The name conjures up images of children suffering in damp rooms more than half a century ago but don’t let that fool you – whooping cough is making a comeback in the UK and US and it isn’t class conscious. The number of reported cases rose dramatically in 2012 to 9741 in England and Wales, a figure ten times higher than in 2011. The cases were mainly in adults but there is a concern about contact with children or babies or other vulnerable people who have not been fully vaccinated.
Small babies and children are particularly at high risk from this highly contagious infection, caused by a bacteria which infects the linings of the airways. As the bacteria spreads it causes a build-up of a thick mucus. It is the mucus that causes the intense bouts of coughing as the body tries to expel it. A secondary effect is a swelling of the inflamed areas of the airways, which then narrow.
At Riverside Nannies we are familiar with early morning requests from parents for emergency childcare due to measles and chicken pox it looks like whooping cough may be making its way back into the list.
Why’s it called whooping cough?
Well that is actually the colloquial name for Pertussis, and refers to the sound created as the sufferer tries to breathe. All in all a thoroughly unpleasant infection with symptoms that can last for many weeks and in certain cases can be life threatening.
How can I prevent my child from catching it?
‘The answer comes in two parts, understanding cross-infection and immunisation’
Understanding that it is highly infectious, and that it is most frequently passed on from adults and other family members is at the heart of prevention. The bacteria, Bordetella Pertussis, can live in the human respiratory tract. The bacterium is carried in droplets of moisture in the air. When someone coughs or sneezes they propel hundreds of infected droplets into the air. If the droplets are breathed in by someone else, the bacterium could infect their airways too. Making oneself fully aware of how to prevent cross infection if someone has cold symptoms is key. Frequently the person with Pertussis doesn’t realise they have it, so unwittingly pass it on. But let’s be careful here, not every cough is Pertussis. Typical symptoms in an adult are flu like that persist and develop into coughing fits. The best way to find out if it is whooping cough is to visit the Doctor. Immunisation is key to prevention and everyone who is in close range to a baby or young child should be – think Parents, Grandparents, care-givers and brothers and sisters.
How can I avoid passing on the infection?
Whooping cough is highly infectious, so if you, your child or someone in close contact with you have it, it is important to stay away from others until the infection has completely cleared. The affected person should stay at home until they have completed a five-day course of antibiotics from their GP, or had intense bouts of coughing (paroxysms) for three weeks (whichever is sooner). Although bouts of coughing may continue after three weeks, it is unlikely you will still be infectious because the bacterium will have gone.
Why is Whooping Cough particularly harmful to small children and babies?
Small babies and children have a higher risk of serious harm, their immune system and lungs are immature and they also have very narrow airways so swelling can cause obstruction. Elderly people are also at risk.
Can Immunisation Help?
It is critical that the immunization programme set out by your health authority is followed rigorously. The vast majority of adults have been immunized however current thinking is that the immunization received as a child wanes in adulthood and boosters are essential. The most ‘at risk group’ are babies who have not completed their immunization programmes. Pregnant mothers in the UK are offered immunization particularly targeting the group who are between 28-38 weeks pregnant. Not only does this benefit them, but also passes antibodies to their unborn child, which is of immense benefit to the new born baby, diminishing the risk of infection.
Any good news here?
Yes -The good news is that the uptake rates on adult immunization amongst pregnant women in the UK has been high and that it is already affecting positively the reported cases of Pertussis. The immunization campaign has been very effective targeting the fact that whooping cough can be very dangerous in babies and young children especially prior to vaccination and by getting vaccinated mothers’ can protect their babies from developing whooping cough in their first few weeks of life as the immunity is passed on once the baby is born.
How is the vaccine given to babies?
In babies it is given as part of the 5-in-1 vaccine, which also protects against diphtheria, tetanus, polio and Hib (haemophilus influenzae type b). In the UK, babies are usually given the 5-in-1 vaccine when they are two, three and four months old and a pre-school booster vaccine is also given before children start school.
Can you tell me more about the symptoms of whooping cough?
The symptoms can start between 6 to 20 days after exposure and typically has three stages.
The first stage starts with runny or blocked nose, sneezing, watering eyes, dry, irritating cough, sore throat, slightly raised temperature, feeling generally unwell. The early symptoms of whooping cough can last for one to two weeks, before becoming more severe.
