Pertussis or whooping cough is a highly infectious disease which can lead to serious complications including death. The disease is especially severe in newborn babies and is a major cause of infant death worldwide; the World Health Organization (WHO) estimates that in 2008 there were about 16 million cases of pertussis, and that about 195 000 children died from the disease. However, vaccination has led to a big reduction in infant deaths in recent years. WHO estimates that, in 2008, global vaccination against pertussis averted about 687,000 deaths.
In 2012 the UK experienced a nationwide outbreak (epidemic) of pertussis. There were over 9,300 cases in England alone – more than ten times as many as in recent years. The causes of this are not clear. In 2013 and 2014 there was a fall in cases, but numbers were still high compared to previous years. In 2015 and 2016 the numbers of cases increased again. 14 babies under three months old died of pertussis in 2012, seven died in 2013, three died in 2014, four died in 2015, and four died in 2016. Vaccination of mothers can protect babies from this disease. See more infomation on the pertussis (whooping cough) vaccination programme for pregnant women.
Early symptoms are often similar to a cold (sore throat, sneezing, slight temperature and an irritating cough). These symptoms can last for up to two weeks before developing into long bursts of severe coughing and choking, followed by ‘whooping’ on intake of breath and vomiting. It can be difficult to recognise the disease in young babies because they do not always whoop, but instead hold their breath for short periods following the coughing spasm. They may turn blue as they are coughing so much they cannot take a breath. Complications are most common in infants under six months, and include weight loss due to repeated vomiting, pneumonia, brain damage due to oxygen deprivation, and death. Whooping cough can last for around 3 months and is sometimes called the 'hundred day cough'.
Whooping cough is most dangerous for newborn babies, but older children and adults can also get the disease. Symptoms can last for a long time and be extremely unpleasant and disabling. Older children and adults can also pass whooping cough on to babies.
In this video, ten-year-old Lauren Burnell and her mother talk about their experience of whooping cough. Subtitles are available (first button in the bottom right hand corner).
It is spread by coughing or sneezing. Individuals are most infectious in the early stages of symptoms, often before they know they have whooping cough.
Pertussis is highly infectious; if a baby who is not immunised comes into contact with someone who has pertussis, it is very likely that they will catch the disease, as this diagram shows:
Pertussis is a cyclical disease; every 3-4 years there is an increase in numbers of cases. The reasons for this are not clear.
It is not possible to develop natural immunity to pertussis without getting the disease itself. The only way to protect your child is vaccination. Babies are protected by the 5-in-1 vaccine. A follow-up dose is given in the Pre-school Booster vaccine.
Pregnant women should receive a dose of pertussis vaccine during their pregnancy to give protection to their newborn baby before his/her vaccines are due.
Before a vaccine was introduced in the 1950s, the average number of suspected cases in England and Wales was over 100,000 each year, and in some years over 2000 people died from pertussis. By 1972, when over 80% of children were vaccinated, this had fallen to 2069 suspected cases and 2 deaths.
In 1975 unfounded concerns about the safety of the vaccine resulted in a fall in vaccination rates; only 3 out of every 10 children were vaccinated against pertussis in 1975. This resulted in major epidemics in 1977-79 and 1981-83.
Since 1992, the UK vaccination rate has remained at around 94%. On average, between 2002 and 2011, 800 cases of pertussis were reported every year in England and Wales, 300 babies a year were hospitalised, and 4 babies died. Numbers are higher in epidemic years like 2012.
Some of the most serious cases of pertussis (requiring hospitalisation and intensive care) are in very young infants, before the age for immunisation, who may be infected by unvaccinated older siblings or their parents. It is possible to catch pertussis more than once, and the protection given by vaccination fades over time. This means that older people who have had pertussis or been vaccinated can still catch the disease and pass it on to more vulnerable people in the community.
There have been several outbreaks of whooping cough in the UK in recent years (including 2012) and work is ongoing to develop vaccines that will give even better protection.
See the NaTHNaC website for information and advice on pertussis vaccination for people who are travelling abroad. NaTHNaC (the National Travel Health Network and Centre) is commissioned by Public Health England to provide up to date and reliable information on travel vaccines for UK travellers.
Natalie talks about losing her third son Gavin to pertussis when he was just a few weeks old. Grateful thanks to Natalie and Shot by Shot for permission to use this film.
In this film, Julia Lamming talks about deciding whether to give the whooping cough vaccine to her baby daughter who had suffered from neonatal fits. Dr Matthew Snape from Oxford Vaccine Group explains how the vaccine itself has changed, and that babies with an identified and stable neurological condition can safely receive the vaccine.