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Pertussis (Whooping Cough)

Introduction

There is a national outbreak of Pertussis (whooping cough) in the UK. The highest rates of infection are in infants under 3 months of age, who are also at highest risk of complications and death and are too young to be protected through routine vaccination.

There have been nine deaths in England up to 1st September last year – all in infants below the age of vaccination. The Department of Health on 27 September 2012, Department of Health website, launched a temporary national vaccination programme for all pregnant women. This will boost immunity in the pregnant woman and provide passive immunity to her unborn child.

What is whooping cough?

Whooping cough is a highly contagious bacterial infection of the lungs and airways. The medical term for whooping cough is pertussis. The condition usually begins with a persistent dry and irritating cough progressing to intense bouts of coughing. These are followed by a distinctive ‘whooping’ noise, which is how the condition gets its name

What causes whooping cough?

Whooping cough is caused by a bacterium called Bordetella pertussis. The bacterium infects the lining of the airways, mainly the windpipe (trachea) and the two airways that branch off from it to the lungs (the bronchi).When the Bordetella pertussis bacterium comes into contact with the lining of these airways, it multiplies and causes a build-up of thick mucus. It is the mucus that causes the intense bouts of coughing as your body tries to expel it.

How does whooping cough spread?

People with whooping cough are infectious from 6 days after exposure to the bacterium to 3 weeks after the ‘whooping’ cough begins. The Bordetella pertussis bacterium is carried in droplets of moisture in the air. When someone with whooping cough sneezes or coughs, they propel hundreds of infected droplets into the air. If the droplets are breathed in by someone else, the bacterium will infect their airways.

How is whooping cough diagnosed?

See your GP as soon as possible if you think you or your child may have whooping cough. Your GP will usually be able to diagnose whooping cough by asking about your symptoms and listening to the cough (the whooping cough is very distinctive).

Sometimes, your GP will need to confirm the diagnosis by taking a blood test to check for antibodies to the whooping cough bacterium

How is whooping cough treated?

If whooping cough is diagnosed during the first few weeks of the infection, your GP may prescribe a course of antibiotics to prevent the infection spreading further. Antibiotics will stop you being infectious after 5 days of taking them. However, without antibiotics, you may still be infectious until 3 weeks after your intense bouts of coughing start.

If whooping cough is not diagnosed until the later stages of the infection, your GP may not prescribe antibiotics. This is because the bacterium that causes whooping cough has already gone by this time, so you are no longer infectious. Antibiotics will make no difference to your symptoms at this stage.

What can be done to stop it spreading?

In the UK, whooping cough is now rare due to successful vaccination against the bacterium causing it. The whooping cough vaccine is given as part of the 5-in-1 vaccine  also protects against diphtheria, tetanus, polio and hib (haemophilus influenza type b).

In the UK, babies are given the 5-in-1 vaccine when they are 2, 3 and 4 months old. A pre-school booster vaccine (DTap/IPV) is also given before children start school (when they are between 3 and 5 years old). The vaccine is an inactive version of the whooping cough infection. After vaccination, the body produces antibodies against the Bordetella pertussis bacterium. These antibodies provide protection against infection.

Further general information can be found here

  • Public Health England – Whooping Cough
  • Public Health England – Immunisation for Pregnant Women
  • The Department of Health Website
  • NHS Choices Website – Whooping Cough

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