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}

The Vaccine

The ‘whole cell’ vaccine that was used in the UK until 2004 was one of the least safe vaccines and occasionally caused brain damage that could be permanent.⁶ The ‘acellular vaccine’ now sued in the UK (and offered at BabyJabs) is much safer and, crucially, there is less risk of severe reactions such as encephalopathy (brain damage), collapse and fits.^{7 8} The new vaccine still commonly causes irritability, drowsiness and loss of appetite. Fits and episodes of collapses and unresponsiveness (known as hypotonic hyporesponsive episodes) may occasionally happen.⁹

Unfortunately, the whooping cough vaccine is one of the less effective vaccines, as shown by how commonplace the illness still is. The effectiveness of the better acellular vaccines in preventing a full attack of whooping cough is over 80%, but somewhat less (70%-76%) at preventing a mild attack.¹⁰ The protection provided by the acellular vaccines usually lasts from between three and six years.^{11 12}

The choices

Infanrix
Type of vaccine:	Triple DTaP vaccine
Manufacturer:	GlaxoSmithKline
Protects against:	Diphtheria Tetanus Whooping cough
Active ingredients:	30IU diphtheria toxoid 40IU tetanus toxoid 25µg pertussis toxin 25µg filamentous haemagglutinin 8µg pertactin
Mercury content:	Nil
Aluminium content:	0.5mg
Other ingredients:	2-phenoxylethanol (preservative)
Primary course:	3 doses, usually given in first year of life
Boosters:	Single dose from 3 years of age

Daptacel
Type of vaccine:	Triple DTaP vaccine
Manufacturer:	Sanofi Pasteur
Protects against:	Diphtheria Tetanus Whooping cough
Active ingredients:	15Lf diphtheria toxoid 5Lf tetanus toxoid 10µg pertussis toxin 5µg filamentous haemagglutinin 3µg pertactin 5µg fimbriae types 2 and 3
Mercury content:	Nil
Aluminium content:	0.33mg
Other ingredients:	‰¤5µg formaldehyde <50ng gluteraldehyde 3.3mg 2-phenoxylethanol
Primary course:	3 doses, usually given in first year of life
Boosters:	Single dose during second year of life Single dose at 4-6 years of age

D or d = diphtheria
T = tetanus
aP = acellular pertussis

The supply of single and small combination vaccines may change over time. At BabyJabs we are on the constant lookout for safe and effective vaccines to offer your child. We may obtain different vaccines to those listed above. We will only offer you alternative vaccines if we are completely confident of their safety and efficacy.


Go back to vaccines at a glance

--------------------------------------------------------------------------------------------------------------------------------------------------------------------------

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.

⁶ Miller DL et al. Report of the National Childhood Encephalopathy Study. HMSO 1980.

⁷ Heijbel H et al. Hypotonic Hyporesponsive Episodes in eight Pertussis Vaccine Studies. Developments in Biological Standardization 1997; 89: 101-3.

⁸ Geier DA, Geier MR. An evaluation of serious neurological disorders following immunization: a comparison of whole-cell pertussis and acellular pertussis vaccines. Brain and Development 2004; 26: 296-300.

⁹ Ciofi degli Atti ML, Olin P. Severe Adverse Events in the Italian and Stockholm 1 Pertussis Vaccine Clinical Trials. Developments in Biological Standardization 1997; 89: 77-81.

¹⁰ Jefferson T, Rudin M, DiPietrantonj C. Systematic review of the effects of pertussis vaccination in children. Vaccine 2003; 21: 2012-23.

¹¹ Tan T. Summary: Epidemiology of Pertussis. The Pediatric Infectious Disease Journal 2005; 24: S35-S38.

¹² Hallander HA et al. Pertussis decay after vaccination with DTPa. Response to a first booster dose 3 1/2-6 1/2 years after the third vaccine dose. Vaccine 2005; 23: 5359-5364.