Travel & Lifestyle: What To Know About The Surge In Whooping Cough Infections

Among the many contagious diseases circulating right now — RSV, walking pneumonia and norovirus among them — is one that you may not have heard of for a while, or perhaps had assumed was an illness of the past: whooping cough.

Whooping cough, or pertussis, is a bacterial infection that initially causes symptoms similar to the common cold, such as a runny or stuffy nose, low-grade fever and mild cough.

However, after one to two weeks, symptoms may progress and become recognizable as whooping cough. These symptoms include:

• Coughing fits, or paroxysms, that can continue for one to 10 weeks
• A high-pitched sound (the “whoop”) when inhaling after coughing
• Exhaustion after coughing fits
• Vomiting from coughing so hard
• Difficulty sleeping
• Trouble breathing
• Fractured ribs

Dr. Janine Zee-Cheng, a pediatrician in Indiana, noted that because vaccinations have made whooping cough uncommon, most people are unfamiliar with the cough’s distinctive sound, which you can hear in this video from the U.S. Food and Drug Administration.

“The cough lasts for a really long time, and it does have a distinctive ‘whoop,’” Zee-Cheng told HuffPost.

It can take a long time to recover completely from a whooping cough infection, and coughing fits may return for several months. When a vaccinated person gets whooping cough, the disease is usually milder.

Babies may not develop a cough at all, but they can have episodes of apnea, or pauses in breathing, which can be serious. One in 3 babies under 1 year old who gets whooping cough needs to be hospitalized. Younger babies and babies who have not received recommended vaccinations are at higher risk. In addition to apnea, the most common complication, babies may also develop pneumonia, convulsions or encephalopathy (brain disease), and 1 in 100 babies will die.

Teens and adults can also develop complications such as pneumonia, but they are at less risk than infants. If they have been fully vaccinated, complications are less likely.

The U.S. Centers for Disease Control and Prevention also recommends that pregnant people receive a dose of Tdap vaccine to protect their baby during the child’s first month of life.

As Zee-Cheng pointed out, many of us assume that when someone doesn’t die of an illness, then they make a complete recovery. But that’s not always how serious illness plays out. Children who need to be on ventilators, have tracheostomies or experience neurological damage as a result of disease may be affected by their illness for many years or the rest of their lives — and their parents’ and siblings’ lives may also be forever changed.

The CDC reported a sixfold increase in cases of whooping cough from the end of 2023 to the same point in 2024. While this sounds alarming, experts attribute the dramatic rise in cases to a return to pre-pandemic levels after social distancing led to record low numbers of infections from 2020 through 2023, with just over 2,000 reported in 2021. In 2024, there were more than 32,000 reported cases. The year with the highest number of cases thus far this century was 2012, with over 48,000 reported cases.

The pertussis vaccine was licensed in the U.S. in 1914. In 1948, it was combined with diphtheria and tetanus vaccines into the DTP shot, and its widespread use brought numbers of cases from a high of over 220,000 in 1941 to a low of just over 1,000 cases in 1976. Today’s version of the vaccine, DTaP, is less associated with side effects than DTP. The DTaP shot was licensed in 1991, yet cases rose fairly steadily over the following years.

There are a couple of reasons for this rise after the record lows of the 1970s and ’80s. Concerns about adverse effects from the earlier DTP vaccine — the most serious of which were found likely not to be associated with the vaccine — may have led to some parents’ hesitancy about the DTaP shot. In addition, the vaccine’s effectiveness wanes over time, meaning that teens and adults who don’t receive booster shots are more likely to be infected with the illness and potentially pass it along to others.

Whooping cough is treatable with antibiotics — but these need to be prescribed within the first couple of weeks after infection, before the signature coughing symptoms begin. This is tricky, as symptoms this early on tend to be mild and indistinguishable from a common cold or other respiratory infection.

Many of us are now accustomed to rapid antigen tests like those available for COVID-19, flu and strep throat that give immediate results, but such a test is not currently available for whooping cough. Zee-Cheng said that the service they use, a large national lab company, takes between two and four days to return results on whooping cough tests, and in most cases a doctor will have a patient with suspected whooping cough — for example, a child who has been exposed to whooping cough by an infected person — start antibiotics right away, before the test results come back.

Zee-Chang said that even though cases are on the rise at the moment, most children presenting with mild symptoms of a respiratory infection will not have whooping cough but simply a common cold. However, in children who are not fully vaccinated, the likelihood of whooping cough increases. This is one of the reasons they say parents should stick to the recommended vaccine schedule. This way, as the immunity of the birthing parent’s booster shot wears off in a baby, they are receiving their first dose of DTaP.

Some public figures who are neither doctors nor scientists have propagated the idea that receiving multiple vaccines at once “overwhelms” a child’s immune system and can cause health issues. Zee-Cheng affirmed that there is no evidence to support such a theory.

In terms of when to see a doctor, Zee-Cheng explained that it depends on the age of the child. “Under 28 days of age, if they have a temperature that’s greater than 100.4 they should be seen by a doctor,” they said. For babies between 28 and 90 days of age, you may not need to run to the doctor at every sign of illness, but Zee-Cheng recommended that parents speak with their pediatrician about when to bring an infant in to be seen.

They also encouraged parents to take advantage of their doctor’s after-hours or nurse triage line.

“If you can run through some questions with someone over the phone first, provided that your child is stable and not in respiratory distress or anything like that, that’s something to to at least consider prior to bringing them into an ER that’s probably full of germs,” Zee-Cheng said.

If you child is having trouble breathing, however, you should take them to the doctor’s office or the hospital right away. Signs that a small child is struggling to breathe include retractions, which you can see in this video. If you’re noticing your baby’s ribs a lot as they breathe, or they appear to be taking a lot of air into their belly, that’s a red flag. Other warning signs include flared nostrils, grunting or head bobbing as they breathe.

Because a baby’s health can deteriorate rapidly, Zee-Cheng suggests calling your doctor (or after-hours triage line) and describing what you see whenever you’re in doubt.

The good news is that most cases of whooping cough are preventable with DTaP vaccines in childhood and Tdap shots at age 11 or 12 and during pregnancy. (Both are combination vaccines for diptheria, tetanus and pertussis/whooping cough, but DTaP is given to younger children and Tdap is given to older children and adults.)

According to the CDC, children who receive all five doses of the DTaP shot (the recommended schedule is at 2 months, 4 months, 6 months, 12-15 months and 4-6 years old) are fully protected from infection at a rate of 98% within one year of their last shot, and at a rate of 70% five years after getting their last shot. Children who are not fully protected are still partially protected, meaning they are less likely to experience serious illness.

The Tdap shot protects about 70% of people within a year of getting it, and 30-40% of people four years after getting it. When pregnant people receive a booster shot, it protects 75% of babies under 2 months old — too young to have received any DTaP shots themselves — from whooping cough, and 90% of babies from being hospitalized with whooping cough.

If you are worried about your child getting whooping cough, the most effective thing you can do is make sure everyone in your family is vaccinated according to the recommended schedule.

“Our job as parents is to make the best decisions that we can for our children based on the available information and evidence,” Zee-Cheng said. “And the best available information and evidence to keep them healthy and alive is to get them vaccinated.”