Summary of symptoms in children over 1 year, teens and adults

Whooping cough sometimes starts with  a bit of a cold and mild feverishness. More often it is just a sore throat and a bit of a tickly cough.

After about 7 to 10 days the cough starts coming in spasms of continuous coughing that may last several minutes.

These paroxysms of coughing usually occur every few hours and there may be little or no coughing between the attacks.

The attacks of coughing may be followed by vomiting or drooling or both. Sometimes after the lungs have been emptied of air from a paroxysm, a deep indrawing of breath causes  a whooping noise from the throat as air is sucked back in.

The number of paroxysms can vary from 5 to 50 in 24 hours. 12 is quite usual.

This can go on for 2 to 6 weeks or more before becoming less severe and slowly fizzling out over several weeks.

Read the Blog “So you think you have have whooping cough”

Summary of symptoms in babies

Babies can get very seriously ill from whooping cough especially if they are not immunised. One in a hundred are likely to die from it despite the best medical care. It is not rare. In recent years about one in a thousand was catching it unless the mother had a pregnancy booster shot.

Babies are too weak to keep coughing so violently and they are prone to not restart breathing after a paroxysm, or sometimes just stop breathing instead of coughing. All babies with whooping cough need hospital treatment.

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Summary of treatment

Once the cough had been going on for about 7 days or more there is NO treatment. It will take its course. Antibiotics can stop it being spread, which is very important. If complications occur these must be treated according whatever they are.

Provided whooping cough is caught in the very early stages before symptoms are fully developed, in the first 7 days for instance, an antibiotic such as azithromycin can reduce its severity. If given in the incubation period it may prevent it altogether.

The same antibiotic is used in the first 3 weeks from onset in order to prevent spreading it to others, but after this time it is unnecessary and not beneficial.

Babies need to be in hospital for treatment of whooping cough and support and they may need high dependency care.

Cough medicines and inhalers do not help.

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Summary of prevention

During the incubation period of whooping cough, which is 7 to 10 days, a macrolide antibiotic such as azithromycin (or erythromycin, or clindamycin) can prevent it developing.

Immunization is the chief prevention method for whooping cough. The precise programme varies from country to country but always consists of a primary course of three injections at monthly intervals starting at about 2 months of age. Boosters are usually given after intervals of years.

A booster injection in mid pregnancy prevents most cases that would otherwise occur in the the first few months of life, which is the most dangerous age to get whooping cough.

Herd immunity is the strongest aspect of whooping cough prevention as it stops it spreading if there are good levels of individual immunity. Individual immunity comes from immunization and occasional exposure to the infection which can boost immunity in those previously immunised without us being aware of it.

The current immunisation programme in all countries is designed to prevent life threatening or severe illness and deaths, which are almost always in very young children in the developed world, and is in this respect very successful. But because the vaccine does not give complete protection, it means that there will always be a certain amount of whooping cough in the general population until a more effective vaccine is produced. This is currently being worked on.

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UK immunisation schedule