Complications of Whooping Cough

Older children and adults (in more detail)

1 in 100 get pneumonia

In my published study of 500 consecutive cases in an English village over 20 years, only 1 in 100 developed significant complications such as pneumonia. NHS website page on pneumonia

Temporarily stopping breathing usually comes after a bout of coughing. In the United Kingdom one child in 100 who gets it under the age of six months dies from it. In older children death is very rare, perhaps 1 in 200,000 cases. In the underdeveloped world, the mortality is vastly greater.

There are minor complications that are often described but usually occur only in the most severe cases. These are; bleeding over the white of the eye (subconjunctival haemorrhage), blood spots in the skin (petechiae), tearing of the ligament at the base of the tongue and umbilical hernia. 

All these are caused by congestion of blood or the strain of coughing, retching and vomiting. If you watch the videos and listen to the sound files on the symptoms page you will understand how the severity can cause these traumatic effects.

Textbooks often give misleadingly exaggerated pictures of complications 

All these things are described in textbooks and reading them gives the impression they are very common. In my experience they are uncommon. (Described in my paper on 500 consecutive cases.)

Fainting from whooping cough (cough syncope)

This is relatively common, especially in adults. Any cough can make some people faint but it is more likely in whooping cough because of the severity. There is a fascinating and helpful blog about it. (Opens in new Tab).

Injury from fainting after a paroxysm

Some people faint with paroxysms and may make involuntary jerking movements resembling a fit. They may have no recollection of the faint, but unlike a true fit, they will usually remember the events leading up to it.

Sudden infant death syndrome

It is suspected that undiagnosed whooping cough could possibly be the cause of some  cases of sudden infant death syndrome  (SIDS). This probably happens less now than in the past, since whooping cough is now recognised as a cause, and tests are now available to detect it more easily.

No long term effects

Whooping cough does not cause long term lung damage. (Young babies who have been very ill with it might may be an exception).

Some years ago people thought that whooping cough led to bronchiectasis, a condition in which the main air passages in the lungs become enlarged and distorted. This allows sputum to accumulate and fester, causing the sufferer to have a chronic productive cough and susceptibility to more severe lung infections and general debility. Most cases of bronchiectasis have probably not been caused by whooping cough itself, but by pneumonia complicating it, which was much more common before antibiotics were in common use.

The only evidence I have seen connecting whooping cough with bronchiectasis showed that the connection was with whooping cough complicated by atelectasis. Atelectasis is a section of lung that collapses devoid of air and will usually become infected. This is similar to and in the spectrum as bronchopneumonia, which is usually associated with breathlessness, fever, malaise, and sometimes chest pain.

It is very likely that debilitated or malnourished children will be more prone to atelectasis with whooping cough. That was usual a century ago in the developed world and still pertains in much of the underdeveloped world today.

Does not cause asthma. But asthmatics are more susceptible to whooping cough

More people who have whooping cough have asthma than those who have not had whooping cough. Whooping cough does not cause asthma.  It just so happens that people with asthma are more susceptible to it.

Voice changes

Many sufferers find they are unable to sing or are hoarse for a long time after whooping cough. It usually recovers but it can take a long time. Occasionally it seems permanent.

Breathlessness