Whooping cough cough phase

Overview

Whooping cough (also called pertussis) is a highly contagious bacterial infection that affects the lungs and breathing tubes. The 'cough phase' is the second stage of the illness, marked by intense coughing fits that can last for weeks or months.

Whooping cough is less common in countries with high vaccination rates, but outbreaks still occur. It is most common in infants and young children who are not fully vaccinated.

Whooping cough can affect people of all ages, but it is most serious in infants under one year old. Older children, teenagers, and adults can also get it, often with milder symptoms.

Symptoms

Common symptoms

• Intense coughing fits that come in bursts
• A 'whooping' sound when breathing in after coughing
• Coughing so hard that you vomit or turn blue
• Feeling very tired after coughing fits
• Cough that lasts for weeks or months

Symptoms in children

• In infants, coughing fits may be followed by a pause in breathing (apnoea)
• Infants may not make the 'whoop' sound; instead they may look like they are choking
• Coughing can cause feeding difficulties and weight loss

Symptoms in older adults

• Milder cough that may be mistaken for a cold or bronchitis
• Prolonged cough that lasts for several weeks
• Less likely to have the 'whoop' sound

Causes

Main causes

• Whooping cough is caused by a bacterium called Bordetella pertussis
• It spreads through droplets when an infected person coughs or sneezes

Risk factors

• Not being vaccinated against whooping cough
• Living in close contact with someone who has the infection
• Being an infant too young to be fully vaccinated
• Having a weakened immune system

When to see a doctor

See a doctor urgently if:

• If you or your child has a severe coughing fit and cannot catch their breath
• If you notice a 'whoop' sound after coughing
• If you or your child vomits after coughing
• If the cough lasts more than a week and is getting worse

Book a routine appointment if:

• If you have a persistent cough that does not improve with home care
• If you are pregnant or caring for an infant and have been exposed to whooping cough

Diagnosis

A doctor will ask about your symptoms, listen to your cough, and may take a swab from your nose or throat to test for the bacteria.

Tests that may be done

• Nasopharyngeal swab (a long cotton swab inserted into the nose)
• Blood test to check for antibodies
• Sometimes a chest X-ray to rule out other lung infections

What to expect at your appointment

The doctor will examine you and may ask you to cough. The test is quick but may feel uncomfortable. Results may take a few days.

Treatment

Treatment for whooping cough focuses on relieving symptoms and preventing spread. Antibiotics may be given if started early, but often the cough has already set in by the time of diagnosis.

Self-care at home

• Get plenty of rest
• Drink fluids to stay hydrated
• Use a humidifier to ease cough
• Avoid irritants like smoke or strong fumes
• Eat small, frequent meals if coughing causes vomiting

Medical treatments

Your doctor may prescribe antibiotics if the infection is caught early (within the first 3 weeks). Antibiotics can also help prevent spread to others. For severe cases, especially in infants, hospital care may be needed, including oxygen, suctioning of mucus, and fluids. Over-the-counter cough medicines are not recommended for whooping cough as they may not help and can have side effects.

When is surgery considered?

Surgery is not a treatment for whooping cough.

Living with this condition

Living with the cough phase can be exhausting. Plan your day to allow for rest. Avoid triggers that make you cough, such as dust, smoke, or sudden temperature changes.

Lifestyle tips

• Stay home from work, school, or daycare until you have been on antibiotics for at least 5 days to reduce spread
• Wear a mask if you must be around others
• Keep up with good hand hygiene to protect family members

Diet and exercise

Eat a balanced diet, but if coughing leads to vomiting, try smaller meals more often. Gentle activity like walking is okay when you feel up to it, but rest when tired.

Mental health and emotional wellbeing

A long-lasting cough can be stressful and affect your mood. It is normal to feel frustrated or anxious. Talk to your doctor if you feel overwhelmed.

Prevention

Yes, whooping cough can be prevented with vaccination. Good hygiene like covering your mouth when coughing and washing hands also helps reduce spread.

Vaccines

The whooping cough vaccine is given as part of the routine childhood immunization schedule. It is also recommended for pregnant women in the third trimester to protect the newborn. Adults may need a booster if they are in close contact with infants.

Screening programmes

There is no routine screening for whooping cough, but if you have been exposed, your doctor may recommend testing or preventive antibiotics.

Complications

If left untreated

• In infants: pneumonia, seizures, brain damage, or death
• In adults: rib fractures from severe coughing, hernia, urinary incontinence, sleep disturbances

Long-term outlook

Most people recover fully from whooping cough, though the cough can last for weeks or months. With proper care and support, almost all children and adults get better. Vaccination is the best protection.

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