Whooping cough

Whooping cough (pertussis) is a highly infectious disease that is spread by coughing and sneezing. It’s a serious infection that causes a long coughing illness and can be life threatening.

Summary

Whooping cough can be very serious for babies and children – especially those under 1 year old. If babies catch whooping cough, they:

  • may not be able to feed or breathe properly.
  • may become so ill they need to go to hospital.
  • could end up with serious complications such as pneumonia and brain damage.
To protect your baby, get your free immunisation during pregnancy and take your baby for their free immunisations when they’re 6 weeks, 3 months and 5 months old. 

When it’s infectious

People with whooping cough are infectious from 6 days after exposure to the bacteria, when symptoms are like a normal cold, to 3 weeks after the ‘whooping’ cough begins – unless they are treated with antibiotics

Many babies catch whooping cough from their older siblings or parents – often before they’re old enough to be vaccinated.

Symptoms

The symptoms of whooping cough usually appear around a week after infection. This delay is known as the incubation period.

The first signs of whooping cough are like a cold, with a blocked or runny nose, sneezing, a mild fever and occasional cough. This is when you’re most infectious.

After about a week you or your child:

  • will have uncontrollable coughing fits that last for a few minutes and are worse at night
  • may make a ‘whoop’ sound when gasping for breath between coughing fits
  • may bring up a thick mucus that can make you vomit or choke.

When to see your doctor

See your doctor if you think you or a family member may have whooping cough, particularly if they:

  • have prolonged coughing spasms
  • turn blue while coughing
  • cough with a whooping sound
  • are un-vaccinated.

When to seek immediate medical advice

You should seek immediate medical advice if:

  • you have a baby of 6 months or younger who appears to be very ill
  • you (or your child) appear to be experiencing significant breathing difficulties such as extended periods of breathlessness
  • you (or your child) develop serious complications, such as seizures (fits) or pneumonia, an infection that causes inflammation of the tissues in your lungs

In babies whooping cough is very serious and may require hospitalisation.

Treatment

If you’ve got whooping cough, it’s important to stay away from others – especially babies, young children and pregnant women.

Whooping cough is normally treated with antibiotics at home. The antibiotics will stop you being infectious after 5 days of taking them (this can be shortened to 2 days if azithromycin is used). Try to keep away from other people during this time – keep your child home from school or preschool.

However, without antibiotics, you may still be infectious until 3 weeks after your intense bouts of coughing start

Young babies (less than 1 year old) with whooping cough may need hospital treatment to avoid developing complications.

If your child is admitted to hospital to be treated for whooping cough, they are normally put into an isolation room. This is to stop the infection spreading to other patients.

See your doctor

If you think you or a family member may have whooping cough, see your doctor as soon as possible.

Your doctor can test to see whether it is whooping cough.

  • If it is whooping cough, you may be given antibiotics. It is important that you complete the course of antibiotics to kill all the bacteria
  • Your doctor will also tell you how to care for yourself or your child at home while you’re recovering.

If whooping cough is diagnosed in the later stages, it is unlikely that you will be prescribed antibiotics as you will no longer be infectious and they will not improve your symptoms.

Self-care

If you or a family member has whooping cough, try these ideas.

  • Warm drinks may be soothing and help break the coughing spasm.
  • A humidifier in the bedroom may help (it must be cleaned every 2 or 3 days).
  • Use saline nose drops to help remove thick mucus.
  • Drink lots of clear fluids.
  • Keep away from things that trigger coughing, like cigarette smoke, perfumes or pollutants.

Call Healthline 0800 611 116 if you are unsure what you should do.

Prevention

Help stop the spread of whooping cough

  • Make sure all your children are up to date with their immunisations.
  • Keep your baby away from anyone with a cough.
  • If you have a cough yourself, stay away from babies.
  • If you’ve got a cough that won’t go away, see your doctor.

Immunisation

All babies in New Zealand can be immunised against whooping cough as part of their free childhood immunisations. New Zealand Immunisation Schedule.

It’s important to protect babies from whooping cough by getting immunised while you are pregnant, and immunising babies on time – at 6 weeks, 3 months and 5 months old. 

The vaccines used are INFANRIX- hexa, INFANRIX-IPV and Boostrix.

Booster doses are given to children when they’re 4 and 11 years old.

What if my child is behind with their vaccinations?

If your baby or child hasn’t been immunised, talk to your GP or practice nurse. They can arrange a time for your child to be immunised. It’s never too late to catch up. Whooping cough vaccine is free for all children under 18.

Who else is the vaccine recommended for?

Pregnant women should get a whooping cough booster vaccination from 16 weeks' gestation onwards. At this time, the mother can pass her immunity on to the baby, helping protect them until they are old enough to be vaccinated themselves.

At age 45, adults are eligible for combined tetanus, diphtheria and whooping cough vaccine if they have not previously received four doses of tetanus vaccine. 

At age 65, adults are eligible for combined tetanus, diphtheria and whooping cough vaccine, which will replace the existing combined tetanus and diphtheria vaccine from late August 2020 as stocks of the latter run out.  

Other adults can receive booster vaccinations for a cost. Immunisation is recommended if:

  • your work involves regular contact with infants
  • you live with or care for infants under 12 months of age – even if the baby has been fully immunised.

Boosters should also be considered for other people who are vulnerable to whooping cough and at high risk of severe illness or complications (e.g., those with chronic respiratory conditions, congenital heart disease or immunodeficiency).

How effective is the vaccine?

Around 84% of babies are protected once they’ve completed 3 doses of vaccine (at 6 weeks, and 3 and 5 months of age).

Immunising against whooping cough during pregnancy protects about 90% of babies in their first few weeks of life.

Protection wanes over time. People can get whooping cough some years later, even if they’ve been immunised or have had it before. That’s why it’s important for 4 and 11-year-olds to have booster immunisations.

Making a decision about immunisation

Risks associated with whooping cough

  • The cough may last up to 3 months.
  • It can lead to pneumonia.
  • It can lead to brain damage, convulsions and death. The risk of brain damage ranges from about one in 100 to one in 1000.

Risks associated with the vaccine

  • In some overseas trials of acellular pertussis, between 0.7 and 2.6 recipients in 10,000 had fits or ‘shock-collapse’ – neither of which cause long-term problems. These reactions have not happened in overseas trials of the vaccine now being used in New Zealand.
  • There is no association between the vaccine and sudden unexpected death in infancy (SUDI, formerly known as sudden infant death syndrome or SIDS).
  • Anaphylaxis is very rare.

Immunisation is your choice. If you have questions, talk to your midwife, doctor or practice nurse or call the free helpline 0800 IMMUNE (0800 466 863).

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