Whooping cough

Whooping Cough, otherwise known as pertussis, is a very serious and life threatening disease. The chances of catching whooping cough are significantly reduced by ensuring you and your family are fully immunised.

Whooping cough vaccinations are recommended for babies and children. Boosters are recommended for 10-15 year olds and adults, including pregnant women, in their last trimester of pregnancy. The immunisation for whooping cough is given at the same time as for tetanus, diphtheria and polio.

Whooping cough is particularly dangerous in babies aged less than 12 months. This is because a mother's antibodies do not provide enough protection from the disease. By four months of age, babies are better protected because by then, they have been immunised with two doses of whooping cough vaccine.

The rapid increase of whooping cough in the community has taken a lot of people by surprise and there is an increased awareness about the disease. Campaigns are designed to address increasing rates of infection by encouraging more people to get the whooping cough vaccination.

Herd immunity is the term used to describe community protection for everyone, but particularly of babies and people at risk, when large numbers of the population are vaccinated.

Pertussis The facts

Recent findings estimate that pertussis is the true cause for 7% of illnesses with a cough per year in adults. Annually, more than 25% of adults experience a coughing illness which lasts for at least five days. Many adults who are sick with a cough don t realise they have whooping cough. In adults it is not such a concern as it is for young children. The older the person who contracts pertussis, the more protected they are.

In people aged 10-70 yoa, death is rare. But in babies aged less than six months, death due to pertussis is estimated to be 0.8%. This is because of the size of their airways and the fact that they are not old enough to have developed resistance. An infection with whooping cough can also lead to pneumonia and brain damage.

Epidemics of pertussis occur every year in Australia. Some areas are overrepresented, especially in communities where there are larger numbers of unvaccinated children and adults.

What is whooping cough?

Whooping cough is a highly infectious, bacterial illness which initially affects the nose and throat. The infection develops causing more mucous to develop, which creates the cough that can have the very identifiable whoop as air is drawn back into the baby's airway and lungs.

Whooping cough starts with similar symptoms to a common cold:

• A runny nose,
• Sore watery red eyes,
• A low-grade fever and
• A general feeling of being unwell.

Babies can also have a change in their feeding or sleeping habits.

A swab test from the back of the throat or a blood test can confirm a case of whooping cough. An early diagnosis can mean quick treatment with antibiotics. This means there is less chance of the disease being spread. Symptoms may also be reduced by early treatment.

If the disease is left untreated an irritating cough will develop that can leave the patient gasping for breath. It's not uncommon for vomiting to occur after a bout of coughing as a child chokes on the mucus. Some babies may not cough, but simply stop breathing for a period of time. It is the inability to breath that causes most problems for babies and can contribute to the cause of death in some infants.

Worldwide, approximately 250,000 people die every year from whooping cough and many more are left chronically unwell; this is not a disease to be taken lightly.

You can hear a small child with the identifiable sound of whooping cough here.

How is Whooping Cough Spread?

Whooping cough is spread very easily through airborne droplets containing the bacteria.

Simply put, if your unimmunised baby is near someone who coughs or sneezes while they are in the infectious stage of whooping cough, it's extremely likely that they will contract the disease.

Of course, stay well away from anyone you know that may be carrying the disease as whooping cough is very contagious.

A newly infected person will usually start to display symptoms around 7-20 days after coming into contact with the disease.

Baby Vaccination for Whooping Cough

The recommendation from peak healthcare bodies is for all Australian babies to receive a government funded immunisation against whooping cough at 2, 4 and 6 months and then again as part of the 4 year old schedule. Current practice is to offer the first round of vaccinations at 6 weeks because the extra 2 weeks of protection is beneficial.

Another booster is recommended between 10-15 years of age. Whooping cough vaccine is part of the National Immunisation Program Schedule NIPS .

Check here for more information about the Immunise Australia Program.

As with most vaccines, the whooping cough vaccine will not absolutely guarantee that your baby will be fully protected. But it does provide as much protection as possible. It will always be better for you and your baby to avoid contact with someone suspected of carrying the disease. Protection after a bout of whooping cough or the vaccine lasts for around 5-10 years.

Who else should be immunised?

It is recommended that all persons who come into contact with young babies and children have a booster immunisation to help prevent the spread of the disease. In addition to childcare workers and nurses, you may like to consider having the booster shot for whooping cough yourself.

Immunisation is recommended for:

• Women and their partners who are planning a pregnancy
• Pregnant women in their last trimester of pregnancy
• Mothers who have not had a booster should have an immunisation shortly after the birth of their baby
• All adults over the age of 50 years. Whooping cough vaccine is combined with diphtheria and tetanus vaccines.
• Grandparents and other family members
• Childcare workers, baby sitters and nannies
• Health care workers
• Any person who has not already been immunised

Whooping Cough and Pregnancy

Currently, health authorities recommend that pregnant women have a booster during their last trimester of pregnancy. Ideally this is between 28-32 weeks gestation but it can be given right up to delivery.

Resources

• http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&np=303&id=1851
• http://immunise.health.gov.au/internet/immunise/publishing.nsf/Content/nips
• http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Immunisation_-DTP,polio,_hep_B,andHib?open
• http://www.ncirs.edu.au/immunisation/fact-sheets/pertussis-fact-sheet.pdf

Updated April 2015