Whooping cough (pertussis)
- Whooping cough is a highly infectious disease that can be life threatening for babies and young children.
- It usually starts with cold-like symptoms and a cough that worsens into uncontrollable coughing.
- Vaccination is the best way to prevent whooping cough.
Whooping cough is a potentially fatal bacterial infection that attacks the airways causing uncontrollable coughing and difficulty breathing.
Young infants infected with whooping cough may stop breathing or turn blue, have apnoea (pauses in normal breathing), pneumonia, feeding problems and weight loss, seizures, brain damage and, in some cases, even die.
Older children and adults can also become infected with whooping cough and, while their symptoms are usually less severe, they can pass the infection to others, including infants too young to be immunised.
What are the signs and symptoms of whooping cough?
Symptoms generally appear 7 to 10 days after infection.
Whooping cough usually starts like a cold with a blocked or runny nose, tiredness, mild fever and cough.
The cough typically gets worse and severe bouts of uncontrollable coughing can develop.
Coughing bouts can be followed by vomiting, choking or taking a big gasping breath which causes a 'whooping' sound. The cough can last for many weeks and can be worse at night.
Some newborns may not cough at all but they can stop breathing and turn blue. Some babies have difficulty feeding and can choke or gag, they may have apnoea (pauses in normal breathing), pneumonia, weight loss, seizures, brain damage and, in some cases, can even die.
Older children and adults may just have a cough that lasts for many weeks.
Not every person makes the whooping sound – this is more common in non-immunised children.
The cough may last up to 3 months, but the person is no longer infectious after 21 days (3 weeks).
Whooping cough was previously referred to as the ‘100-day cough’ as it can persist for months and can be so severe that it could cause vomiting, broken ribs and hospitalisation.
Pneumonia is a relatively common complication, and seizures and brain disease occur rarely.
How is whooping cough spread?
Whooping cough spreads by airborne droplets, that is, an infectious person coughs or sneezes bacteria into the air which can then be inhaled by other people in close proximity.
Once a person is infected with whooping cough and starts experiencing symptoms they can be infectious to others unless they are treated early.
Without treatment people with whooping cough are infectious during the first 3 weeks of their illness and can infect others in their household, workplace, child care centre and school.
Who is most at risk of whooping cough?
Everyone is at risk of getting whooping cough.
Whooping cough spreads easily through households and families. People living in the same household as someone infected with whooping cough are especially at risk of becoming infected, and young unvaccinated children are at most risk of serious complications if they are infected.
Babies are at greatest risk of severe illness with 80% of whooping cough deaths occurring among infants less than 3 months old. Immunisation of pregnant women offers the baby protection until the child can receive their own vaccinations starting at 6 weeks of age.
Whooping cough can cause serious illness in older children and adults, people with asthma are 4 times at greater risk of being hospitalised with whooping cough and more than half the cases in Australia occur in adults.
Immunisation reduces the risk of infection but vaccine immunity fades over time, so you can still get whooping cough infection even if you’ve been immunised.
How can whooping cough be prevented?
Whooping cough vaccine
The whooping cough vaccine provides good protection from infection.
Immunity does fade over time, which means that booster injections at specific ages are needed.
Whooping cough vaccines come as a combination vaccine that also protects against other diseases such as diphtheria and tetanus.
The whooping cough vaccine is free under the National Immunisation Program (external site) for
Immunisation for your child
Children are recommended to get a vaccine that protects against whooping cough. See the WA Childhood Immunisation Schedule.
Adolescents are also recommended and offered the vaccine at the beginning of high school, around 12-13 years of age (Year 7 or equivalent). See the School-based immunisation program.
It is important your child gets all their vaccinations on time to ensure they have the best possible protection against infectious diseases.
If your child’s vaccinations are overdue, see your immunisation provider to catch-up.
Immunisation during pregnancy
It is recommended you receive a whooping cough vaccine during the third trimester of pregnancy (between 28 and 32 weeks). However, the vaccine can be given at any time during the third trimester up to delivery.
Vaccination during pregnancy has shown to be more effective in reducing the risk of whooping cough in young infants than vaccinating the person after they have given birth.
The whooping cough vaccine is delivered in one injection with diphtheria and tetanus (dTpa). It's safe and can be given even when you are breastfeeding.
Read more about the whooping cough vaccine in pregnancy.
Immunisation for adults
A booster for adults is recommended:
- if you have not had a whooping cough vaccination in the past 10 years
- for both parents when they are planning a pregnancy
- for other adult household members, grandparents and carers of infants under 12 months of age
- for adults working with young children, especially health care and child care workers.
Anyone who wants to reduce their likelihood of becoming sick with whooping cough may consider receiving a whooping cough vaccine. Discuss this with your immunisation provider.
If you are a close contact of someone with whooping cough:
If you have been exposed to someone with whooping cough early in their illness while they are infectious, watch out for symptoms and see your doctor if you become unwell with a cough.
Some babies and some pregnant people may need antibiotics to prevent whooping cough infection if they have had significant contact with an infectious person.
Minimise spread of infection
Whooping cough is spread by infected people coughing or sneezing. The following actions can help reduce the risk of infection spreading:
- Teach children about cough and sneeze etiquette e.g. cough or sneeze into your elbow rather than your hand.
- If you have a respiratory illness, avoid contact with at-risk people until you are symptom free.
- If you used a tissue to cover your nose or mouth, place this in a closed bin after use.
- Wash your hands.
How is whooping cough diagnosed?
Your doctor may ask about your symptoms and whether you’ve had any contact with someone infected with whooping cough.
If your doctor thinks you have whooping cough, they will take a swab from the back of your nose and send it to the laboratory to confirm the diagnosis.
How is whooping cough treated?
Young infants particularly those too young to have been immunised may need treatment in intensive care in hospital ; these infants are very vulnerable to infection and can die.
Antibiotics are used to treat whooping cough in the early stages of illness and can help prevent the spread of whooping cough infection to others.
People who are not treated early with the right antibiotics can spread the infection in the first 3 weeks of showing symptoms.
After 5 days of antibiotic treatment, people are normally no longer infectious, however, the cough often continues for many weeks, despite being treated with antibiotics.
Notifiable disease
Whooping cough is a notifiable disease. This means doctors, hospitals and laboratories must confidentially notify confirmed cases to the local Public Health Unit. Public Health Unit staff can provide advice about the best way to stop further spread of infection.
Infectious children are restricted from going to pre-school and school.
Unimmunised contacts may be excluded from child care unless they take the recommended antibiotics.
Where to get help
Last reviewed: 08-11-2023
Acknowledgements
Public Health
This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.