Whooping cough is a scary illness for parents, with viral videos circulating the Internet of the devastating effects it can have. Some of that fear comes from not knowing exactly what it is, so we’ve asked for help from Dr Elysia Thornton-Benko, a GP from Bondi Road Doctors. She takes us through the illness and what all parents should know.
When are children most at risk of whooping cough?
Babies are most at risk before six weeks, before their first immunisation.
“The younger the child, the more at risk they are,” says Elysia. Often under six months, babies are hospitalised if diagnosed with whooping cough, for respiratory support.
What is whooping cough and why is it so dangerous?
“It’s actually caused by a bacteria called Bordetella pertussis, [which is] mainly spread through the respiratory droplets,” says Elysia. “The problem with it, is that the respiratory symptoms that it causes.”
Whooping cough starts off with just your usual cold, known as a catarrh phase, and then it progresses to what we call a paroxysmal phase, where the child has ‘whoops’.
Elysia explains that a child will cough, cough, cough, and then it order to take a breath, the child has to make that big, effort-filled whoop sound, before the coughing continues.
This means not a lot of oxygen gets in and the person suffering is under “respiratory compromise”, ie. breathing issues.
“Sometimes they cough so much that they vomit,” she says.
Listen to Dr Elysia on Kinderling Conversation:
Why is it so bad for babies?
“The immune system is just so immature, so fighting it is an added effort,” Dr Elysia says. “The lungs haven’t been expanded for very long. They really only expand on birth, so it also depends on if the child is premature, because lungs actually only fully develop around 36 weeks in utero.”
So particularly for a premature baby, lungs might not be fully ready and there’s an increased risk.
How can it be prevented?
There are whooping cough vaccinations for pregnant mums and babies.
For mothers in their final trimester, at 28 weeks, they can now be given a booster, “so they have the antibodies on board in time for birth and hopefully to cover that initial six-week period before initial immunisations of childhood,” says Elysia.
“Definitely since that’s come on board there’s been a significant reduction in issue and it gives added protection to that newborn baby.”
Baby will still get their first six-month initial course of vaccinations at six weeks, four months and six months. Later on they get boosters.
Are younger children at risk?
Other children are certainly at risk because their immune systems are young, though not as much as newborn babies. Non-immunised children are definitely at risk.
Elysia says that in most cases, “if they’ve had that full six month course of immunisation, then they should be relatively protected and they still can get the infection, as an adult can who’s been fully immunised, but it will be less severe.”
“It also depends on if they have other conditions, what their immune system is like, what other medications they might be on, so it’s never just clear cut.”
How is it treated?
“The treatment won’t change the course of the disease. There is an antibiotic and actually a combination family of antibiotics. It will reduce the infectivity, so that’s why we tend to give it,” says Elysia.
Without treatment, whooping cough is infective for around three weeks so unimmunised children and children who aren’t being treated need to stay at home for three weeks.
If you have the antibiotic, within that first three-week period, then you can reduce the infectivity down to just five days (so you should stay at home). The cough can continue for many weeks and will gradually resolve.
How prevalent is it?
The disease is rising because people aren’t getting immunised. Elysia says that now the booster for pregnant women has been introduced, there’s definitely cover there.
It’s not an extremely common illness, but she says we are definitely are seeing it and especially in communities with people who are not as immunised. We need a certain amount of people immunised (ie. herd immunity) to protect everybody else.
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