Whooping Cough: Back to the Future

Whooping cough, or pertussis, is a highly contagious bacterial infection of the lungs caused by the bacteria Bordetella pertussis. It is also known as the ‘100 day cough’. It's spread from person to person through the air in tiny droplets of fluid when someone with the infection coughs, sneezes or talks. Infection can occur at any age, but it's more common in those under five years old. The incubation period between exposure and symptoms is about seven days. Initial symptoms are similar to a cold, with a runny nose, mild fever and dry night-time cough. A pattern of coughing spasms develops, with a series of short coughs followed by a sudden drawing-in of breath that makes the characteristic whooping sound (the whoop may not be heard in small babies). The bouts of coughing, which tend to occur at night, often end in vomiting. In England and Wales, GPs handle an estimated 35,000 consultations for pertussis infection and it's responsible for more than nine deaths a year. Most children, in the UK at least, are vaccinated against Whooping Cough at three to four months old.

The disease has associations with a bygone era, as it is now less common than 50 years ago, however, recent evidence from the UK’s Department of Health, suggests however, that cases have nearly trebled since 2003. Before the vaccine was introduced in the 1950s England saw tens of thousands of cases each year, but this then rapidly fell to about 2,000 cases annually after the immunisation programme began. In 2003, there were just 386 cases in England but provisional figures suggest there were as many as 1,071 in 2007. However, there is some evidence to suggest that Whooping Cough is also influenced by four year cycles, so the increase in cases, may not simply correlate to fewer people immunising their children Also, during this period, uptake of the jab remained steady over the last few years - around 93% or 94% coverage between 2003 and 2007. Recent research from the University of Oxford said that while immunisation is effective, doctors needed to be aware that protection did not last indefinitely.

A child with a persistent cough should be investigated for whooping cough, researchers warned, even if they had been fully immunised. In babies, the spasms of coughing may occur after feeding. During the coughing spasm, the child may go red or blue in the face and copious amounts of mucus may be produced from the nose or mouth. Nosebleeds and subconjunctival haemorrhages (bleeding into the white of the eye) may occur with intense coughing. Babies with whooping cough can, in rare cases, suffer from apnoea (when breathing stops) and sudden death. Causes and risk factors Whooping cough is fairly easily diagnosed by observing the symptoms and examining a swab taken from the throat or nose for traces of the bacteria. If you suspect whooping cough, or if your child develops an unusual cough that causes vomiting or doesn't improve after a couple of days, see a doctor. Get urgent medical advice if your child seems particularly unwell, goes blue during coughing or has other worrying symptoms. Treatment and recovery Mild whooping cough can be treated at home with plenty of rest and fluids, but in some cases hospital treatment may be needed. The benefit of antibiotics is debatable. They don't appear to shorten the course of the illness, but may prevent whooping cough in people who've been exposed to it and it spreading to other people. It's not unusual for the cough to persist for two to three months. The number of cases of pertussis has been greatly reduced since the introduction of immunisation.

Babies are routinely immunised to prevent whooping cough when they are two, three and four months old. Since November 2001, children in the UK have been routinely offered a preschool booster between the ages of three and five. Commenting on the upturn in Whooping Cough cases, Debbie Purser, CEO at April International UK said: “As with any illness, prevention is always better than cure. That’s why April International UK recommends parents immunising their children whenever possible against diseases.  Whilst immunisation helps, it cannot be guaranteed 100 per cent effective, so April International UK would recommend continuing to be extra vigilant, in case booster jabs or actual treatment is needed. All of April International UK’s policies cover treatment costs relating to Whooping Cough and our 24 hour helpline is there so you’re always in safe hands, should medical assistance be needed. Our priority is to look after the health of our policyholders and their families and to avoid any illness from getting any worse. A critical part of this is speed of response and our helpline can respond rapidly, wherever you are in the world.”