Whooping Cough (Pertussis)

What is Whooping cough?

Pertussis, commonly known as ‘whooping cough’, is an extremely contagious infection of the respiratory tract caused by the bacterium Bordetella pertussis. Whooping cough infection can be life-threatening in babies: It can cause apnoea (temporary cessation of breathing), pneumonia, feeding difficulties, weight loss, seizures, brain damage and, in some cases, death.

What are the symptoms?

The early symptoms resemble those of a cold: blocked or runny nose, tiredness, a cough and mild fever. The cough gradually worsens and severe bouts of uncontrollable coughing can develop. This can lead to vomiting and choking, and also the intake of large gasping breaths which cause a ‘whoop’ sound, giving pertussis its common name. The infection can last for 1 – 2 months and and its awful symptoms are often worse at night. The high-pitched whoop may be absent in very young infants, older children and adults.

Where is it found?

Pertussis is found in all regions of the world and, despite established immunisation programs over the past 50 years, it remains a challenging disease to control. One major stumbling block is the waning over time of immunity that is gained from immunisation or infection, leading to renewed susceptibility to infection. Outbreaks are cyclical, happening every 3 to 4 years. The largest outbreak of whooping cough since reporting began in 1991 occurred between 2008 and 2012 in all states and territories of Australia. Parents are the most likely source of infection for infants and the highest rates of disease occur in infants under 6 months and children aged between 5 and 9 years. Young infants are much more likely to develop severe disease than older age groups.

How is Whooping cough transmitted?

Whopping cough is spread from person to person when an infected individual coughs bacteria into the air and it is inhaled by others nearby. If not treated early, people with whooping cough are infectious for a period of 3 weeks.

What is Whooping cough Vaccination?

In Australia, whooping cough vaccines for adults are only available in combination with diphtheria and tetanus, with or without other antigens such as inactivated poliomyelitis (IPV).

Vaccination is recommended for any adult who wishes to reduce their likelihood of becoming infected, and is particularly recommended for those in close contact with young infants (e.g. family members, healthcare workers, child care workers). Vaccination is also recommended for pregnant women: in some states, this is funded under the National Immunisation Program (NIP).

Adults: Diphtheria toxoid given in combination with Tetanus or Tetanus/Pertussis (ADT, Adacel / Boostrix) or Tetanus/ Pertussis/ Polio (Adacel Polio / Boostrix IPV).

Children under 10 years: Diphtheria toxoid given in combination with Tetanus and others. (InfanrixHexa, Infanrix IPV, Pediacel, Quadracel, Tripacel)

Whooping cough vaccines provide good protection from infection but the fading of immunity over time means that boosters are needed.

Schedule

A primary series of vaccinations is given to infants from 6-8 weeks of age. Three doses are administered at least 4 weeks apart, with boosters at 4 years of age and again at 12 -17 years of age.

A single booster of tetanus/diphtheria-containing vaccine (preferably also containing pertussis) is given at 50 years of age, however boosters are administered every10 years for travellers to countries where health services are difficult to access. This timeframe is reduced to every 5 years for those travellers who will be undertaking activities with a high risk of injury, i.e. mountaineering, bike riding, rock climbing and caving in areas remote from good medical care.

Level of protection

Over 95%

Possible Side Effects

Pain, redness or swelling at injection site, as well as transient fever, headache and malaise.

In young babies, decreased appetite, fever and crying. In children who had DTP (tetanus, diphtheria, whooping cough) as their primary vaccination, boosting with the same vaccine produced extensive limb swelling in 2% of recipients.

Acute allergic reactions occur in 1 per 1 million doses.

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