Is it whooping cough or just a cold?

Whooping cough cases have been rising across England, as well as in many other countries, since December 2023 due to a combination of factors. Whooping cough is a cyclical disease that peaks every 3 to 5 years - the last cyclical increase was in 2016.

Whooping cough cases were very low during the pandemic as fewer people mixed to spread the infection. Numbers are now rising as the pandemic reduced immunity in the population and also because the UKHSA says uptake of whooping cough vaccinations have fallen in recent years.

What causes whooping cough?

Whooping cough is caused by the bacterium Bordetella pertussis, and its early symptoms are very similar to those of a cold - runny nose, red watery eyes, a sore throat and raised temperature. Around a week later, the characteristic cough - including the whoop caused by the individual gasping for air - follows.

Dr Krishna Vakharia, GP and EMIS Clinical Director says that in the first 5 to 6 days the symptoms of whooping cough are similar to cold symptoms with the main difference being that the coughs become more intense later and more frequent at night.

What are the signs it's whooping cough

At first, whooping cough may seem like a normal cough but it you can tell it apart with time by the following characteristics:

• Whooping cough lasts longer; where a normal cough may last just a few days or weeks, whooping cough may last several months.

• Whooping cough usually has several uncontrolled coughing spasms which can be quite severe and cause vomiting.

• There is a 'whooping' sound when inhaling compared to normal coughs - although this only happens in around one half of cases.

• Choking and face colour changes - red or blue - are more common with whooping cough than with normal coughs.

• Breathing difficulties are also more common with whooping cough than with normal cough.

• The cough sometimes produces a thick mucus which can cause you to be sick.

• Sometimes the force of coughing can cause light bleeding under the under the whites of the eyes and skin.

Dr Vakharia says that children may also have red faces from the strain of coughing, may experience periods of shortness of breath and may briefly turn blue, but this is restored shortly.

The symptoms will become less severe and occur less frequently over time, but it can take months to stop completely.

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Chronic persistent cough in adults

A cough is termed "chronic", which means persisting and long-term. This typically means it has hung around for more than eight weeks. Other types of cough such as a shorter-term cough, lasting up to three weeks, is called "acute", and if it is somewhere in the middle, it's called "subacute". Infections (such as the common cold or a chest infection) are the most common reason for acute coughs, but these usually settle within about three weeks.

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When is it contagious?

Whooping cough is spread in the drops of coughs and sneezes, and you can be infectious for around three weeks from the time they develop the 'catarrhal' phase - when you have a runny nose, sneezing, temperature is up, and a mild cough. After this the bouts of severe coughing start.

How to treat whooping cough

Treatment depends on age and how long the infection has been present. Children under six months and people with severe symptoms or who are very ill will usually be admitted to hospital for treatment.

Antibiotics may be given within the first few weeks to reduce the spread of the infection. Most people are no longer infectious after three weeks and may not need any treatment. While antibiotics should reduce spread, they don't speed up recovery, or reduce the severity of symptoms.

To ease the symptoms you can:

• Stay hydrated by drinking plenty of fluids.

• Rest and get sleep.

• Painkillers such as paracetamol or ibuprofen may speed up recovery as well as reduce signs of the infection such as high temperature.

• Wash your hands and face regularly, put used tissues in the bin and wash clothes.

Vakharia says that cough medicines are not generally recommended as they are not suitable for young children and are of little or no benefit in whooping cough.

How to stop whooping spreading

To stop the infection spreading, the National Institute for Health and Care Excellence (NICE) suggests:

• Keeping infected children off nursery or school and adults off work until 48 hours after starting antibiotics, or three weeks after coughing starts, whichever is sooner.

• Cover your mouth and nose when coughing and sneezing.

• Dispose of tissues straightaway

• Wash hands with soap and water regularly.

What about the whooping cough vaccine?

Timely vaccination in pregnancy and in infancy are both important to protect vulnerable young babies from serious disease.

Dr Gayatri Amirthalingam, Consultant Epidemiologist at UK Health Security Agency, says:
"Vaccination remains the best defence against whooping cough and it is vital that pregnant women and young infants receive their vaccines at the right time."

All pregnant women are offered a whooping cough vaccine to protect babies and young children from whooping cough, ideally between 20 and 32 weeks. This passes protection to their baby in the womb so that they are protected from birth in the first months of their life when they are most vulnerable and before they can receive their own vaccines.

All babies are given three doses of the 6-in-1 vaccine at 8, 12 and 16 weeks of age to protect against whooping cough and other serious diseases such as diphtheria and polio with a pre-school booster offered at 3 years 4 months. This booster doesn't offer lifelong protection, but can help prevent children getting whooping cough when young and more vulnerable to the effect of infection.

Can you get whooping cough twice?

If you have had whooping cough before, it is unusual, but you can still get it again. However, the symptoms tend to be less severe the second time around.
Also, protection from the whooping cough vaccine tends to wear off after a few years.