Whooping cough: what is it and why is it on the rise?

1. The catarrhal/early phase

In the early stage, symptoms include a runny nose, sore throat and a mild cough, and a fever can occur, meaning that it is similar to lots of cough/colds.

2. The paroxysmal, or coughing phase.

This is where symptoms begin to differ from other cough/cold infections, which tend to improve after a few days.

With whooping cough, although sneezing, runny nose and fever improve, after about 1-2 weeks the cough begins to get worse leading to intense bouts, or paroxysms, of coughing. Your child can have many many bouts of coughing each day, and this phase can last a couple of weeks or more.

A bout of coughing means that your child is coughing and coughing, multiple times in a short period. Each cough involves exhaling, and in about half of cases, as your child tries to breathe in there is often a whooping sound. During a coughing bout, you might see your child going red in the face, during the minute or so of the paroxysm.

They might have lots of bouts one after the other, or may also cough up thick mucus and/or vomit after coughing episodes. Then in between bouts, they may be back to normal, running around and playing!

3. The convalescent, or easing phase

The cough of the whooping cough infection can last up to three months, hence the name 100-day cough. But in this last phase, the paroxysms of coughing gradually ease, becoming less frequent each day.

What should you do if you suspect your baby or child has whooping cough?

If you are concerned that you or your child has whooping cough, then please contact your doctor.

A swab can be taken from the back of the nose for whooping cough, but the results can take some time to come back, so if your symptoms sound typical of whooping cough, you may be given treatment with antibiotics while waiting for the swab results.

If your child isn’t seen for the first few weeks, the swab may well come back negative as the bacteria may no longer be in the body but the results of the infection in terms of the cough, can take much longer to go away. Sometimes a blood test is then used to confirm the diagnosis.

If your baby is under 6 months old, if your child is getting worse or not improving, or if you are pregnant and think you either have whooping cough or have been in contact with someone who has it, please see your GP or phone 111 urgently.

Why is whooping cough seeing a resurgence at the moment?

Whooping cough has been on the rise this year with almost 8,000 cases confirmed between January and May 2024, which sadly include 9 infant deaths.

Whooping cough seems to be a cyclical infection, in that there are peaks of infection every 3 to 5 years. The last peak seen in the UK was in 2016, so we are overdue for a peak of infection and it is thought that the pandemic may have delayed this, as we all restricted and changed our behaviours.

Although we have an immunisation against whooping cough, not everyone takes the vaccines, including pregnant women. In fact, only just under 60% of pregnant women had the vaccine in March 2024, compared with over 70% in the same month in 2017.¹

Is whooping cough more dangerous for babies and children than adults?

The cough of whooping cough is miserable, with children often vomiting after coughing. Most people will get better, in time, but some may develop complications, which are more common in babies under 12 months old.

Complications include pneumonia as well as painful ribs and even a hernia from the raised pressure in the tummy during coughing.

Dehydration can occur and can be fatal, from not drinking due to coughing and vomiting, if your child stops urinating, or if the urine appears very concentrated and in small amounts, if they appear to be more unwell, difficult to rouse or you have concerns please seek urgent medical help.

A medical emergency that can occur is a pneumothorax, which is a collapsed lung. If your child appears more unwell, if they are having difficulty breathing, are breathing extremely rapidly, appear blue/grey around the mouth or face, have a seizure or stop breathing phone 999.

How can parents protect themselves and their children against whooping cough? Can you still get it if you are vaccinated?

The old saying prevention is better than cure remains true and there is a vaccine against whooping cough. This is routinely offered as part of the 6-in-1 vaccine which is given to children aged 2 and 3 years and 4 months old before a booster dose at the pre-school boosters appointment, which are given between ages 3 years 4 months and age 5.

In addition to this, if you are pregnant you will be offered a whooping cough vaccine. This is actually to try and protect your baby before they are old enough to get their vaccines. Please see our feature about whooping cough vaccinations for more information.

If you have been in contact with someone who has had whooping cough then you may be eligible for antibiotics to try and prevent you from getting the condition. These are often given to babies under 6 months old as they are more likely to develop complications.

No vaccine is 100% effective, but giving the whooping cough vaccine to women during pregnancy is 90% effective in preventing whooping cough in babies under 3 months old.²

What is used to treat whooping cough? Is there anything parents can give children at home if it’s a mild case?

Whooping cough is treated with antibiotics. Make sure that your child stays hydrated, so give plenty of fluids and if they are uncomfortable/unwell with a fever then paracetamol or ibuprofen can be given. As always if you have concerns please seek medical advice.

How long does whooping cough last and how long are you contagious?

While the symptoms of whooping cough can last approximately three months, it is most contagious for the first three weeks of the infection and is spread by breathing in droplets containing the bacteria in the air, from coughs and sneezes etc.

If your child has whooping cough, you will be advised to keep your child at home/off school for 2 days after starting antibiotics for whooping cough, or for 2 weeks after symptoms start if antibiotics are not used.

If you don’t use antibiotics, even if you are still coughing, after 14 days children can go back to school. Sticking to these rules helps prevent the spread of the infection.

And remember, it is never too late to be vaccinated against conditions like whooping cough if you did not give your little ones the vaccines when they were babies, please contact your GP for more information.

Please note: this advice is not personalised or meant to replace individual advice given to you about your child by your doctor or medical team. As always, if you are concerned about your child’s health then please seek medical advice.

References:

<sup>1. UKHSA encourages timely vaccination as whooping cough cases rise, gov.uk
2. Pertussis (whooping cough) vaccination programme for pregnant women: information for healthcare practitioners, gov.uk</sup>

Read more:

• Is the combined whooping cough vaccination safe when pregnant?
• Kids' coughs - when to take your child to the doctors
• What to expect after your baby's had injections