Editor’s note: This story is an update of an article originally published on August 20.
Whooping cough — a highly transmissible infection of the lungs and airways that mostly affects babies and young children — is on the rise in the United States.
Why Is Whooping Cough Coming Back?
Stephen Aronoff, MD, a professor of pediatrics who specializes in infectious diseases at the Lewis Katz School of Medicine at Temple University in Philadelphia, suggests that the increase in infections, at least in part, is due to people coming out of isolation, not masking, and dropping social distancing and vigorous respiratory-hygiene practices that were common during the peak years of coronavirus spread.
“We certainly saw traditional respiratory viruses in kids basically disappear in 2021 and 2022, and it wasn’t until everything got back to normal that we started to see resurgences of those viruses,” he says.
Other factors likely contribute to the swelling case count, such as improvements in the diagnosis and reporting of the illness.
Vaccination Provides the Best Protection Against Whooping Cough
Despite the waning power of vaccination, Alex Sette, a doctor of biological sciences and a professor at the La Jolla Institute for Immunology in California, underscores that these shots continue to offer the best defense against whooping cough.
“There is a lot of concern in the medical scientific community about misinformation and the whole polarization associated with vaccine acceptance,” says Dr. Sette. “People may not be as diligent in providing childhood vaccination to their children, which is very concerning because if more people are not properly vaccinated, that is potentially a leading factor in the increased circulation of pertussis.”
The CDC stresses that vaccination is the best way to protect against pertussis and its complications. DTaP (diphtheria, tetanus, pertussis) vaccination is recommended at 2, 4, and 6 months; at 15 through 18 months; and at 4 through 6 years.
“By vaccinating the pregnant mother-to-be, you boost her level of antibodies and that passes on and protects the child in the first few months when it’s most vulnerable,” says Sette.
Whooping Cough Is a Potentially Life-Threatening Illness
Whooping cough is caused by Bordetella pertussis bacteria, which attach to the cilia (tiny, hair-like extensions) that line part of the upper respiratory system, then release toxins that damage the airways, causing them to swell.
After the initial symptoms fade, the illness can take a dramatic turn for the worse. At that point, an infected person typically has severe coughing fits as their body tries to clear mucus from the airways.
In bad cases, people experience spells of harsh and constant coughing. The “whooping” sound comes from a sudden inhalation as they fight to catch their breath. These coughs can sometimes last as long as three months.
“One of my professors used to refer to pertussis as the cough of 1,000 days, because people can have these prolonged, chronic coughs,” says Dr. Aronoff.
Babies especially may struggle to breathe or have life-threatening pauses in their breathing. About 1 in 3 infected babies younger than 1 year old who get whooping cough need care in the hospital.
Sometimes, the coughing can be so severe that the afflicted person may vomit or even fracture a rib.
Antibiotics can kill the infection, and by identifying the illness early on through medical tests, treatment can begin to reduce the chances of extreme illness.
Because the bacteria that cause whooping cough spread easily via small respiratory droplets, and because babies are most vulnerable, Aronoff urges adults who are sneezing or coughing to be extra cautious around younger children.
“Historically, pertussis has not been such a problem in adults as it is in unimmunized younger infants,” he says. “Older individuals, however, can acquire the bacteria and then unknowingly spread it to younger kids. Grandpa may have a nasty cough and not think twice about it when he’s holding his 2-month-old grandchild, but then the grandchild gets infected.”
As whooping cough cases continue to trend upward, Aronoff encourages everyone to keep up with their vaccinations.
“Vaccines work, and the data show that when we don’t vaccinate, we have outbreaks,” he says.
