Whooping cough is also known as pertussis, which means ‘violent cough’. The disease killed ten thousand children a year in the UK during the early 20th century. Though its seriousness has declined steadily over the last hundred years, it remains surprisingly common.

The Disease

Whooping cough is an infectious disease that has three characteristic phases. The initial ‘catarrhal’ stage consists of a cough, runny nose and temperature – similar to a bad cold. This is typically followed after a week by uncontrollable spasms of coughing which, when severe, are separated only by the ‘whoop’ as the child forcefully breathes in between coughing bouts. This is described as the ‘paroxysmal’ stage. The final ‘resolution’ stage heralds an improvement in the child’s condition and the road to recovery, though this can take some time, which is why the disease is known in Japan and China as the ‘hundred-day cough’.^{1 2} Nowadays, most cases are relatively mild with less than half developing the characteristic ‘whoop’. Most children with whooping cough now only have what appears to be a bad cold followed by a cough, making the diagnosis easy to miss. Serious complications can occur but are much less common than they used to be.³ The most common complication, affecting around 1 in 100 children is pneumonia that is normally readily treatable with antibiotics. Nevertheless, whooping cough can still be a distressing and unpleasant illness with prolonged episodes of coughing with vomiting that may last for several weeks. It is difficult to be sure of the death rate from whooping cough now, but the risk of dying is probably around 1 in 30,000 cases.

Whooping cough is remarkably common, despite high vaccine uptake. A third to a half of all children with a cough lasting over three weeks may be suffering from whooping cough.^{4 5}

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¹ Miles JV Jr. Pertussis. Journal – Lancet 1959; 79(2): 49-56.

² Geier D, Geier M. The True Story of Pertussis Vaccination: A Sordid Legacy? Journal of the History of Medicine 2002; 57: 249-284.

³ Jenkinson D. Natural course of 500 consecutive cases of whooping cough: a general practice population study. British Medical Journal 1995; 310: 299-302.

⁴ Miller E et al. Serological evidence of pertussis in patients presenting with cough in general practice in Birmingham. Communicable Disease and Public Health 2000; 3: 132-4.

⁵ Harnden A. Grant C. Harrison T. Perera R. Brueggemann AB. Mayon-White R. Mant D. Whooping cough in school age children with persistent cough: prospective cohort study in primary care. BMJ 2006; 333(7560): 174-7.