Patient information · Paediatrics and infectious disease
Whooping cough
the hundred-day cough, and why babies matter most
Whooping cough is a bacterial infection causing prolonged, exhausting bouts of coughing that can last three months. In older children and adults it is miserable but rarely dangerous. In young babies it is a different illness altogether, and they usually catch it from an adult who thought they just had a lingering cough.
Call 999 if a baby or child
- has pauses in breathing, or stops breathing during or after a coughing bout
- turns blue or grey around the lips, or goes floppy
- is struggling to breathe, or sucking in below the ribs
- is having seizures, or is very difficult to rouse
- is under six months old with a suspected whooping cough — seek assessment the same day regardless
- is not feeding, or vomiting after every cough and becoming dehydrated
Babies under six months may not whoop at all — they may simply stop breathing between coughs, which is the most dangerous presentation. Most whooping cough deaths are in babies too young to have completed vaccination. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
How it progresses
- It begins like an ordinary cold — runny nose, mild cough, sometimes a slight fever. This is when it spreads most, and before anyone suspects it.
- Then come bouts of intense coughing, often in runs of ten or more, frequently worse at night, leaving the person exhausted and red or blue in the face.
- The whoop is the sharp intake of breath at the end of a bout. Many adults and older children never whoop — its absence does not exclude the diagnosis.
- Vomiting after coughing is very characteristic and worth mentioning to us.
- Between bouts, people often appear completely well, which is why it is so often dismissed.
Diagnosis and antibiotics
- Diagnosed with a swab early in the illness, or a blood or saliva test later on.
- Antibiotics only help if started within about three weeks of the cough beginning. Given early they shorten the illness; given later they do nothing for symptoms.
- Even late, antibiotics are prescribed to stop you passing it on, particularly to babies and pregnant women.
- Household contacts, especially those around babies or in late pregnancy, may be offered preventive antibiotics.
- Cough medicines do not work for whooping cough. Nothing much shortens the cough once established — time is the treatment.
Managing at home
Helps
- Small frequent meals and drinks, since coughing bouts trigger vomiting
- Rest, and sleeping propped up
- Keeping a calm environment — excitement and activity trigger bouts
- Fresh air and avoiding smoke, dust and strong smells
- Recording bouts on your phone to show us — this genuinely aids diagnosis
Avoid
- Cough medicines, which do not work here
- Smoky environments and vaping indoors
- Contact with babies, pregnant women and anyone unwell
- Assuming a lingering cough after a cold is nothing
- Sending a child back to school before the exclusion period ends
Staying away from others
Stay off school, nursery or work until 48 hours after starting antibiotics, or for 21 days from the start of the cough if you are not taking them. Whooping cough is a notifiable disease and we are required to inform public health, who will trace and protect close contacts.
Vaccination in pregnancy protects the newborn
The pertussis vaccine is offered in every pregnancy, ideally between 16 and 32 weeks. Antibodies cross the placenta and protect the baby through the first weeks of life, before their own vaccinations begin at eight weeks. It is around 90% effective at preventing whooping cough in young infants and is the single most important protective measure there is. It can still be given later in pregnancy or after birth if it was missed. Protection from childhood vaccination wanes over years, which is why teenagers and adults get whooping cough and pass it on.
Book an appointment if you or your child have had a cough for more than two weeks with bouts, vomiting after coughing, or a whoop, particularly if there is a baby or a pregnant woman in the household. We can test, treat and arrange vaccination, including pertussis vaccination in pregnancy.
Testing and pertussis vaccination in pregnancy
Appointments seven days a week, 9am–7pm, on Whitechapel Road.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.