Key facts
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Pertussis, also known as whooping cough, is a highly contagious respiratory illness caused by the bacteria Bordetella pertussis
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The illness begins with cold-like symptoms and a cough that worsens, sometimes resulting in violent coughing fits, and can last for weeks or months.
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A characteristic “whoop” sound may occur when the affected person gasps for air between coughs
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Whooping cough is most dangerous for babies
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Vaccination is the best way to prevent whooping cough.
Overview
Whooping cough, or pertussis, is a respiratory infection that is highly contagious. It is caused by the bacterium Bordetella pertussis , and it is spread from person to person by coughing and sneezing. The disease can affect anyone but it is most dangerous for babies. Vaccination against pertussis is included in the UK’s routine immunisation schedule for babies.
Signs and symptoms
The first signs of whooping cough are similar to a cold, such as a runny nose and sore throat; a high temperature is uncommon. The cough associated with pertussis can last for weeks or months.
After about a week, the following symptoms may develop:
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Coughing bouts that last for a few minutes and are worse at night
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A “whoop” sound, which is a gasp for breath between coughs (though young babies and some adults may not “whoop”)
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Difficulty breathing after a coughing bout and possibly turning blue or grey (especially in young infants)
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Bringing up thick mucus, which can cause vomiting
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Becoming very red in the face (more common in adults)
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The coughing episodes can be violent enough to trigger vomiting,
Dangers and complications
Babies under 12 months old with whooping cough have an increased chance of developing serious problems, such as dehydration, breathing difficulties, pneumonia, and seizures. Babies with whooping cough can temporarily stop breathing, turn blue, and experience seizures or brain damage, with roughly half of infected infants under one requiring hospital care.
While less severe in older children and adults, whooping cough can still cause problems such as sore ribs, hernia, middle ear infections and urinary incontinence. A severe cough can also lead to chest pain, which could indicate pneumonia.
Transmission
Whooping cough spreads easily from person to person through the air. When an infected person coughs or sneezes, they release small particles containing the bacteria, which others can then breathe in. This is more likely to happen when people spend a lot of time together or share breathing space.
People can spread the bacteria from the start of symptoms and for up to three weeks after the coughing begins. Some people may have mild symptoms and not know they have whooping cough, but can still spread the bacteria. Many babies who get whooping cough are infected by older siblings, parents, or caregivers who are unaware they have it.
Treatment
Treating whooping cough early with antibiotics may make the infection less serious. If diagnosed within two weeks of the cough starting, antibiotics can help stop it spreading to others, although they may not reduce symptoms.
Hospital treatment is usually needed for severe whooping cough or if it is in a young baby. To ease symptoms, get plenty of rest, drink fluids, and take paracetamol or ibuprofen if uncomfortable. Aspirin should not be given to children under 16.
Prevention
The best way to prevent whooping cough is through vaccination. The whooping cough vaccine is routinely given as part of the 6-in-1 vaccine for babies at eight, 12, and 16 weeks, and the 4-in-1 pre-school booster for children aged 3 years 4 months. Pregnant women are also advised to have the whooping cough vaccine, usually around 20 weeks of pregnancy, to help protect their baby for the first few weeks of life.
Preventive antibiotics, also known as postexposure antimicrobial prophylaxis, may be given to someone who has been exposed to the bacteria to prevent them from getting sick. It’s also recommended to practice good hygiene to prevent the spread of bacteria and viruses.
Although people who have had whooping cough have some immunity, it does not provide lifelong protection, and re-infection is possible.
History
The earliest medical descriptions of pertussis are thought to be from a Persian physician who described an outbreak of violent coughing in Rey (near present-day Tehran) in the late winter of 1501.
In the early 20th century, whooping cough was a common childhood disease and a major cause of childhood deaths – in the United States, for example, there were up to 200,000 cases reported annually.
In 1906 the bacterium was isolated, leading to the development of the first vaccine in 1913. A much more effective vaccine was developed in 1939, and in the late 1940s it was combined with diphtheria and tetanus to create a single jab and was rolled out widely. It was refined again in the 1980s.
The advent of vaccination has not seen the disease disappear completely. Pertussis is cyclical, with outbreaks every three to five years. The last big outbreak in the UK was in 2012, when there were over 9,300 cases in England alone – this was more than 10 times as many as in previous years – and 14 babies under three months old died.
After a historic low during the Covid pandemic, 2024 saw a resurgence of the disease globally – in England, between January and May 2024, there were 7,599 confirmed cases, with eight infant deaths over the same period. By contrast, there were just 858 cases reported during the whole of 2023.
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