Whooping Cough: Why It’s Still a Health Concern Today
, by Tatianna Gerard, 14 min reading time
Though it may not get as much attention as other illnesses, whooping cough, or pertussis, is a highly contagious disease that’s still affecting families worldwide. Known for its severe, persistent cough, whooping cough is a highly contagious respiratory disease that affects people of all ages. Surprisingly, many people are unaware of just how widespread it is, or that cases have surged in recent years. In Australia alone, more than 41,000 cases have been recorded since the start of the year, breaking the previous record of 38,748 cases set in 2011. This recent spike highlights the importance of understanding whooping cough, recognising its symptoms, and knowing how to protect loved ones, particularly vulnerable infants and elderly family members.
Our blog will help you understand whooping cough, from spotting the symptoms to exploring prevention and treatment options, so you can stay informed and keep your family safe.
Symptoms of whooping cough
Whooping cough (pertussis) often starts with symptoms similar to a common cold but develops distinct characteristics as it progresses. Recognising these symptoms can help in seeking appropriate medical care and reducing the spread.
1. Early symptoms
In the first one to two weeks, whooping cough may present with mild, cold-like symptoms, including:
- Runny or stuffy nose
- Mild fever
- Occasional cough
- Watery, red eyes
These early signs can make whooping cough difficult to distinguish from other respiratory infections.
2. Progression in children: The “whoop” sound
After the initial phase, symptoms usually become more severe, particularly in children:
- Intense coughing fits: The cough may intensify, often occurring in rapid fits that make it challenging to catch a breath.
- The “Whoop” sound: Children may produce a high-pitched “whoop” sound when inhaling after a coughing fit.
- Physical symptoms: Coughing fits can be intense enough to cause vomiting, facial flushing, or even a bluish tint due to lack of oxygen.
These coughing spells may persist for several weeks, contributing to the term “100-day cough,” as the condition can linger for up to three months or more. They are often more frequent at night, impacting sleep.
3. Symptoms in adults
In adults, whooping cough symptoms are often milder, without the characteristic “whoop” sound:
- Persistent, dry cough: Adults may experience a lasting cough, which can continue for weeks or even months.
- Occasional coughing fits: While usually less severe than in children, adults may still experience fits of intense coughing.
Adults often misinterpret these symptoms as bronchitis or a lingering cough, increasing the risk of transmission, particularly to infants and older adults.
What are the 3 stages of whooping cough?
Whooping cough progresses in three distinct stages, each with characteristic symptoms and duration. We’ve summarised these stages in the infographic below to give you a clear, visual overview.
How to test for whooping cough
Diagnosing whooping cough, especially in its early stages, can be challenging because initial symptoms resemble those of a common cold or other respiratory illnesses, however, there are specific tests that healthcare providers use to accurately identify whooping cough (pertussis). If you suspect whooping cough, it’s important to seek medical care promptly for testing and, if necessary, treatment.
1. Nasopharyngeal swab or aspirate
The most common and reliable test for whooping cough involves a nasopharyngeal swab or aspirate. In this procedure, a healthcare provider will take a sample of secretions from the back of the throat, specifically the nasopharynx (the area where the nose and throat meet). This is done by inserting a swab through the nostril or using a suction device to collect a sample.
- Purpose: The sample is tested to detect the presence of Bordetella pertussis, the bacteria that causes whooping cough.
- Timing: This test is most effective if done during the first few weeks of symptoms, as the bacteria are more likely to be present in this period.
- Result time: Results may take a few days to come back, as the sample is usually sent to a lab for testing.
2. PCR test
The Polymerase Chain Reaction (PCR) test is a rapid diagnostic test that amplifies the DNA of Bordetella pertussis, allowing for a quicker diagnosis than traditional culture methods.
- Accuracy: PCR testing is highly sensitive and can detect the bacteria even if only a small amount is present in the sample.
- Availability of results: PCR results are typically available within one to two days, making this a preferred method when a prompt diagnosis is needed.
- When to use: This test is most effective within the first three weeks of symptoms, as the accuracy decreases as the infection progresses.
3. Blood test
For individuals with prolonged symptoms, a blood test may be used to measure the immune system’s response to whooping cough bacteria. This test is usually recommended only if the illness has been present for a few weeks.
- Purpose: A blood test checks for antibodies against Bordetella pertussis. Elevated antibody levels can indicate a recent or current infection.
- Timing: Blood tests are generally more accurate later in the illness (usually after two to four weeks), as it takes time for the body to produce detectable levels of antibodies.
4. Chest X-ray
In cases where the symptoms are severe or complications like pneumonia are suspected, a chest X-ray may be conducted. Although it doesn’t directly diagnose whooping cough, a chest X-ray can help rule out other respiratory conditions or detect complications resulting from severe coughing.
- Usage: Chest X-rays are typically used in conjunction with other tests to provide a comprehensive assessment of the respiratory system.
- Purpose: They help identify if the lungs have been affected or if there are signs of additional infections.
Choosing the right test
The type of test used often depends on the duration of symptoms and the healthcare provider’s assessment. Nasopharyngeal swabs and PCR tests are generally the preferred options in the early stages, as they directly detect the bacteria. Blood tests are more suitable for later stages, when direct detection may be less reliable but antibodies may be present.
Why testing matters
Testing for whooping cough or pertussis is crucial for several reasons:
- Accurate diagnosis: Early and accurate diagnosis ensures timely treatment, which can reduce the severity of symptoms and prevent complications.
- Preventing spread: Knowing whether someone has whooping cough allows for preventive measures to reduce the risk of spreading it, especially to young children and other high-risk individuals.
