Just when you thought you had your family’s health routines under control—you sent in the school physicals, you stocked up on kids’ vitamins—there’s a new, er, old concern on the horizon. Whooping cough is cropping up across the country—in levels that haven’t been seen since before the pandemic. The Centers for Disease Control and Prevention (CDC) recently shared an alert that cases of pertussis, commonly known as whooping cough, are surging across the US, with numbers double those seen last year.
Coming on the tails of a similar CDC announcement that Fifth disease is on the rise, it seems like we’re staring down a surge of illnesses—even before we really make headway into fall. Whooping cough might sound like a relic from your great-grandmother’s era, but it’s very much a present-day concern. This highly contagious respiratory illness can be particularly dangerous for infants and pregnant people, but a vaccine can prevent severe illness in most cases.
We spoke with pediatric infectious disease specialist Christina Gagliardo, MD, of Atlantic Health System’s Goryeb Children’s Hospital, to explore why we’re seeing this spike in cases and what you can do to better protect your family.
What is whooping cough?
Whooping cough is a highly contagious respiratory disease caused by the bacterium Bordetella pertussis. You may also see it called “pertussis”. It’s known for causing severe dry coughing fits, often followed by a distinctive “whooping” sound in between coughs as the person tries to catch their breath. However, this telltale sign doesn’t always appear, especially in infants.
The symptoms of whooping cough usually progress through three stages, Dr. Gagliardo tells Motherly. “Early on, the symptoms resemble cold symptoms with sneezing, nasal congestion, runny nose and a mild cough. The second stage, which can last from a couple of weeks to several weeks, is characterized by the cough getting worse, with coughing fits where the baby or child may gag, choke, vomit after the cough, or have trouble breathing,” she says.
Whooping cough can be particularly concerning for babies, as young infants with severe whooping cough may experience episodes of apnea, where they can experience a life-threatening pause in breathing, Dr. Gagliardo explains. “In the third stage, beginning approximately around the fourth week, the vomiting and harsh coughing fits resolve, but a persisting cough may continue until about the sixth week.” Whooping cough typically lasts around 6 to 10 weeks in total.
The current surge in whooping cough cases
According to the CDC report released in July 2024, whooping cough cases have more than doubled compared to the same period in 2023. The numbers are rapidly returning to pre-pandemic levels, with experts anticipating over 10,000 cases this year—similar to what we saw in 2019.
“It is possible that preventive actions such as masking, distancing, and emphasis on good hand hygiene used during the COVID-19 pandemic lowered transmission of whooping cough, and we are now seeing a rise in cases,” says Dr. Gagliardo. “There may be other factors contributing such as increased awareness of the illness, better tests we have available to diagnose whooping cough, or a genetic change to the bacteria.”
A drop in vaccination rates during the pandemic could also be a factor for the increase in both pertussis and parvovirus activity, the virus that can cause Fifth disease, she notes. “The impact of an overall decrease in vaccination rates during the pandemic and waning protection over time may also be contributing to the rise,” she says.
“Since fewer people were getting these infections [during the pandemic], we may also have a larger susceptible population now, so these illnesses are spreading more.”
Symptoms to watch for
Whooping cough can be tricky to identify early on because its initial symptoms often mimic a common cold. Here’s what to look out for:
Early stage (1-2 weeks):
- Runny nose and sneezing
- Low-grade fever
- Mild, occasional cough
Later stage:
- Severe coughing fits
- Gagging or vomiting after coughing
- Exhaustion after coughing episodes
- The characteristic “whoop” wheezing sound (though not always present)
In infants, symptoms can be more severe and may include:
- Apnea (pauses in breathing)
- Cyanosis (turning blue or purple due to lack of oxygen)
- Difficulty feeding
If you or your child develop symptoms of whooping cough, especially after known exposure:
- Contact your healthcare provider immediately
- Stay home to avoid spreading the infection
- Take prescribed antibiotics as directed
Remember, early treatment is crucial, especially for infants and high-risk individuals. If your infant or child is having trouble breathing, you should seek medical care immediately.
Who’s at risk?
While anyone can contract whooping cough, certain groups are at higher risk for severe complications:
- Infants younger than 12 months, especially those under 3 months
- Pregnant people in their third trimester
- People with weakened immune systems or chronic respiratory conditions
The CDC report highlights that about one-third of babies under 12 months who get whooping cough require hospitalization.
Treatment
“Whooping cough is usually treated with an antibiotic, most commonly azithromycin,” Dr. Gagliardo says, adding that household members who have been exposed in the home should also be treated with antibiotics.
“In infants and children who are hospitalized, treatment may also include oxygen and fluids. Some infants who have progressed to severe illness may require ventilator support to breathe,” she notes.
Dr. Gagliardo shares things parents can do at home for their child with whooping cough, which include ensuring plenty of fluids to stay hydrated, offering small meals to avoid vomiting after coughing, using cool mist vaporizers to loosen mucus, and keeping the child away from airway irritants such as smoke.
Prevention is key
The most effective way to prevent whooping cough is through vaccination in people of all ages, especially in kids and pregnant people. “Children who have not been vaccinated against pertussis are up to 8 times more likely to become infected than those who are vaccinated,” says Dr. Gagliardo. And getting a maternal vaccination in pregnancy can protect both you and your developing fetus, who won’t be eligible for their own shot until they reach 6 weeks of age. “Immunization in pregnancy is recommended between 27 and 36 weeks of gestation to optimize the mother’s protection and provide some passage of protective antibodies to the infant before they can get their first vaccine dose.”
The CDC recommends:
- DTaP vaccine for children under 7
- Tdap vaccine for older children and adults
- Tdap vaccine for pregnant people during every pregnancy (ideally between weeks 27-36)
Importantly, getting vaccinated during pregnancy protects 9 out of 10 babies from being hospitalized with whooping cough, the CDC reports. “Children receive the whooping cough, or pertussis vaccine at 2, 4, 6, and 15 to 18 months of age, and a booster at 4 to 6 years of age. Infants can get the first dose as early as 6 weeks of age,” says Dr. Gagliardo.
Additional prevention measures
While vaccination is crucial, there are other steps you can take to protect your family from whooping cough. Dr. Gagliardo emphasizes the importance of a multi-faceted approach:
“The most effective way to protect infants who are too young to be vaccinated is to ensure that all family members and people who are going to take care of or see your infant are up to date on their whooping cough or pertussis vaccines. Common sense practices such as good handwashing, covering your mouth when you cough, and keeping your infant away from others when they are sick are also ways to help prevent the spread of pertussis.”
Following this expert advice, here are key preventive measures to implement:
- Practice good hand hygiene: Wash hands frequently with soap and water for at least 20 seconds.
- Avoid close contact with people who are coughing or sick.
- Ensure family members cover their mouths and noses when coughing or sneezing, preferably using a tissue or the inside of their elbow.
- If you’re pregnant, consider wearing a face mask when in crowded places, like on public transit.
- Keep your home and frequently-touched surfaces clean and disinfected.
- Ensure all family members and caregivers are up to date on their whooping cough vaccinations.
Remember, these measures not only help prevent whooping cough but also protect against other respiratory illnesses. By combining vaccination with these everyday practices, you’re creating a strong shield of protection for your entire family.
