Whooping cough

Whooping cough is a highly contagious disease that is characterized by violent coughing fits. It is caused by a bacterium that spreads through droplets projected into the air by someone with the disease, for example, when they cough or sneeze.

In Québec, between 240 and 1600 cases of whooping cough are reported each year.

In general, whooping cough begins with the following symptoms:

• Light fever
• Runny nose
• Red, watery eyes
• Coughing

After 7 to 14 days the cough then intensifies and becomes more frequent.

The fit of coughing is followed by a high-pitched intake of breath that sounds like a ‘whoop’. Hence the name ‘whooping cough’ is given to the illness. Sometimes, the sufferer may then vomit or stop breathing for a few seconds.

The illness is most serious in babies younger than 1 year. In babies less than 1 year old, the cough may be mild or absent. Sometimes, the main symptom is apnea, which is the repeated cessation of breathing.

The symptoms usually appear 5 to 10 days, sometimes even 21 days, after contamination. Whooping cough lasts 6 to 10 weeks. However, in adolescents it can last longer than 10 weeks.

When to consult

Only a healthcare professional can diagnose whooping cough. If you have an excessive or persistent cough, see a doctor or your CLSC. This way, you will know whether or not you have whooping cough and receive treatment if needed. The more prompt the treatment, the more effective it is.

If you have been in contact with someone with whooping cough, consult your doctor or your CLSC. Some people, pregnant women for example, can receive preventive treatment.

Whooping cough can be treated with antibiotics provided the cough has been present for less than three weeks. This treatment helps reduce risk of transmitting the disease. In some cases, it also reduces symptoms. It is very important to take all the antibiotics prescribed even if you start to feel better.

To relieve your symptoms, you can take over-the-counter medicine such as acetaminophen, Tylenol^® for example, and ibuprophen, Advil^® for example.

Avoid taking medication that includes identical ingredients at the same time. For instance, do not take Tylenol^® and Tylenol^® Sinus together because both medicines contain acetaminophen.

Children and adolescents

If your child is over 3 months old, you can give them acetaminophen, Tylenol^® for example. Make sure you follow instructions supplied with the product and according to your child’s weight.

Avoid giving children and adolescents acetylsalicylic acid such as aspirin. In children and adolescents, such medication can lead to a serious illness of the brain and liver called ‘Reye's syndrome’.

Possible complications of whooping cough include:

• Otitis
• Pneumonia
• Convulsions (the body stiffens and muscles contract in a jerky and involuntary manner)
• Rib fractures
• Hernias

Some complications are rarer:

• Brain damage
• Death

The risk of complications from whooping cough is higher in babies less than 1 year old. Most infected infants less than 6 months old need to be cared for in hospital. However, infants less than 3 months old are affected by the most serious complications. They account for:

• nearly half of hospital admissions and most admissions to intensive care;
• nearly all deaths caused by whooping cough. Deaths are, however, rare.

The bacterium is spread through droplets from the nose and throat of those infected. The contagious period varies according to the situation:

• Someone with whooping cough and who has not been treated is contagious up to 3 weeks after starting to cough
• Someone with whooping cough and who has been treated is contagious up to 5 days after the beginning of treatment
• Someone who has stopped coughing is unlikely to transmit the disease

Whooping cough spreads easily between members of the same household or between children attending the same daycare or school.

If you have whooping cough, make sure you stay far from young children or women in the final stage of pregnancy. This precaution must be exercised until your treatment is complete.

Preventing transmission

Sick children and adults should stay home from school and work and avoid young children and pregnant women. They should stay home until 7 days after the appearance of the skin rash.

Vaccination

Vaccination is the best way to be protected against whooping cough. The whooping cough vaccine is a combined vaccine, meaning that it protects against several diseases at the same time. Components of the vaccine vary depending on the person’s age.

Québec’s immunization schedule provides for the administration of the whooping cough vaccine from 2 months of age. It is also recommended that all pregnant women get the whooping cough vaccine during each pregnancy.

Pregnant women

Since May 2018, Québec experts have recommended adding the whooping cough vaccine to the regular immunization schedule for pregnant women. The ideal time to get vaccinated is between the 26^th and the 32^nd week of pregnancy. Vaccination is recommended during each pregnancy.

Vaccination during pregnancy is very effective in preventing whooping cough and its complications in babies. Babies are given their first dose of whooping cough vaccine when they are 2 months old and several doses are needed to ensure lasting protection. This means that infants are not protected during the critical period of the first few months of life unless the mother got the vaccine while she was pregnant. Getting the whooping cough vaccine during pregnancy allows antibodies to be transferred directly to the baby across the placenta, protecting the baby from birth until it is old enough to get its own vaccine.

According to the INSPQ advisory on the appropriateness of introducing whooping cough vaccination for all pregnant women in Québec  (in French only), recent studies show that vaccination during pregnancy is effective and prevents around:

• 90% of hospital admissions associated with this infection in children less than 3 months old;
• 95% of deaths associated with this infection in children less than 3 months old.

Québec experts believe that whooping cough vaccination during pregnancy will help prevent a high number of serious whooping cough cases.

According to the INSPQ’s optimal whooping cough vaccination strategy for Québec  (in French only), the whooping cough vaccine is considered safe for the mother and her unborn child. Several countries offer vaccination for pregnant women:

• United States;
• Australia;
• New Zealand;
• United Kingdom;
• Ireland;
• Belgium;
• Some of Latin American countries.

Millions of doses have been administered. No notable problems for mother or fetus have been detected in these countries. An analysis was conducted in the United States on data concerning more than 53 885 pregnant women who were vaccinated during pregnancy. The study did not find any link between vaccination against whooping cough and premature delivery or any other complications during pregnancy or defects in the unborn baby.

Under the Québec Immunisation Program, anyone can get vaccinated against whooping cough for free.

See the Québec Immunisation Program page to know the procedure for getting vaccinated.

Anyone not protected against whooping cough can catch it. Given that the immunisation program begins at 2 months old, children younger than that are most at risk of catching whooping cough. The risk is much lower if the mother was given the vaccine while she was pregnant.

Whooping cough is a reportable disease in Québec.

When laboratory staff and health professionals detect a case of whooping cough, they must inform public health authorities.