- Appropriate care: A confirmed diagnosis enables healthcare providers to recommend appropriate treatments and isolation protocols.
How to prevent whooping cough: Vaccination and safety tips
Vaccination is the most effective way to prevent whooping cough, particularly because it provides protection not only to the person vaccinated but also to those around them, especially young infants who are most vulnerable. Infants are at the highest risk for severe complications from whooping cough, and because they cannot be vaccinated until they reach a certain age, it’s crucial for those in close contact with them to be vaccinated.
1. DTPa vaccine for children
The DTPa vaccine is specifically designed for children and offers protection against three diseases: diphtheria, tetanus, and pertussis (whooping cough). The vaccination schedule includes five doses, which are typically administered at the following ages:
- 2 months
- 4 months
- 6 months
- 15–18 months
- 4–6 years
This schedule ensures that children build up immunity to whooping cough early in life. It’s important for parents to follow this schedule closely, as each dose boosts the child’s immune response and strengthens their protection.
2. DTPa booster for adolescents and adults
Protection from the DTPa vaccine wanes over time, so a booster shot is recommended for older children, teens, and adults. This booster not only reinforces immunity against whooping cough but also protects against diphtheria and tetanus. Key recommendations for the DTPa booster include:
- Pre-teens (11–12 years): The first DTPa booster dose is typically given at this age to maintain immunity as they enter adolescence.
- Adults (19 years and older): Adults who have never received a DTPa booster should get one, especially if they are in contact with infants or work in healthcare settings.
- Pregnant women: Pregnant women are advised to get the Tdap booster during the third trimester of each pregnancy, regardless of prior vaccination history. This helps transfer protective antibodies to the baby, offering some immunity in the first few months of life when the baby is too young to be vaccinated.
3. Cocooning strategy for infant protection
One effective approach in protecting young infants, known as "cocooning," involves vaccinating those who will be in close contact with the baby, including parents, siblings, grandparents, and caregivers. By creating a “cocoon” of immunity around the infant, the risk of exposure to whooping cough is significantly reduced. Since infants cannot receive the DTPa vaccine until they’re at least two months old, this strategy provides a crucial layer of protection during their most vulnerable early weeks.
4. Importance of staying up-to-date with vaccinations
Given the contagious nature of whooping cough, it’s essential for individuals to stay up-to-date with their vaccinations. Immunity from the DTPa and Tdap vaccines fades over time, which is why booster shots are necessary. Maintaining vaccination status not only protects the individual but also contributes to community immunity, lowering the overall risk of whooping cough outbreaks.
Other preventive measures
While vaccination is the primary tool to prevent whooping cough, additional everyday practices can help reduce its spread. Since whooping cough is a highly contagious illness, it is transmitted through respiratory droplets released when an infected person coughs or sneezes. This means that anyone nearby can easily contract the disease by inhaling these droplets or by touching surfaces contaminated with the bacteria and then touching their face. To minimise the risk of transmission, consider these extra preventive steps:
Practicing good hygiene
Maintaining good hygiene is essential in reducing the spread of whooping cough:
- Covering your mouth and nose: Always cover your mouth and nose with a tissue or the inside of your elbow when coughing or sneezing. This helps prevent respiratory droplets from dispersing into the air.
- Regular handwashing: Wash your hands frequently with soap and water, especially after coughing, sneezing, or being in public places. Proper hand hygiene can significantly reduce the risk of transferring bacteria from surfaces to your face.
- Using hand sanitiser: When soap and water aren’t available, using a hand sanitiser is a convenient alternative. Keep a small bottle handy when you’re out and about to ensure you have a quick way to sanitise your hands.
While alcohol-based sanitisers are generally recommended for their effectiveness, those with sensitive skin might prefer a natural hand sanitiser that doesn’t contain harsh alcohol or ethanol-based additives. For example, ViroCLEAR Hand Sanitiser is formulated without alcohol; instead, it contains a low content of Benzalkonium Chloride (BAC) as its active ingredient. BAC is a safer alternative that’s known for its germ-killing properties while being less harsh on the skin compared to high-alcohol formulas. Additionally, ViroCLEAR includes chamomile extract, which provides soothing and gentle care for the skin.
Wearing face masks
Face masks are another valuable preventive measure, particularly in situations where you’re in close contact with others or in crowded public areas:
- Surgical masks: A standard surgical mask can provide a layer of protection by preventing respiratory droplets from spreading to others. Surgical masks are primarily designed to protect those around the wearer, as they help contain droplets from the wearer’s mouth and nose.
- P2 masks (equivalent to N95): For individuals seeking more comprehensive protection, a P2 mask is recommended. Unlike surgical masks, P2 masks offer at least 94% filtration capacity that helps protect the wearer from inhaling airborne particles, including bacteria, providing greater protection, in this case, against contracting whooping cough. Getting P2 masks are better for individuals who may be at high risk or for caregivers looking after someone with whooping cough.
Read more on the differences between surgical masks and P2 masks.
Avoiding close contact with infected individuals
Since whooping cough is highly contagious, limiting close contact with infected individuals is essential, especially for unvaccinated infants or those who are more vulnerable to complications. If someone in your household is diagnosed with whooping cough, following isolation guidelines and maintaining good hygiene practices can help prevent it from spreading to others.
Disclaimer
The content provided on this blog is for informational purposes only and is based on research conducted by our team using credible medical and relevant sources. While we strive to ensure the information is accurate and up-to-date, it should not be considered a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health professional regarding any medical condition or concerns.