Whooping cough (pertussis) is an infectious disease caused by the Gram-negative bacterium Bordetella pertussis.

It typically presents in children. There are around 1,000 cases are reported each year in the UK.

Immunisation

• infants are routinely immunised at 2, 3, 4 months and 3-5 years. Newborn infants are particularly vulnerable, which is why the vaccination campaign for pregnant women was introduced
• neither infection nor immunisation results in lifelong protection - hence adolescents and adults may develop whooping cough despite having had their routine immunisations

PC

2-3 days of coryza precede onset of:

• coughing bouts: usually worse at night and after feeding, may be ended by vomiting & associated central cyanosis
• inspiratory whoop: not always present (caused by forced inspiration against a closed glottis)
• infants may have spells of apnoea
• persistent coughing may cause subconjunctival haemorrhages or even anoxia leading to syncope & seizures
• symptoms may last 10-14 weeks and tend to be more severe in infants

Diagnostic criteria

Whooping cough should be suspected if a person has an acute cough that has lasted for 14 days or more without another apparent cause, and has one or more of the following features:

• Paroxysmal cough.
• Inspiratory whoop.
• Post-tussive vomiting.