Whooping cough, or pertussis, is a highly contagious respiratory disease caused by the bacterium Bordetella pertussis. It is characterised by severe coughing fits, followed by a high-pitched “whoop” sound during the subsequent intake of breath.
This disease, although preventable by vaccination, has been resurging in the UK, with the latest data from the UK Health Security Agency (UKHSA) indicating 2,591 confirmed cases in May 2024 alone. This alarming increase calls for heightened vigilance among healthcare workers and awareness among parents.
Understanding whooping cough
Whooping cough begins with mild respiratory symptoms, similar to those of a common cold, such as runny nose, mild cough, and fever. After one to two weeks, the symptoms progress to severe coughing fits. These fits can be exhausting and may end in vomiting, a red or blue face, and a distinctive whooping noise, especially in children. The cough can last for weeks or even months, hence the nickname “the 100-day cough”.
Susceptible populations
Infants under six months old are particularly vulnerable to whooping cough, as they are either too young to have received the full course of vaccinations or have not yet built sufficient immunity. Children between 1-10 years and adolescents also represent a significant proportion of cases, often due to waning immunity. Additionally, pregnant women and unvaccinated individuals are at higher risk of contracting and spreading the disease.
Importance of vaccinations
Vaccination remains the most effective way to prevent whooping cough. The UK’s routine immunisation schedule includes the pertussis vaccine at two, three, and four months of age, followed by boosters at three years and four months, and again between 13 and 18 years of age. Pregnant women are also advised to get vaccinated between 16 and 32 weeks of pregnancy to protect their newborns.
Vaccinations not only protect individuals but also contribute to herd immunity, reducing the spread of the disease within the community. Despite this, vaccine coverage has seen slight declines, potentially contributing to the recent surge in cases.
What healthcare workers should look out for
Healthcare workers play a crucial role in early diagnosis and management of whooping cough. Here are key signs and symptoms to monitor:
- Persistent cough: A prolonged cough lasting more than two weeks, especially if it is severe or comes in fits.
- Whooping sound: The characteristic “whoop” sound after coughing fits, particularly in children.
- Vomiting post-coughing: Episodes of vomiting after coughing, which can be a significant indicator in children.
- Apnoea: In infants, episodes of not breathing (apnoea) can be a critical sign.
- Cyanosis: A blue or red face during coughing fits.
Laboratory tests such as PCR and culture from nasopharyngeal swabs can confirm the diagnosis. Early detection is vital for preventing complications and controlling outbreaks.
What parents should look out for
Parents should be vigilant when looking for the following symptoms in their children, especially if they have not completed their vaccination schedule, or have been in contact with someone diagnosed with whooping cough:
- Cold-like symptoms: Initial symptoms like a runny nose, mild cough, and low-grade fever.
- Severe coughing fits: Progression to intense coughing spells that can last for several minutes.
- Whooping sound: Listening for the high-pitched whooping sound, particularly after a coughing fit.
- Apnoea in infants: Monitor for periods where the baby stops breathing momentarily.
- Vomiting or exhaustion: Post-cough vomiting or extreme tiredness after coughing fits.
Parents should seek medical advice if they notice these symptoms. Early treatment with antibiotics can help reduce the severity and spread of the disease.
Rising cases: A call to action
The rise in whooping cough cases in the UK is a stark reminder of the importance of maintaining high vaccination coverage and early detection. Public health campaigns are focusing on educating the community about the benefits of vaccination and the dangers of whooping cough, particularly for the most vulnerable groups.
Healthcare workers – particularly GPs and paediatric specialists – should ensure that they are vigilant in identifying potential cases and advocating for timely vaccinations. Parents should be proactive in getting their children vaccinated and seek prompt medical attention if they notice symptoms of whooping cough.
As the UK navigates this increase in whooping cough cases, a concerted effort from healthcare professionals, parents, and public health authorities is essential to protect the population and prevent further spread of this preventable yet potentially severe disease.
If you notice the symptoms described above in yourself or your child, please contact your Primary Care 24 GP practice and request an urgent appointment.
