Whooping cough (Pertussis)

About whooping cough

Whooping cough, also known as pertussis, is a serious and highly contagious respiratory infection caused by the bacterium Bordetella pertussis. The disease usually begins like the common cold but progresses to prolonged bouts of coughing. This cough may last up to 3 months, even after antibiotic treatment is completed and the person is no longer infectious.

The name 'whooping cough' comes from the sound that is sometimes made when a person gasps for a deep breath at the end of a bout of coughing. Vomiting after coughing is common.

Whooping cough is particularly dangerous for babies less than 6 months of age. They are too young to be fully immunised, have more serious illness, and are more likely to develop complications.

Older children and adults who have not received a recent whooping cough vaccination are also at risk of infection. They may have milder symptoms and unknowingly spread the infection to infants.

In Australia, cases of whooping cough tend to increase every few years. There is an increased risk of spread to infants and other community members during such times.

Immunisation is the best way to reduce the risk of whooping cough.

Symptoms of whooping cough

Whooping cough begins with symptoms similar to those of a cold such as a cough, tiredness, blocked or runny nose and low-grade fevers, which may last for one to 2 weeks. After these symptoms, the cough usually worsens to include:

• severe cough that can occur in bouts
• characteristic 'whooping' sound on breathing
• vomiting at the end of a bout of coughing
• apnoea – the child stops breathing for periods of time and may go blue.

Other symptoms may include poor appetite, fatigue and dehydration. People may appear well between bouts of coughing. During the recovery period, the cough gradually decreases but can last up to 3 months.

Babies under 6 months may not cough at all, instead they may stop breathing and turn blue, or have difficulties feeding and can choke or gag. In adolescence and adults, whooping cough may present as a non-specific persistent cough.

Complications of whooping cough

Whooping cough is most serious in babies. Young babies less than 6 months of age can have severe or life threatening illness.

Some of the complications of whooping cough in young babies include:

• apnoea (stopping breathing for periods of time)
• dehydration from poor feeding
• middle-ear infections
• pneumonia (chest infection)
• inflammation of the brain
• seizures (fits) and coma
• permanent brain damage
• death.

Spread of whooping cough

Whooping cough is highly contagious. It is spread when a person breathes in the bacteria that has been coughed or sneezed into the air by an infectious person.

People usually develop symptoms between 4 to 21 days after being exposed.

People with whooping cough are infectious from the onset of their first cold symptoms, until 21 days after the onset of cough or until they have completed 5 days of appropriate antibiotic treatment.

People at risk of whooping cough

Anyone can get whooping cough. People living in the same household as someone with whooping cough are at risk of infection.

Babies less than 6 months of age are at greatest risk of severe disease, hospitalisation, and death. These infants are too young to be fully immunised. Many babies who get whooping cough become infected from older children and adults who might not even know they are infected.

Prevention of whooping cough

Immunisation against whooping cough

Immunisation is a safe and effective way to protect you from serious disease caused by whooping cough.

Whooping cough (pertussis) vaccines provide good protection from infection but immunity fades, which means that additional doses (boosters) are recommended.

Whooping cough (pertussis)-containing vaccines are only available in Australia as combination vaccines that protect against other diseases such as diphtheria and tetanus

Free whooping cough (pertussis)-containing vaccine is available for the following people under the National Immunisation Program:

• children at 2 months (from 6 weeks), 4 months, 6 months, 18 months and 4 years
• adolescents in Year 7 at secondary school (or age equivalent)
• pregnant women from 20 weeks gestation (ideally between 20 and 32 weeks) during every pregnancy.

Free catch-up immunisations are also available for eligible people who have not been fully vaccinated, including:

• people under 20 years of age
• people aged 25 years and under who have missed human papillomavirus (HPV) vaccination
• refugees and humanitarian entrants of any age.

If you are not sure whether you are eligible for free whooping cough (pertussis)-containing vaccine, ask your immunisation provider.

Adult immunisation against whooping cough

Immunisation against whooping cough is also recommended for the following adults if they have not received a whooping cough (pertussis)-containing vaccine in the last 10 years:

• parents, guardians and carers of infants less than 6 months of age
• people aged 65 and older
• travellers (recommendations may vary depending on travel destination).

Booster dose

A booster dose of whooping cough (pertussis)-containing vaccine is also recommended for the following people every 10 years:

• all adults working with infants and young children less than 4 years of age
• all healthcare workers.

Pregnancy and whooping cough immunisation

Pregnant women should be vaccinated for pertussis during each pregnancy, preferably between 20 and 32 weeks gestation.

If pregnant women are not vaccinated between 20 and 32 weeks, they should receive whooping cough (pertussis)-containing vaccine as soon as possible and at any time up to delivery. If the vaccine is given within 2 weeks of delivery, the newborn may not be adequately protected.

Vaccination of pregnant women before delivery has been reported to reduce pertussis disease in infants by 80% to 91%.

Read more about protecting your baby from whooping cough.

If you would like more information, ask your immunisation provider.

Immunisation and HALO

The immunisations you may need are decided by your health, age, lifestyle and occupation. Together, these factors are referred to as HALO.

Talk to your doctor or immunisation provider if you think you or someone in your care has health, age, lifestyle or occupation factors that could mean immunisation is necessary. You can check your immunisation HALO using the Immunisation for Life infographic.

Diagnosis of whooping cough

People with symptoms of whooping cough should seek prompt medical care from their GP (doctor) or hospital. Call an ambulance immediately if you or your child have difficulty breathing or if their lips start turning blue.

Whooping cough is diagnosed based on symptoms, physical examination and medical history (including immunisation status). The diagnosis is confirmed by tests such as a nose and throat swab or blood tests.

Treatment of whooping cough

Antibiotic treatment can help prevent spread of infection to other people and reduce the severity of symptoms if started early in the illness.

Some babies may need treatment in hospital.

People with whooping cough should:

• get plenty of rest
• drink plenty of water or other fluids to stay hydrated – small sips may be easier to manage between bouts of coughing
• avoid cigarette smoke.

People with whooping cough should limit their contact with infants and women in the last month of pregnancy.

Public health response to whooping cough

People with whooping cough

People with whooping cough are usually infectious from the onset of first cold-like symptoms until 21 days after cough symptoms, or until 5 days of appropriate antibiotic treatment has been completed.

People with whooping cough should limit their exposure to others, particularly babies and pregnant women, while they are infectious.

Infants and children diagnosed with whooping cough must not attend childcare services or primary school for 21 days after the onset of cough, or until they have received 5 days of appropriate antibiotic treatment.

People who have been exposed to whooping cough

Preventive antibiotics may be recommended for some people who are exposed to whooping cough and have close contact with babies under 6 months of age or women in the last month of pregnancy. This may include household, childcare and healthcare settings. Preventive antibiotics are usually recommended even if the exposed person is fully immunised against whooping cough (pertussis).

Children aged less than 7 years old who are not vaccinated against whooping cough and were in the same room as someone with pertussis while they were infectious must not attend children's services and primary school. They must not attend for 14 days from the last contact with the case or until the exposed child has received 5 days of appropriate antibiotic treatment.

Where to get help

• In an emergency, always call triple zero (000)
• Your GP (doctor)
• Emergency department of your nearest hospital
• Victorian Virtual Emergency Department
• Your local government immunisation service
• Maternal and Child Health Line (24 hours) Tel. 132 229
• NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• Immunisation Program, Department of Health, Victorian Government
• National Immunisation Information Line Tel. 1800 671 811
• Pharmacist