Permanent brain damage
Death.

How it is transmitted
The Bordetella pertussis bacterium is highly infectious. An infected person spreads the disease when they cough and sneeze. If immunisation rates are high, the risk of catching whooping cough is low.

The incubation period for whooping cough is between six and 20 days. A person is infectious for the first 21 days of their cough or until they have had five days of a 10-day course of antibiotics.

Diagnosis methods
Whooping cough should be diagnosed and treated immediately if there is a typical history of the disease. There are a number of tests, but they are not always reliable and may take weeks to become positive. Treatment should not be withheld while waiting for these results.

Treatment options
In its early stages, the symptoms of whooping cough can be reduced by taking antibiotics. Treatment will reduce the risk of passing the infection to others, if it is given in the first 21 days of the illness. Members of the patient’s family are at increased risk of acquiring the disease, and are usually prescribed erythromycin as a preventative measure, regardless of whether or not they are fully vaccinated.

Immunisation can prevent illness
In Victoria, a combined vaccine against whooping cough and other diseases is given free-of-charge to all children when they are:

Two, four and six months of age (Diphtheria, tetanus, whooping cough, hepatitis B polio and haemophilus influenzae type b (Hib)
Four years old (Diphtheria, tetanus, whooping cough and polio)
In Year 10 at secondary school. Adolescents receive a booster dose of diphtheria, tetanus and pertussis vaccine.

Children need all of these injections in order to be fully protected.

It is also recommended that new parents or adults planning a family receive a booster dose of the diphtheria, tetanus and whooping cough vaccine to protect the new baby from whooping cough in the first months of life. The vaccine for adults is not available as part of the National Immunisation Program and must be purchased privately.

Side effects of the vaccine
Immunisation prevents the child from catching whooping cough, or at least protects them from a severe bout should they become infected. Severe reactions to the vaccine are rare, and they are much less common than the effects that occur with the disease itself. Some of the mild side effects of the vaccine include:

A mild temperature
Irritability or crying. Your child may appear generally unsettled
Drowsiness or tiredness
Soreness and swelling in the area where the injection was given.

Where to get help

Your doctor
Nurse on Call Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)
Your local Maternal and Child Health centre
Immunisation Program, Department of Human Services Tel. 1300 882 008
The Maternal and Child Health Line is available 24 hours a day Tel. 132 229.

Things to remember

Whooping cough (pertussis) is a very contagious respiratory infection caused by the bacterium Bordetella pertussis.
The major symptom of whooping cough is the characteristic cough, which is often followed by a ‘whooping’ sound on inhalation.
One in every 200 babies who contract whooping cough will die.
It is possible to prevent whooping cough by immunisation.

Related topics:

You might also be interested in:
Diphtheria tetanus pertussis hep B polio and Hib vaccine - for children.
Immunisation - childhood.
Infections - bacterial and viral.

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