What to Know About Symptoms, Prevention

• New CDC data shows a resurgence in whooping cough, with cases returning to “pre-pandemic levels.”
• Experts believe that missed routine vaccinations during the COVID-19 pandemic may be partially driving the increase in whooping cough cases.
• Symptoms of whooping cough include cough seizures and difficulty breathing, which may be life threatening for infants.
• Following the recommended routine immunization schedules is the best way to protect yourself against this bacterial infection.

A preventable illness that causes cough, seizures, and difficulty breathing is rising in the United States.

As of October 5, around 17,579 whooping cough cases have been reported, with the highest numbers in the Middle Atlantic states. By comparison, there were only 3,962 whooping cough cases around this time last year.

In June, the CDC warned that whooping cough cases were increasing, “returning to its more typical pre-pandemic cyclic patterns of more than 10,000 cases a year.”

According to experts, the five-fold increase in pertussis cases over the past year is partially linked to missed routine immunizations during the COVID-19 pandemic.

Infants are most at risk for severe illness and death, but whooping cough can affect older children and young adults. Vaccination against whooping cough with the DTaP or Tdap vaccine (depending on age) reduces the risk, but protection can wane over time, leading to outbreaks.

As the current whooping cough surge dovetails with winter respiratory virus season, cases are relatively low compared to influenza, RSV, or COVID-19. Still, the rising cases of whooping cough remain a public health concern.

“The numbers are smaller, but they’re not trivial because we don’t wish whooping cough on anyone,” said William Schaffner, MD, professor of preventive medicine and infectious diseases in the Department of Health Policy at Vanderbilt University Medical Center in Nashville.

Healthline spoke with Schaffner to learn more about what’s driving the surge in whooping cough cases and why following routine vaccination schedules is crucial for preventing infectious diseases.

This interview has been edited and condensed for clarity and length.

Schaffner: We have substantially reduced whooping cough over the years, and it has that overtone of an infection from the history books because we don’t hear it talked about very often.

Pertussis, or whooping cough, is a bacterial infection transmitted through close contact via respiratory droplets. The infection can lead to inflammation of the throat and the bronchial tubes, and because the patient’s airways are so tiny, they can get swollen and have difficulty breathing.

What happens in the body is that the bacteria, as it multiplies, produces a series of proteins that then go out into the body, and it’s these toxins that produce the illness. The persistence of those toxins in the body is what produces these long-term cough seizures.

The Tdap vaccine protects us against the effects of those toxins. We routinely include vaccination against whooping cough among the shots that children start to receive very early in life, but what happens is the protection can wane over time, so you have to keep up your protection. Even mild whooping cough is still a very nasty, troubling infection.

Schaffner: Whooping cough produces cough seizures, not the conventional kind of cough, but a whole series of coughs together, such that you may have difficulty breathing during the cough seizures. When they stop, you inhale, and that’s the ‘whoop.’

The illness is called the ‘cough of 100 days’ because these cough seizures can last for a long period of time.

During the cough seizure, sometimes they are so severe you can faint, and if you fall, you can injure yourself.

Furthermore, these cough seizures can occur at any time and are very disruptive to your life. If they interrupt your sleep, you’re not going to feel good the next day, and you’re not functioning optimally. So, these are very troubling infections.

Schaffner: I think the major reason is that during COVID, we began to get a lot of medical care through telemedicine because we were staying at home and not going to the doctor for fear of acquiring COVID.

As a consequence, both children and adults fell behind in their vaccination schedules, and in order to keep up your protection against whooping cough, you have to keep up your routine vaccinations.

The current surge is affecting children who have not had a complete Tdap series or missed the Tdap vaccine completely. Younger adults who also missed the series may also be affected.

Schaffner: Whooping cough can be life threatening for infants. However, this bacterial infection can also impact older adolescents and young adults who don’t keep up with their vaccinations.

The vaccination routine for children starts when they are very young. They get a series of doses of diphtheria, tetanus, and acellular pertussis (DTdap) vaccine at 2, 4, and 6 months of age, then their fourth dose at 15 months, and another dose at 4 to 6 years of age.

Adults should get Tdap updates every 10 years. Whooping cough doesn’t affect older adults as much, because now we use a different vaccine that works very well in the relatively short term, and it has many fewer side effects than the previous Tdap vaccine. However, the duration of protection is not as prolonged as the older vaccine.

Another group of people who should be vaccinated is pregnant people. The recommendation is that you get a dose of Tdap during every pregnancy. That’s not so much for the mother’s benefit because that protection goes across the placenta and begins to protect newborns and young infants before we start vaccinating them.

Once the baby is born, anyone who wants to visit that baby should be up to date with their Tdap vaccinations because we want to create a cocoon of protection around those vulnerable babies.

New CDC data shows whooping cough cases have increased five-fold over the past year, returning to pre-pandemic levels.

Experts say missed routine immunizations during the COVID-19 pandemic may be partially responsible for the increase. Ongoing vaccine hesitancy may also be driving rising whooping cough cases.

Following routine immunization schedules offers the best protection against whooping cough, which can be deadly for infants.