Whooping cough in children: coughing bouts, babies at risk and vaccination

The NHS says the first signs are similar to a cold, such as a runny nose and sore throat, and that a high temperature is uncommon. After about a week come coughing bouts lasting a few minutes, worse at night, with a possible whoop as the child gasps for breath between coughs. They may bring up thick mucus, vomit and go very red in the face. The cough may last several weeks or months.

NHS inform adds red and watery eyes at the start, slight bleeding under the skin or in the eyes from the strain of coughing, and that in very young babies the cough may not be noticeable but there may be brief periods where they stop breathing. Young children's skin can briefly turn dusky or blue if they have trouble breathing.

The NHS says babies under 6 months are more likely to develop problems and lists dehydration, breathing difficulties, pneumonia and seizures. NHS inform adds weight loss, kidney problems and brain damage from lack of oxygen, and says death is very rare. Older children and adults tend to be less severely affected but coughing can cause sore ribs, hernia, middle ear infections or leaking urine (NHS) and nosebleeds or bruised ribs (NHS inform).

NHS inform also says a previous infection or childhood vaccination does not give lasting protection: the vaccine tends to wear off after a few years, and people who have had whooping cough are not immune, though it tends to be less severe the second time.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if your baby is under 6 months and has symptoms of whooping cough, if a cough is very bad and getting worse, or if you have been in contact with someone with whooping cough and you are pregnant. NHS inform says to speak to the GP practice or phone 111 for a cough that has lasted more than 3 weeks.

The NHS says to call 999 or go to A&E if lips, tongue, face or skin suddenly turn blue or grey, if the child finds it hard to breathe properly (shallow breathing), has chest pain worse when breathing or coughing, or is having seizures. NHS inform adds long periods of breathlessness or choking, and periods where breathing stops.

The NHS says treatment depends on age and how long the infection has been present. Hospital treatment is usually needed for severe whooping cough or a baby under 6 months. If diagnosed within 3 weeks of the cough starting, antibiotics are given to help stop it spreading, and they may not reduce symptoms. NHS inform says people who have had whooping cough for more than 3 weeks do not normally need specific treatment because they are no longer contagious and antibiotics are unlikely to help.

At home the NHS suggests rest, plenty of fluids and paracetamol or ibuprofen if uncomfortable. NHS inform adds cleaning mucus and sick from the child's mouth and avoiding cough medicines because they are not suitable for young children and unlikely to help. Finish any antibiotic course.

The NHS says a person is contagious for up to 3 weeks after the coughing starts. NHS inform says infectious from about 6 days after infection, when there are only cold-like symptoms, until 3 weeks after the coughing bouts start, and that antibiotics can shorten the infectious period.

The NHS lists the routine vaccines: the 6-in-1 vaccine at 8, 12 and 16 weeks and at 18 months, and the 4-in-1 pre-school booster at 3 years 4 months, plus a vaccine for pregnant women to protect the baby in the first weeks of life. The NHS says it is usually given around 20 weeks of pregnancy, while NHS inform says the best time is soon after the 16th week, so check the timing with the midwife. NHS inform says other household members may be offered antibiotics and a vaccine dose to stop them becoming infected.