Whooping cough
Whooping cough, also called pertussis, is very easy to catch (infectious). It is a bacterial infection of the lungs and airways. It is spread in the droplets of the coughs or sneezes of someone with the infection.
It causes repeated coughing bouts. The cough can last for 2 to 3 months or more, and can make babies and young children in particular very ill.
Immunisations can help protect your child. It is really important that children receive these and that you get a whopping cough vaccine if you are pregnant
Symptoms of whooping cough
- The first symptoms of whooping cough are similar to those of a cold, such as a runny nose, red and watery eyes, a sore throat, and a slightly raised temperature.
- Intense coughing bouts start about a week later.
- The bouts usually last a few minutes at a time and tend to be more common at night.
- Coughing usually brings up thick mucus and may be followed by vomiting.
- Between coughs, you or your child may gasp for breath – this may cause a ‘whoop’ sound, although not everyone has this.
- The strain of coughing can cause the face to become very red, and there may be some slight bleeding under the skin or in the eyes.
- Young children can sometimes briefly appear blue – this often looks worse than it is and their colour should return to normal quickly.
- In very young babies, the cough may not be particularly noticeable, but there may be brief periods where they stop breathing.
- The bouts will eventually start to become less severe and less frequent over time, but it may be a few months before they stop completely.
Who’s at risk of whooping cough
Whooping cough can affect people of any age, including:
- babies and young children – young babies under 6 months of age are at a particularly increased risk of complications of whooping cough
- older children and adults – it tends to be less serious in these cases, but can still be unpleasant and frustrating
- people who’ve had whooping cough before – you’re not immune to whooping cough if you’ve had it before, although it tends to be less severe the second time around
- people vaccinated against whooping cough as a child – protection from the whooping cough vaccine tends to wear off after a few years
You can get whooping cough if you come into close contact with someone with the infection.
A person with whooping cough is infectious from about 6 days after they were infected – when they just have cold-like symptoms – until three weeks after the coughing bouts start.
Antibiotic treatment does not stop the cough but can reduce the length of time someone is infectious and stop the spread.
If your child has any of the following:
- Breathing very fast, too breathless to talk, eat or drink
- Breathing that stops or pauses
- Working hard to breathe, drawing in of the muscles below the rib or noisy breathing (grunting)
- Is pale, blue, mottled or feels unusually cold to touch
- Difficult to wake up, very sleepy or confused
- Weak, high-pitched cry or can’t be settled
- Has a fit (seizure)
- Has a rash that does go away with pressure (see the 'Glass Test')
- Is under 3 months old with temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red features)
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
If your child has any of the following:
- Have a cough that is particularly severe or is getting worse
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Breathing a bit faster than normal or working a bit harder to breathe
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Dry skin, lips or tongue
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Not had a wee or wet nappy in last 8 hours
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Poor feeding in babies (less than half of their usual amount)
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Irritable (unable to settle them with toys, TV, food or hugs even after their fever has come down)
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Is 3-6 months old with temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
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Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
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Temperature less than 36°C in those over 3 months
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Getting worse or you are worried about them
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS 111 - dial 111
If your child has none of the above:
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Watch them closely for any change and look out for any red or amber symptoms
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If your child has any other symptoms associated with their fever, you may want to look at the information on sore throat, cough, earache, diarrhoea and vomiting or tummy ache or our other pathways.
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Additional advice is also available for families for help cope with crying in otherwise well babies
Self care
Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111
This guidance has been reviewed and adapted by healthcare professionals across North East and North Cumbria with consent from the Hampshire development groups.
Choose appropriate sized spacer with mask (or mouthpiece if child is over 3 years with good technique and is not significantly short of breath).
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Shake the inhaler well and remove cap.
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Fit the inhaler into the opening at the end of the spacer.
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Place mask over the child’s face or mouthpiece in their mouth ensuring a good seal
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Press the inhaler once and allow the child to take 5 slow breaths between each dose or count to 10
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Remove the inhaler and shake between every puff. Wait 1 minute between puffs.
Repeat steps 1 – 5 for subsequent doses
Plastic spacers should be washed before 1st use and every month as per manufacturer’s guidelines
Choose appropriate sized spacer with mask (or mouthpiece if child is over 3 years with good technique and is not significantly short of breath).
