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FAQ

For the average case of whooping cough there is no treatment likely to make a difference to the course of the illness or materially reduce the symptoms. It will generally take its course no matter what. Attempts to get benefit from bronchodilators, cough suppressants or antibiotics are generally futile.

There are a few exceptions however.

One exception is in those who get severe illness. This is most often infants, particularly those under 3 to 6 months, but it also applies to the frail or very elderly and those debilitated by other illness or malnutrition. In such cases treatment with steroids can reduce the severity and antibiotics might be used to prevent complicating infections. Supportive measures with hydration and oxygenation may be necessary. Such cases would obviously be in hospital. It should be noted that in the developed world one would not expect even 1% of cases to require hospitalization because most cases are mild.

Another exception is when serious complications occur. This is also rare and probably affects about 1 or 2% of cases in the developed world. The most frequent complication is pneumonia which requires standard antibiotic treatment. Some patients get a secondary infection of bacterial tracheo-bronchitis causing increased cough and sputum which may improve with antibiotics, but does not generally cause illness.

For very young babies whooping cough is a dangerous illness and they can die from pneumonia, respiratory failure and encephalopathy. It is to protect babies that we have an immunization program, and it is effective.

Many people with whooping cough are given an antibiotic such as azithromycin. This is to kill any Bordetella pertussis they may still carry so as to make it more difficult to pass it on to others. It does not help the disease because the bugs have already done the damage by the time it is usually diagnosed. If however you have such an antibiotic while you are incubating the disease it is believed it may prevent it developing.

September 2006
A physiotherapist has emailed me an anecdote that I am inserting below. I would appreciate any feedback about it.

"We have named the following technique Christabel's method after my
daughter (9) as she noted that by attempting to stop herself from
inspiring reflexively between coughs she could reduce the length and
the violence of the cough and prevent reflux. Simply put she delays
herself breathing in and holds what breath she has left for as long as
possible then tries to breath slowly. This technique may not work on
the first cough of the series but in our experience appears to slow
down subsequent coughs. The techniques requires practice but does
allow the patient some control back in their bodies! As this method
requires the patient to overcome their natural reactions I suspect
this is only suitable for older children and adults."

September 2008
The feedback about this has been consistently positive.

November 2011
Many sufferers of whooping cough find that eating or drinking certain things provokes a coughing spasm.
I have been passed anecdotal information from A.H., a paediatric speech and language therapist in the UK who has suggested that some coughing spasms may be due to liquid nourishment leaking past the vocal cords into the windpipe. The theory being that whooping cough might be causing some weakness of the vocal cords (it certainly can cause voice changes). I understand that she has found that thickening liquids before drinking can help this problem. Liquids should be thickened to the consistency of syrup before drinking, using a proprietory thickening agent that can usually be obtained from a pharmacy. One such product that should be easily available is 'ThickenUp® Clear', made by Nestle.
If you suspect liquids are provoking some coughing, this is probably worth a try. Feedback (no pun intended) would be appreciated.

April 2014
I have had no feedback confirming the usefulness of the above.

I have received an observation from a sufferer which I offer as something that may be worth trying. Feedback on it would be appreciated.

"I would like to report having developed apparently successfully a technique of control vaguely similar to "Christabel's method". Essentially, this involves from the first cough onwards, or as soon as practicable, breathing out such air as can be expelled from the lungs (not accepting the instinctive idea, or perhaps reflex, that none is left inside). This outward breathing seems to "unlock" the passages and enable a very slow and steady controlled, inward breath to follow. Keep on doing this at each cough in the series. Initially I found this worked only if was already awake at the onset of the paroxysm, but now I find that, even if I am just woken by the onset of a coughing paroxysm, the technique has so far seemed to work.

It has really helped me, as a complete layman, to visualise this process by way of a metaphor which I offer it for what it is worth.

My body depends on two chemical factories working 24/7 and served by pipes which alternately carry raw material to the factory and then waste material from it. The pipes have a common entrance containing a highly sensitive safety valve, which closes the pipes instantaneously if HQ detects any risk of foreign bodies entering and possibly blocking the pipes. My job is to keep the pipes open even though an external disturbance has appeared to create such a risk. I can achieve this by asking HQ to reopen the pipes to allow some waste material out (since during this direction of flow through the pipes foreign matter cannot enter). Once reopened, the pipes will next allow new raw material in again until some new risk of foreign matter is identified."

Role of antibiotics in whooping cough