Class of adults and some raised hands


These are some of the frequently asked questions sent via my email comment page

Dear DR J. One of your recent blogs says the parapertussis variety of whooping cough may be commoner in 2023. What is the difference?

It is believed to be a bit less severe on average but not in an obvious way in my experience.There is a big problem however. Blood and oral fluid tests will show negative for this form of whooping cough. PCR tests which are usually take by a swab test from the throat or nose may show up parapertussis. It depends on the laboratory providing the test.

 Dear Dr J. I am getting over whooping cough. Does that put me at special risk if I get coronavirus covid-19?

Nobody can answer that question  until it has actually happened to a number of people in a way that can be measured, and that information may never be available. But our understanding of how whooping cough affects the body does not raise any particular anxiety about it causing sufferers to be especially susceptible or be likely to suffer more severely. Having two infections together is always concerning because the problems add up.

Dear Dr J. I have been diagnosed with whooping cough and had several antibiotics, steroids, inhalers and cough medicines, none of which have done any good. We are desperate to find something to relieve it and get me/my wife better faster. What can we do Dr J? 

Oh dear! I am really sorry for you, but the whole point of this site is to point out that it is a prolonged distressing illness very often, and there is no treatment that makes any real difference. It just gets better in its own good time, which may be as short as 3 weeks but is more likely to be 2 to 3 months.  There is no remedy except prevention by making sure everybody gets all their shots, then far fewer people would get it.

Dear Dr J. What is the treatment for whooping cough?

Try the treatment page

Dear Dr J. How long is it infectious for?

From the start of whooping cough symptoms most people are incapable of passing it on after 3 weeks if they are given NO antibiotic which kills the bug. But there are no hard and fast rules and some people may be infectious for 4 or even 5 weeks.  If you have an antibiotic which kills the bug (Bordetella pertussis) you are considered unable to pass it on after 3 days on the antibiotic (Azithromycin is usually the one).  

This all sounds very straightforward, but it is sometimes difficult to know when whooping cough symptoms start because  getting a viral cold or respiratory infection makes people susceptible to whooping cough. So the start of the symptoms in that case is the start of the cold, not whooping cough. That makes things difficult. 

The best course of action is to get the antibiotic and then you are sure. Isolating the patient from anyone susceptible for at least 3 weeks is a reasonable alternative and then antibiotics can be avoided.

Dear Dr J. Every year I get a cough which sounds just like the cough on your site. Could this be whooping cough?

It is extremely improbable but if you suspect it get a blood test done and find out.

Dear Dr J. We seemed to be getting over whooping cough after an exhausting 8 weeks when suddenly it has come back again . What has gone wrong? How long will it last?

This is very common. When whooping cough is in its recovery phase, catching another mild respiratory infection will cause all the bad whooping cough symptoms to come back again, but only for the duration of the cold , then it will settle again.

Dear Dr J. I am pregnant and I have whooping cough (or been in contact with whooping cough) and am very worried about whether the baby could be damaged. 

Whooping cough in pregnancy does not harm the baby unless you are still infectious when the baby is born. The baby could catch it then, which would be extremely serious. Fortunately, in such circumstances, giving erythromycin to mother before birth and baby after birth, would  stop both getting it. All pregnant women should now be immunized against whooping cough between 28 and 32weeks ideally. Later may be OK too. It is 90% effective at protecting babies from whooping cough before they get their shots.

Dear Dr J. My husband (wife, child) has had this terrible cough for 3 weeks and I am wondering whether it is whooping cough. I am really worried. 

Get a doctor to see the patient straight away! This site is not a substitute for a doctor. If somebody thinks they have whooping cough they need to see a doctor. Not necessarily to get whooping cough confirmed but to make sure it is nothing more serious.

Dear Dr J. I have had fever and a bad cough that is making me choke for 4 days now. I sound just like the recording. Is this whooping cough?

Probably not. Whooping cough starts as an ordinary cough that gradually becomes choking over a week, or often more. I only diagnose whooping cough if somebody has a typical choking cough for three weeks, although I may strongly suspect it after 2 weeks.

Dear Dr J. My doctor is useless. I have told him/her it is just like whooping cough, but he/she does not seem to think it could be and I get prescribed more antibiotics and told it is just an ordinary cough. How can I get through?

You are probably fighting a losing battle. As long as your doctor does a physical check, you are probably not missing out on anything, but I agree, it is difficult to have confidence. There is a page on this site that you could print out and give to your doctor in the hope that they may be prepared to learn something from you, or, having read it, tell you with good reason why it does not fit with whooping cough. (Printout page for doctors).

Dear Dr J. Does whooping cough cause any long term lung damage?

No. Therre is no evidence it does that. It used to be thought it was a cause of bronchiectasis. This might have true in the past but probably not now. To cause lung damage it would probably have to cause pneumonia first.

Dear Dr J. Can I get whooping cough more than once? 

Yes quite a lot of adults with it tell me they had it as a child. Many people tell me they get a choking cough that sounds like whooping cough every year. I don’t think that can be whooping cough.

 Immunity to whooping cough only last a few years (perhaps 15 years after natural infection or the old whole cell vaccine. We all probably get mild versions of it that boost our immunity for a few more years without us realising it.

Dear Dr J. I have heard that whooping cough vaccine can cause permanent brain damage. Is it true?

NOT true. In the 1970s people thought it might be true of the old type vaccine used then, but research done at the time showed it not to be true. The question was asked about the old whole cell vaccine. It could occasionally caused feverish reactions that brought out previously unrecognised infant epilepsy. That is what caused the confusion.

 In the developed world we now use acellular vaccine which is much purer than the old vaccine anyway and does not cause any kind of damage.

Dear Dr J. What is Bordetella parapertussis? Does it cause whooping cough?

It is a closely related bacterium that can also cause whooping cough. It is a less severe form. It is probably responsible for less than 1% of cases. (lab-diagnosis)

Dear Dr J. I am going to Australia to see our new grandson. Can I get a whooping cough booster as he will not be immunized and I understand it is more common in adults.

It is a good and sensible idea. Your doctor or travel clinic should be able to give you a booster of REPEVAX. (see prevention also)

Dear Dr J. I am pregnant and have been advised to have a whooping cough booster injection.

This is a very important protection for you baby as whooping cough is getting more common. You can have Repevax or equivalent quite safely. It should be given between 28 and 38 weeks although timings vary depending on where you live. The USA and the UK are slightly different. It gives your baby a very great protection (about 90%).

Dear Dr J. I am recovering from whooping cough and feel quite reasonable. What is it safe for me to do activitywise.

You should be able do your normal activites including exercise quite safely. Driving and having a coughing attack is obviously a no-no.

Dear Dr J. Since I started with whooping cough I cannot sing and my voice sounds different.

This is quite common in adults. It usually clears but may last longer than the coughing. Very occasionally the voice never completely recovers.

Dear Dr J. I know I (my child) have had whooping cough. Do I (he/she) still need to get the regular immunization shots?

That is the official recommendation but some experts think it is not worthwhile with acellular vaccine.

 If you are sure you really have had natural whooping cough it would be reasonable to assume that has given you good immunity to that disease, although it is never very long lasting anyway.

Reviewed 10 January 2023