This post is also available in: Svenska
Facts and advice about whooping cough. Written by pediatricians, for parents. Standing next to a small baby with severe whooping cough (pertussis) is among the most painful things I have ever experienced. The baby has such horrible coughing attacks that they often end up turning bluish gray and losing their breath, sometimes even consciousness. A baby with severe air deprivation and anxiety is among the most heartbreaking things you can see, believe me. And no one can help them through their coughing attacks.
As a pediatrician, you do what you can, and often have to help the child start breathing again after the coughing attack. But sometimes it does not help. Two infants died of whooping cough in 2014, and one child died in 2015. I also know that many babies with whooping cough have repeatedly presented at the pediatric emergency room and been sent home without sampling, without anyone thinking about the disease, because they did not have the coughing attack in the emergency room.
Symptoms of whooping cough in infants
The first symptom of the disease in an infant may be apnea, a pause in breathing. If your child has a pause in their breathing, you may gently shake or agitate the child. Generally the child will then start breathing again. If not, give mouth-to-mouth resusitation and call emergency services (112 for Europe, 911 in USA). You must go to the pediatric emergency room if you notice a pause in breathing, and make sure that the child is tested for whooping cough.
If someone in the family has been coughing for a long time, the child should probably have antibiotic treatment as if it were whooping cough, before the test result are confirmed.
The infection continues as a common cold with a runny nose and coughing for a few days. But unlike a common cold, the cough does not go away. It gets worse and worse.
The coughing attacks become severe and when the child inhales, they make a loud beep sound. It is a high-pitched intake of breath that sounds like a “whoop” as the child is losing their breath.
Symptoms of whooping cough in older children and adults
In older children and adults, pertussis infection looks much more like a common, tenacious cold. The coughing sounds typical for infants, are not usually heard. The disease is also not dangerous for older children and adults.
If you are close to an infant and have a difficult cough – test yourself! I know that there are many who have been denied the tests by medical doctors. I get so angry every time.
All infants who may have been infected, should have antibiotics
Antibiotics help against whooping cough if they are taken at the very beginning of the infection, before the coughing starts. The antibiotics are most effective if they are taken before you get the symptoms. There is a special antibiotic called Ery-Max (erythromycin) that children receive. Ordinary penicillin does not help. Unfortunately though, Ery-Max can cause a lot of gastrointestinal side effects. But a screaming baby with a stomach ache for ten days is so much better than a baby with whooping cough.
Vaccine against whooping cough
Whooping cough (pertussis) vaccine is included in the general vaccination program. It is a truly life-saving vaccine. Babies who have received a dose of the vaccine can certainly get the disease, but they will survive.
Many adults lack the protection against whooping cough and can infect infants
Children receive booster whooping cough vaccines at 5 and 15 years of age. But after that there are no extra doses. This means that very many adults are unprotected against the disease.
In addition, there was a period in the 1980s when people did not vaccinate against whooping cough in Sweden due to suspicions that the old pertussis vaccine (so-called whole cell vaccine) had given severe side effects in some infants.
The vaccine that children receive in Sweden now (acellular whooping cough vaccine) has no serious side effects, but is also not 100% effective.
Therefore, the number of cases of whooping cough in Sweden is increasing, and the risk of infants becoming infected is increasing.
Wooping cough (pertussis) vaccine for pregnant women protects infants against whooping cough
The UK recently had an even worse pertussis epidemic than we are currently experiencing in Sweden. There, 14 babies died in 2012 and 13 babies in 2013 to 2016 caused by whooping cough. In 2017, no child in the UK died of whooping cough after introducing the whooping cough vaccination to pregnant women.
Whooping cough vaccine for pregnant women protects them in two ways. One, the mother forms antibodies that are transmitted via the placenta to the newborn baby. And two, the mother herself receives protection and does not risk becoming ill and infecting the newborn.
In Sweden, general vaccination of pregnant women against whooping cough was not recommended, as it was not considered cost-effective considering how rare the infection was. In addition, there were suspicions that the child’s own vaccination protection at 3 months, could be affected by the vaccination during the mother’s pregnancy. However, thankfully from 2022, the public health authority issued a statement that now recommends pregnant women to take the whooping cough vaccination from week 16.
Breastfeeding does not provide any protection against whooping cough.
Whooping cough is a deadly disease for infants. It can be prevented in infants when vaccinating pregnant women, by vaccinating for infants from the age of two months, and by antibiotic treatment for infants exposed to the infection. Test infants and their family members for suspected whooping cough.