Pertussis (whooping cough)

Whooping cough, also known as pertussis, is a highly infectious respiratory illness caused by the bacterium Bordetella pertussis.

Whooping cough can affect people at any age. Infants less than 6 months of age are most at risk of developing serious complications from the disease such as pneumonia, seizures and brain damage.

Whooping cough can be life threatening for a young infant.

Symptoms

Whooping cough sometimes begins like a cold with a runny nose, tiredness, a mild fever and a cough. Typically, people go on to develop bouts of severe, uncontrollable coughing which may result in vomiting.

A high-pitched whooping sound may also be heard when the person gasps for air while coughing. The cough typically lasts for two weeks or more.

In some cases, a mild but persistent cough may be the only symptom of whooping cough, particularly in older children and adults. Infants are also less likely to have the typical symptoms of whooping cough.

They may not have a cough at all but may appear to be gagging and gasping for air. They are often unable to feed well and may become blue around the mouth.

How whooping cough is spread

Whooping cough is easily spread to other people by droplets when an infected person coughs or sneezes. It can also be spread by direct contact with secretions from the nose or mouth of an infected person. It is most easily spread to those living in the same household or in close contact with the infected person.

It can take anywhere from 6 to 20 days (commonly 7 to 10 days) after coming in contact with pertussis for the disease to develop.

Infectious period

A person is infectious for as long as 21 days from when the cough first begins, or until they have completed 5 days of a course of appropriate antibiotics. The cough can continue for many weeks, despite antibiotics.

Individuals with whooping cough should be excluded from childcare facilities, school, work or settings where there are people at risk of infections, until they are no longer considered infectious.

Who is at risk of infection

Anyone can get whooping cough. The majority of cases are in adults and adolescents. Parents, grandparents and others in close contact with infants such as healthcare providers and childcare workers are at risk of passing the infection to infants.

Infants less than 6 months of age who are too young to be fully vaccinated, account for the majority of hospitalisations and deaths from whooping cough.

If you have contact with someone with pertussis

If you or your child have been exposed to someone with whooping cough while they are infectious, watch out for symptoms and see your doctor if you develop a cough.

If you have a cough and your doctor suspects you have whooping cough, a swab from the back of the nose/throat or a blood test can confirm the diagnosis.

Babies less than 6 months of age and those who are at risk of passing the infection on to them, who have had significant contact with an infectious person may benefit from a course of preventative antibiotics. Your GP can provide advice on whether you need a course of antibiotics.

Protection

Vaccination is the most effective way to avoid whooping cough infection. However, immunity does fade over time and it is still possible to get whooping cough even if you have been vaccinated in the past.

People with a coughing illness should avoid contact with infants less than 6 months of age and other people who may be vulnerable to illness.

Vaccination

Children and adolescents

Whooping cough vaccination is offered to all children as part of the funded National Immunisation Program (NIP). The first dose can be given from 6-8 weeks of age, followed by doses at 4 and 6 months. Booster doses are then given at 18 months and 4 years of age. A further booster dose is given in high school through the school immunisation program in the ACT.

If your child has missed one or more of their vaccinations, please see your doctor to arrange a catch up.

Adults

An adult booster vaccine is available for purchase on private prescription from your doctor. This vaccine is recommended for anyone in contact with infants, especially health care workers, child care workers and new parents. Any adult wishing to protect themselves against whooping cough should discuss vaccination with their doctor.

Pregnant women

The adult booster vaccine is free and strongly recommended for women during each pregnancy. It should be given mid second trimester to early third trimester (ideally between 20 and 32 weeks), but it can be given at any time up to delivery, or as soon as possible following the birth.

If the vaccine is given after the birth it can be purchased on private prescription from your doctor.

Find out more about pertussis vaccination for pregnant women.

More information

Whooping cough (Pertussis) is a notifiable disease. For more information about whooping cough, contact your GP or call the Health Protection Service, Communicable Disease Control Information Line during business hours on 02 5124 9213.

Acknowledgements

• Heymann DL. Control of Communicable Diseases Manual. 20th edn. Washington: American Public Health Association, USA; 2015.
• Australian Technical Advisory Group on Immunisation (ATAGI). The Australian immunisation handbook 10th ed (2017 update). Canberra: Australian Government Department of Health, 2017.
• Australian Government, Department of Health, Pertussis SoNG 2015.