Whooping Cough Cases Increase: Why and What To Do About It

Sick child with mom taking the temperature

Whooping cough cases are increasing in the United States, with both Vermont and New Hampshire reporting more cases than this time last year.

Whooping cough—known more formally as pertussis—is a highly contagious bacterial infection that affects the respiratory system. Symptoms may include a “whoop” noise when someone gasps for air after a coughing fit.

While the disease can severely affect the respiratory system, doctors say vaccinations help stop its spread.

“This illness is serious, vaccine-preventable, and families can make decisions that favor better health outcomes,” stresses Geraldine Rubin, MD, a Dartmouth Health Children’s pediatrician at Cheshire Medical Center.

Infection rates going back to pre-Covid rates

Rubin says the uptick in cases reflects a concerning wider trend.

The CDC (U.S. Centers for Disease Control and Prevention) reports that the rate of infection nationally is beginning to return to pre-COVID-19 pandemic patterns when more than 10,000 cases were typically reported each year.

The lower rate of infection during the pandemic has been attributed in part to practices such as masking and remote learning.

But Rubin and others say dropping vaccination rates are playing a role in the return of whooping cough.

“We’ve lost the historical perspective that pertussis used to be a severe disease that could lead to Apnea, pneumonia and even death for infants,” she says.

Concerns are growing

Health experts across the U.S. are also sounding alarms.

Over the weekend, former US FDA (Food and Drug Administration) commissioner Scott Gottlieb, MD, wrote on X (formerly Twitter) that the "U.S. is experiencing more than four times as many pertussis cases compared with last year."

In that post, Gottlieb pointed to a comment in September to NBC News by Tina Tan, MD, then president-elect of the Infectious Diseases Society of America, that “With the increase in vaccine hesitancy that has been going on since the Covid-19 pandemic, we’re seeing outbreaks occurring in kids who are not vaccinated.”

Vaccination offers the best protection

The CDC recommends getting vaccinated.

The federal agency points to historical data that shows that before the availability of a pertussis vaccine in the 1940s, public health experts reported more than 200,000 cases of pertussis annually.

However, since the introduction of the diphtheria, tetanus toxoid, and whole-cell pertussis (DTaP) vaccine in 1948, the number of cases each year has decreased by more than 90 percent compared with the pre-vaccine era.

What you need to know about getting your family vaccinated

While anyone can get pertussis, children who have not had the vaccination and infants whose mothers did not receive the Tdap vaccination are at the highest risk for complications or death, says Rubin.

The elderly are also more likely to develop serious illness after infection. That’s why it is important for everyone to know whether they need a vaccine or are due for a booster.

“You should check your family’s vaccine status,” says Rubin. “Talk to your pediatrician and look at your medical records.”

The CDC provides these guidelines for DTap for children under seven years old. The CDC also notes that different vaccines against tetanus, diphtheria, and pertussis (Tdap and Td) are available for older children, adolescents, and adults.

More about pertussis

You can also stay aware of symptoms and respond proactively if you suspect you or a loved one has been exposed.

According to the CDC, early symptoms can look like a common cold. These can include a runny or stuffed-up nose, a low-grade fever, and a mild, occasional cough. Babies and young children may not cough but have apnea or difficulty breathing.

In older children and adults, a persistent cough may develop into coughing fits one to two weeks after the first symptoms start. The CDC says the coughing fits can cause people to:

  • Make a high-pitched "whoop" when they inhale after a coughing fit
  • Vomit during or after coughing fits
  • Feel very tired after the fit, but usually seem well in between fits
  • Have difficulty sleeping at night
  • Struggle to breathe
  • Fracture (break) a rib

Stay away from people with known exposure to help protect yourself and your loved ones. The disease is state-reportable, so schools and other organizations should notify you if you or your child has been exposed.

Practice hand-washing and stay home if you are feeling sick or have a fever. If you are concerned, contact your healthcare provider.