Whooping cough cases have increased more than fourfold in the United States compared to last year, and some experts believe the increase is due to vaccine fatigue in the wake of the pandemic.
“Since the COVID-19 pandemic, vaccine hesitancy has increased, leading to more infections among unvaccinated children,” said Dr. Tina Tang, president-elect of the Infectious Diseases Society of America.
Babies are given the DTaP vaccine, which protects them against three diseases: whooping cough, diphtheria, and tetanus. This vaccine is effective against diphtheria and tetanus, but its effectiveness against whooping cough decreases over time.
Advisers to the U.S. Food and Drug Administration met Friday to discuss the need for a stronger, longer-lasting whooping cough vaccine.
Until the next generation vaccine is developed, booster vaccinations are recommended approximately every 10 years, starting when children enter junior high school in their early teens.
Experts say that whooping cough outbreaks in many states are being driven by teenagers and preteens, whose immune systems are weakened by the disease.
The CDC reported Thursday that there have been 14,569 confirmed cases of whooping cough so far in 2024, a significant increase from last year’s total of 3,475.
The preliminary number of cases reported so far this year is the highest since 2014, a CDC spokesman said.
This bacterial disease is officially called whooping cough, but is often referred to as “whooping cough” because of the sounds people, especially infants, make as they try to get enough oxygen despite successive coughing fits.
Doctors said the newly reported figures likely significantly underestimate the true spread of the highly contagious respiratory infection.
“For every case of whooping cough that we find, there are probably 10 that don’t seek medical attention,” said Dr. Jim Conway, a pediatrician and infectious disease specialist at UW Health in Madison, Wisconsin.
The CDC said the new figures indicate that whooping cough cases are returning to pre-pandemic levels, when there were about 10,000 cases reported nationwide per year, and experts say growing anti-vaccine sentiment is contributing to the outbreak.
“The incidence of the disease is increasing among adolescents and adults because they are not receiving proper vaccinations,” Tan said.
This age group may be particularly vulnerable if they have not received a pertussis booster vaccination since childhood.
Some parts of the country are seeing a surge in cases: The Wisconsin Department of Health Services, for example, said Thursday that the number of whooping cough cases in the state has increased 10-fold from last year, with 625 confirmed cases in 2024 compared to 51 in 2023.
“While whooping cough can affect people of any age, people between the ages of 11 and 18 account for nearly half of all cases reported so far this year in Wisconsin,” the state health department said in a news release.
“This is really increasing rapidly,” Conway said. “We’re concerned about it.”
Cases are also on the rise in Connecticut. “I don’t think we’ve seen this many cases in over 15 years,” said Dr. Andrew Carlson, a pediatrician and medical director of primary care at Connecticut Children’s Hospital in Hartford. The state has reported 111 whooping cough cases so far this year, but just 11 so far in 2023.
Doctors at Duke University School of Medicine in North Carolina and Children’s National Hospital in Washington, D.C., told NBC News they haven’t seen any whooping cough cases recently. Dr. Andy Shane, chief of pediatric infectious diseases at Children’s Medical Center of Atlanta, said pertussis cases in Georgia increased over the summer but have since decreased.
The outbreak has seen a surge in infections among teenagers and young adults, starting with an outbreak at a Philadelphia-area high school in April. Last weekend, Portland State University canceled a football game after a spike in whooping cough cases among players.
“We saw a lot more cases in teenagers in the spring,” said Dr. Karen Lavin, chief of infectious diseases at Nemours Children’s Health Center in Delaware. “The vaccine is effective, but immunity weakens over time, so it’s important for parents to make sure their children are up to date on their vaccines.”
The ‘tragic’ side of whooping cough
People suffering from a persistent cough may go to the doctor only to be sent home after testing negative for either the flu or COVID-19. If left untreated, whooping cough can spread bacteria through coughing for a long period of time.
“The bacteria is shed for three to four weeks,” Conway says, “and once it’s in the community, it’s pretty difficult to eradicate.”
Older children and most healthy adults who become infected usually don’t experience many symptoms other than that pesky cough.
Doctors’ biggest concern are infected newborns, whose tiny airways cannot withstand the coughing fits that accompany whooping cough and who often must be put on ventilators to help them breathe.
“That’s the heartbreaking aspect of this,” Conway said. “These babies are coughing so much they can’t eat or drink and they end up in intensive care.”
Whooping cough vaccine and when to get a booster shot
Pregnant women are encouraged to get a whooping cough booster vaccination late in pregnancy to give their babies some protection when they are born (when they are most vulnerable to whooping cough) and before they are eligible to be vaccinated themselves.
According to the CDC, infants should begin their first whooping cough vaccination at 2 months of age, with booster shots at 4 and 6 months of age.
Another shot is given before the child turns 2 years old and again when they start kindergarten.
“The importance of getting vaccinated cannot be overstated,” Shane said, “doing everything we can to protect ourselves is key to getting through this respiratory disease season successfully.”