-
Shake the inhaler well and remove cap.
-
Fit the inhaler into the opening at the end of the spacer.
-
Place mask over the child’s face or mouthpiece in their mouth ensuring a good seal
-
Press the inhaler once and allow the child to take 5 slow breaths between each dose or count to 10
-
Remove the inhaler and shake between every puff. Wait 1 minute between puffs.
Repeat steps 1 – 5 for subsequent doses
Plastic spacers should be washed before 1st use and every month as per manufacturer’s guidelines
- Keep your child well hydrated by offering them lots to drink
- Most children with coughs and colds do not require treatment with antibiotics.
- If your child seems to be in pain or discomfort, you can give your child Paracetamol or Ibuprofen, following the instructions on the container.
- Do not give cough syrup. It is not recommended for children under 6 years. It can make children sleepy and does not help.
- Try using saline nose drops or spray if your baby has a blocked nose.
- For children over 2 years, vapour rubs (containing camphor, menthol and/or eucalyptus) may help children sleep better.
Treatment for whooping cough
Treatment for whooping cough depends on your age and how long you’ve had the infection.
Children under 6 months who are very ill and people with severe symptoms will usually be admitted to hospital for treatment.
People diagnosed during the first 3 weeks of infection may be prescribed antibiotics to take at home. These will help stop the infection spreading to others, but may not reduce the symptoms.
People who’ve had whooping cough for more than 3 weeks won’t normally need any specific treatment, as they’re no longer contagious and antibiotics are unlikely to help.
While you’re recovering at home, it can help to get plenty of rest, drink lots of fluids, clean away mucus and sick from your or your child’s mouth, and take painkillers such as paracetamol or ibuprofen for a fever.
Avoid using cough medicines, as they’re not suitable for young children and are unlikely to be of much help.
Stopping the infection spreading
- Stay away from nursery, school or work until 48 hours after starting antibiotic treatment or, if not taking antibiotics 21 days from the start of symptoms
- Cover your or your child’s mouth and nose with a tissue when coughing and sneezing
- Dispose of used tissues immediately
- Wash your and your child’s hands regularly with soap and water
- Other members of your household may also be given antibiotics and a dose of the whooping cough vaccine to stop them becoming infected.
Vaccinations for whooping cough
There are 3 routine vaccinations that can protect babies and children from whooping cough:
- the whooping cough vaccine in pregnancy – this can protect your baby during the first few weeks of life; the best time to have it is soon after the 16th week of your pregnancy
- the 6-in-1 vaccine – offered to babies at 8, 12 and 16 weeks of age
- the 4-in-1 pre-school booster – offered to children by 3 years and 4 months
These vaccines don’t offer lifelong protection from whooping cough, but they can help stop children getting it when they’re young and more vulnerable to the effects of the infection.
Older children and adults aren’t routinely vaccinated, except during pregnancy or a whooping cough outbreak.
Complications of whooping cough
Babies and young children under 6 months are usually most severely affected by whooping cough.
They’re at an increased risk of:
- dehydration
- breathing difficulties
- weight loss
- pneumonia – an infection of the lungs
- fits (seizures)
- kidney problems
- brain damage caused by a lack of oxygen reaching the brain
- death – although this is very rare
Older children and adults tend to be less severely affected, although they may experience problems caused by repeated coughing, such as nosebleeds, bruised ribs or a hernia.
Where should you seek help?
- If it is non-urgent, speak to your local pharmacist or health visitor.
- If your child has any of the above features in amber, urgently see your GP. For an urgent out-of-hours GP appointment, call NHS 111.
- You should only call 999 or go your nearest A&E department in critical or life threatening situations or if your child is showing any of the signs in the red section above.
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.
Sound advice
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.
Sound advice
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Some primary and secondary schools may have an allocated school nurse, however this can vary depending on the area – telephone your child’s school to ask for the contact details of your school nursing team.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Some primary and secondary schools may have an allocated school nurse, however this can vary depending on the area – telephone your child’s school to ask for the contact details of your school nursing team.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
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