Whooping cough in newborns

Whooping cough, or pertussis, is a serious bacterial infection that’s passed from person to person via a cough or sneeze. It caused thousand s of deaths in the 1940s and 50s, but nowadays it’s rare, thanks to childhood immunisations – children are vaccinated against it at two, three and four months.

However, if there is an outbreak, newborns who have yet to receive their first set of immunisations (which cover a range of diseases as well as whooping cough), as well as those whose parents have chosen not to immunise them, are particularly at risk. Also, immunisation doesn’t guarantee protection – rarely, babies who have completed their immunisations do develop whooping cough.

What causes whooping cough in newborns?

Whooping cough is caused by bacteria that attach to the cilia, which are microscopic hairs that line the respiratory tract. As a result, the respiratory tract becomes inflamed and mucus builds up.

If your newborn has spent five or more hours, over the space of a week, in the same room as someone who has whooping cough she’s at high risk of developing the disease if she hasn’t completed her immunisations. It’s thought that over 70 percent of people who are exposed go on to develop it.

What are the symptoms?

Whooping cough usually takes around three weeks to incubate. It initially starts with a mild cough, low-grade fever and runny nose. It develops into a more acute phase after a week or so: your newborn’s cough will worsen and she will suffer from bouts of intense coughing that sounds dry and harsh, and ends with the characteristic ‘whoop’ sound as she inhales. Your newborn’s coughing bouts may be so severe that she vomits, and her face may turn blue as she tries to take in air.

Whooping cough can last for several weeks _ in fact, it has been termed the ‘100-day cough’ – but the coughing usually starts to ease off at around week six, but may recur over the next four to eight weeks.

Newborns are especially at risk of complications if they develop whooping cough. Other infections can more easily affect the lungs of a baby with the disease, so it’s possible for whooping cough to develop into pneumonia. Signs your newborn might have pneumonia along with whooping cough include a sudden deterioration in her condition, a high fever, and difficulty breathing between coughing bouts. Pressure on the blood vessels in her nose due to coughing can cause them to rupture, resulting in nosebleeds. Seizures are also a possibility.

Treatment

It’s usually obvious that your newborn has whooping cough due to the sound that give it its name, but not all babies produce the whoop at the end of a coughing bout. If there’s any doubt, your doctor will take a culture from your baby’s nose.

Treatment is based on your child’s age but in most case newborns are admitted to hospital for supportive care and monitoring. She’ll likely need oxygen and intravenous fluids, and may be given antibiotics (this doesn’t actually help her symptoms but will ensure she is no longer infectious after five days of antibiotic treatment – without it she’d be infectious for several weeks). Medications that are used to treat asthma also may be used to control her coughing bouts.

Prevention

The best way to help protect your baby from whooping cough is to ensure she receives her immunisations using the pertussis vaccine. This is usually part of the DTaP vaccine - the diphtheria, tetanus, and pertussis vaccine – usually given to children at two, three and four months, with a booster at three years of age.

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.

Last Modified: 14/11/2008