Whooping cough

Since the introduction of the triple DTP vaccination (protecting children against diphtheria, tetanus and pertussis or whooping cough), the incidence of this disease has fallen dramatically. The DTP jab is given at two, three and four months old by your GP, along with one for Hib meningitis. The Department of Health strongly recommends that your child has these vaccinations.

Babies and toddlers who haven't been vaccinated or are too young to have the DTP jab yet are still at risk of contracting whooping cough which causes a characteristic persistent cough with a whooping noise that can be very distressing for the child and his parents. Some babies do not develop a whoop but stop breathing for short periods of time (up to 30 seconds) instead.

Unvaccinated babies and children should be kept away from anyone suspected of having the illness as it can prove especially severe in children under 12 months old.

What causes pertussis?

The illness pertussis takes its name from the bacteria 'bordetella pertussis' and is passed on by infected mouth and throat mucus during bouts of coughing. The bacteria enters via the mouth or nose and infects the windpipe, damaging the lining and the main air passages in the lungs. The subsequent inflammation causes extra mucus production and a narrowing of the airway, creating the characteristic whooping noise as the person tries to draw in air after each coughing spasm.

What are the symptoms?

Whooping cough follows three distinct phases:

• Blocked nose, slight temperature and minor cough
• Within two weeks, a much more persistent cough, usually sounding like a series of short coughs followed by a 'whooping' noise as air is squeezed in through the narrowed windpipe (less likely in babies). The coughing spasm may cause shortage of breath and may be followed by vomiting due to the effort of coughing.
• As the child becomes better, the cough and its accompanying whoop may linger for up to three months.

Can it be treated?

If your GP suspects whooping cough, he will take a throat swab and send it off to the lab for analysis. It caught early enough - in the snuffly first phase of the illness - the antibiotic erythromycin can be prescribed to cut short the illness, although it cannot 'cure' the cough itself. Very young babies who develop whooping cough may need to be hospitalised and monitored carefully, especially if their breathing becomes very laboured.

What you can do

• Confirm the diagnosis with your GP as soon as possible as antibiotics are only effective if given in the early stages of the illness (see Can it be treated?, above)
• Offer plenty of fluids and encourage your child to rest
• Give the recommended dose of infant paracetamol for any pain or fever
• Always seek medical help straightaway if your child is struggling to breathe

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