Whooping cough is one of those childhood illnesses that we don’t see as much of as we used to, but is still around and every so often reminds us of its presence. Dr Joe Kosterich talks about whooping cough, including how often we see it, what its symptoms are, how to test for it, vaccinating for it and how to treat it.
Hi, I’m Doctor Joe.
Some childhood illnesses have all but disappeared in western countries. In Australia we see very few cases these days of things like polio and measles, and that’s largely because of the vaccination programs over the last 40-50 years.
Part of that is also vaccination for whooping cough, but whooping cough is one infection that hasn’t quite completely gone away. It seems to go in waves. We see some years there are very few cases, other years it builds up and there are more cases, then it seems to settle down again. These waves seem to occur every 3-5 years or so. And nobody seems to understand exactly why.
Interestingly, vaccination rates have been relatively stable in Australia for a good number of years. So it’s not because suddenly people are stopping getting vaccinated that we get these rises. I suppose what it does remind us is that bacteria are not quite as silly as we thought and some of them will find a way around it.
Okay, whooping cough necessarily causes a cough, hence the name and it causes a really barky cough that can end up with a whooping type sound, again hence the name. It is caused by a bacteria. It is not a pleasant illness. It can be fatal. Fortunately that is fairly rare.
In Australia there have been a few deaths over a period of some years. There are not very many but it is obviously a tragedy whenever that occurs. Most children who get whooping cough will recover. I think that’s an important point to make. Adults who get whooping cough, it is more miserable than when you get it as a child, but again, the vast, vast, vast majority will recover. It’s very rare to get deaths due to whooping cough in adults.
Apart from the cough there’s not a lot else. You don’t necessarily get many of the cold type symptoms. You don’t necessarily get a runny nose or a headache and in younger children they may get a fever but not always. But it’s that ongoing cough with the typical bark and whoop that tells us what the diagnosis is.
There are ways of doing tests and samples can be taken from the back of the throat or from the back of the nose and sent off to the lab to analyse whether the cough is due to whooping cough or not. A cough that goes away in a week is pretty unlikely to be whooping cough. One of the hallmarks of the illness is that it can drag on for weeks and occasionally even a couple of months or so.
Treatment wise there are some antibiotics that can be used. They’re not an absolute cure and there are different schools of thought around this, but generally a course of antibiotics will be used if whooping cough is confirmed.
Other treatments though are very much supportive type measures. In the most severe illnesses in children they may require hospitalisation. Again be aware that this is the exception rather than the rule, and again in rare instances some children will need even ventilatory support, but, you know, fortunately that’s not common.
The group at biggest risk for whooping cough are the very young so we’re talking the under six months and particularly the under two months who of course haven’t had their first vaccine yet. This is not to say that every baby under two months is at great risk so you don’t need to get too scared or panicked about it. And not withstanding that we do have cases in Australia and as we said before it fluctuates from year to year.
It is not a particularly common illness. It is there but it’s not particularly common. You are far more likely, far, far more likely to find that a baby that has a cough has just got a regular cold or virus. Again if it’s dragging on with any concerns, that’s when you need to go and see your doctor.
Now in terms of prevention, the main one is vaccination. Whooping cough vaccine has had its controversies and we won’t go in to that but I think most people have heard about those. It has been shown over a good number of years to be effective. It’s not 100%. It’s not impossible to get the illness if you’ve had the vaccine but it makes it far less likely and I think that’s an important point to note.
It is part of the regular schedule. For adults they can have boosters as well. There’s no set schedule with that. You do need to have a chat about that with your doctor, particularly if you have a newborn at home, have a chat with your doctor as to whether or not you as an adult might need a booster or not. I do emphasise there are no set recommendations or guidelines on this. However for children there certainly are and it’s part of the schedule.
Alright, so to sum up. Whooping cough, a potentially serious illness. Not a common illness. Treatable in most instances if one does get it. Potentially serious requiring hospitalisation in some instances. Very rarely, fatal in others. So something that’s about the place but please be aware that it’s one of the rarer, rather than commoner, causes of a cough.
|To learn more about this disease and how to treat it, visit Whooping Cough (Pertussis).
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