What's the difference between whooping cough and a normal cough?

There were 1,888 cases of whooping cough recorded in April 2024 alone.

Words by Olivia Mustafa

The UK is experiencing a rapid rise in whooping cough, with almost 5,000 cases confirmed between January and April 2024 and eight infant deaths.

New figures from the UK Health Security Agency (UKHSA) show 1,888 cases of the illness were detected in April, up from 1,319 cases in March, 918 in February and 556 in January. This compares to just 858 cases of whooping cough for the whole of 2023.

The jump in cases between March and April 2024 is the biggest increase so far this year - with 569 more cases reported.

Eight infants are also known to have died in between January and April 2024. Three of those died in April alone.

Speaking before the data for April was released, Dr Michael Head, Senior Research Fellow in Global Health told ITV News these figures are significant - but not unprecedented.

"The data is definitely concerning," he said.

"We do see large outbreaks of whooping cough on a cycle every few years but the one we're seeing at the moment is big."

But what has caused this most recent spike in cases, and how simple is it to tell the difference between whooping cough and a regular cough?

What is whooping cough?

Whooping cough is a infection of the lungs and airways. It is caused by bacteria called Bordetella pertussis, and is very contagious.

Whooping cough can be dangerous in young children Credit: PA

What are the symptoms?

The first signs of whooping cough are similar to those of a cold, such as a runny nose and a sore throat.

Symptoms then progress after about a week into coughing bouts lasting a few minutes, which might get worse at night. Coughing can last for weeks or months.

Those with the illness may make a 'whoop' sound, caused by gasping for breath between coughs - but this does not happen everyone with whooping cough.

It can cause breathing difficulties, with young infants turning blue or grey and adults becoming red in the face after coughing bouts.

Whooping cough may also bring up thick mucus, which can cause vomiting.

How is it different to a normal cough?

Dr Head explained whooping cough is similar to other kinds of respiratory illness in the early stages.

He said: "You'll have some kind of cough, and perhaps a runny nose or a fever. It is very, very hard to tell the difference at that stage between whooping cough and anything else.

"You can only really notice it's whooping cough later on in the presentation when that distinctive 'hoop' sound kicks in."

Given not everyone experiences this symptom, the illness is difficult to accurately diagnose without laboratory testing, according to Dr Head.

"That's another reason why it is hard to get outbreaks under control and why vaccination is vital," he said.

How serious is it?

Whooping cough can lead to serious and sometimes deadly complications in babies and young children.

Around a third of babies under the age of one with whooping cough will need hospital care.

Complications can include apnea (life-threatening pauses in breathing), pneumonia, convulsions and encephalopathy (disease of the brain).

Teenagers and adults can also experience complications, but they are generally less serious in those who are older.

What has caused this recent outbreak?

According to Dr Head, outbreaks of whooping cough happen every few years.

He said: "The reasons are not totally clear but will be related to drops in vaccine uptake and probably waning of immunity in older children and younger adults.

"Once you get to that sort of nine or ten years of age, the immunity from the vaccines does start to wear off. Waning of immunity and any lower vaccine uptake does mean the vulnerable populations like children and pregnant women are more likely to be exposed."

Dr Head believes the time of year could explain the uptick in cases across the past few months.

"The reason why we see respiratory infections during the winter is that people will cluster indoors. If it's cold and wet, if you're indoors with little ventilation, the window shut, then there's many opportunities for that bacteria to spread," he said.

Vaccine uptake has fallen in recent years - both the jabs for pregnant women and children - according to the UKHSA. Credit: PA

How is it treated?

Those with severe whooping cough, or babies under 6 months with the illness, will need hospital treatment. It is treated with antibiotics.

How contagious is it?

People with whooping cough are contagious from about six days after the start of cold-like symptoms to three weeks after the coughing starts.

Starting antibiotics within three weeks of starting to cough can reduce the time someone is contagious for.

Dr Head explained whooping cough is about as contagious as measles, which is one of the most infectious diseases around.

"It has an R number of 15 to 17, so one infected person can potentially infect 15 to 17 other separable people," he said.

"It's also mostly in the upper respiratory tract meaning it is easier to spread because the bacteria are nearer the the the mouth and nose."

Is there a vaccine?

All babies are offered a whooping cough vaccination as part of routine NHS vaccines. It is given as part of the six-in-one vaccine for babies at eight, 12, and 16 weeks old.

It's also administered in the four-in-one pre-school booster, for children aged three years and four months old.

The NHS recommends all pregnant women are vaccinated against whooping cough between 16 and 32 weeks.

Dr Head said: "High vaccine coverage is vital to maintain each and every year to protect pregnant women and babies. Otherwise, we get outbreaks like we're seeing this year.

"If you are recommended for vaccine, then do take up the offer for you or your child."

What should those worried about whooping cough do?

Ask for an urgent GP appointment or call NHS 111 if:

  • a baby under six months old has symptoms

  • you have a very bad cough that is getting worse

  • if you've been in contact with someone with whooping cough and you're pregnant

  • you or your child has been in contact with someone with whooping cough and have a weakened immune system

Call 999 or go to A&E if:

  • you or your child turn blue or grey (on black or brown skin this may be easier to see on the palms of the hands or the soles of the feet)

  • the sufferer is experiencing breathing difficulties, seizures or chest pain

Visit the NHS website for more advice.

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