The second stage is characterised by intense bouts of coughing which bring up thick phlegm (mucous). Common is a ‘whoop’ sound with each sharp intake of breath after coughing. Also common is vomiting after coughing, especially in infants and young children and tiredness and redness in the face from the effort of coughing. This stage usually last at least two weeks, but can last longer, even after treatment. This is because the cough continues even after the bacteria has been cleared from your body.
The third stage (recovery stage) is when the symptoms of whooping cough gradually start to improve, with fewer and less extreme bouts of coughing occurring. This period of recovery can last up to three months or more. However, intense bouts of coughing may still occur during this period.
Are the symptoms always accompanied by a whooping cough sound?
Infants younger than six months may not make the ‘whoop’ sound after coughing, but they may start gagging or gasping, and may temporarily stop breathing. Though very rare, it is possible for whooping cough to cause sudden unexpected death in infants Young children may also seem to choke or become blue in the face (cyanosis) when they have a bout of coughing. This looks worse than it is, and breathing will usually quickly start again.
Riverside Training Company recommend every family member or caregiver who will be alone with children to undertake a paediatric first aid course. We offer these year-round on public dates and for private groups. Dates are posted on our website http://www.riversidechildcare.net and at https://www.facebook.com/nannytraining
Young babies (less than a year old) with whooping cough are likely to be treated in hospital in order to avoid developing complications. Babies over one year may also need to be admitted depending on the severity of the illness. Whooping cough is much less serious in older children than it is in babies and young children, you should still see your GP who will usually advise you to manage the infection at home (see signs of serious illness below.)
- You need to get ensure children
- Get plenty of rest
- Drink lots of fluids
- Offer small portions of favourite food at regular intervals – if not eating -milk shakes, rice pudding, pasta with chicken etc may be useful. (High in protein and carbohydrate.) Do not worry about healthy diets at this time however sudden sugar highs are unlikely to be helpful. Diets supplements should only be used if advised by a health worker.
- Keep as upright as possible at night. • c
- Cough medicine is unlikely to be any help. •
- Sips of water can help with coughing so have a drink available.
- Avoid very dry air in the room by putting a bowl of water near a heat sources you can also buy humidifiers which may help
- If warm enough fresh air (but away from people) is always good but avoid sudden cold air as may trigger coughing.
- Clear away excess mucus or vomit during bouts of coughing so it cannot be inhaled and cause choking ibuprofen and/or paracetamol can be used to relieve other symptoms such as a high temperature and sore throat – Remember aspirin should not be given to children under the age of 16
Preventative treatment may be recommended for vulnerable people you live with or had regular contact with, this includes
- Newborn babies
- Children under the age of 10 who have not been vaccinated
- Women in the last month of pregnancy •
- People with a weakened immune system, •
- People with a long-term health condition such as asthma or heart failure
Preventative treatment is also usually recommended if a household member works in a healthcare, social care or childcare facility as they could pass the infection on to other vulnerable contacts such as an elderly parent. Preventative treatment usually involves a short course of antibiotics, and in some cases, a booster dose of the vaccine
Signs of serious illness / When must I take my child to see a doctor?
If you see any of these symptoms in your baby or young child seek medical help urgently:
- A high-pitched, weak or continuous cry
- A lack of responsiveness, reduction in activity or increased floppiness
- In babies, a bulging fontanelle (the soft spot on a baby’s head)
- Neck stiffness (in a child)
- Not drinking for more than eight hours (taking solid food is not as important)
- A temperature of over 38°C for a baby less than three months old, or over 39°C for a baby aged three to six months old
- A high temperature, but cold feet and hands
- A high temperature coupled with quietness and listlessness
- Fits, convulsions or seizures
- Turning blue, very pale, mottled or ashen
- Difficulty breathing, fast breathing, grunting while breathing, or if your child is working hard to breathe, for example, sucking their stomach in under their ribs
- Your baby or child is unusually drowsy, hard to wake up or doesn’t seem to know you
- Your child is unable to stay awake even when you wake them
- A spotty, purple-red rash anywhere on the body (this could be a sign of meningitis)Repeated vomiting or bile-stained (green) vomiting
On a final note this NHS Whooping Cough short video provides more useful advice.