Whooping cough, also known as pertussis or the “100-day cough,” is experiencing a resurgence in the United States, with reported cases significantly exceeding those from the previous year. According to the Centers for Disease Control and Prevention (CDC), the week ending December 7, 2024, saw 553 cases, a stark contrast to the 105 cases reported during the same period in 2023. This alarming increase highlights the importance of understanding the disease, its symptoms, and the crucial role of vaccination in mitigating its spread. Whooping cough is a highly contagious respiratory illness characterized by severe coughing fits that can make breathing difficult. While it can affect individuals of all ages, infants are particularly vulnerable to serious complications, including death.
The symptoms of whooping cough vary depending on the age of the infected individual. In infants, the initial presentation often resembles a common cold, making early diagnosis challenging. While some babies may experience only mild cold-like symptoms, others develop more severe manifestations, including apnea, a life-threatening cessation of breathing. Apnea restricts oxygen delivery throughout the body, potentially leading to cyanosis, a bluish discoloration of the skin, lips, and tongue in Caucasian babies, and a greyish discoloration in babies with darker skin tones. Other severe complications in infants include pneumonia, seizures, and dehydration. Any of these symptoms warrant immediate medical attention. Infants under six months of age are often hospitalized for observation and treatment, regardless of the severity of their symptoms.
Older children and adults typically experience cold-like symptoms in the initial stages of whooping cough. After one to two weeks, these symptoms progress to intense, persistent coughing fits, often accompanied by a characteristic “whooping” sound during inhalation. This sound, however, may not be present in all adults. These coughing episodes can last for several minutes, worsen at night, and may be so severe as to induce vomiting and the expulsion of thick mucus. Facial redness during coughing spells is more common in adults. The coughing associated with whooping cough can persist for weeks or even months, and subsequent respiratory illnesses can trigger a recurrence of these fits.
The resurgence of whooping cough in 2024 is evident in the over 30,250 cases reported in the U.S., a substantial increase compared to the approximately 6,150 cases reported by the same time in 2023 and even exceeding pre-pandemic levels of 2019. This rise follows a period of decreased incidence during the COVID-19 pandemic, likely due to social distancing measures and increased hygiene practices implemented to control the spread of the coronavirus. While the current numbers are concerning, they remain lower than those seen in previous decades, according to the CDC. The geographical distribution of cases shows widespread occurrence across the contiguous U.S. and Alaska, with the East North Central region reporting the highest number of cases, led by Ohio.
The resurgence of whooping cough underscores the importance of vaccination, particularly as the disease returns to pre-pandemic patterns, typically peaking in cycles every three to five years. Vaccination remains the most effective strategy for controlling the spread of whooping cough and mitigating the severity of its symptoms. The introduction of the whooping cough vaccine in the 1940s dramatically reduced the annual incidence of the disease, which had previously reached hundreds of thousands of cases in the U.S. While the vaccine provides robust protection, its effectiveness wanes over time, necessitating booster shots throughout childhood and adolescence.
The recommended vaccination schedule for infants includes a series of shots administered at two, four, and six months of age. These combined vaccines also protect against other diseases like tetanus, diphtheria, polio, and hepatitis B, depending on the specific formulation. Booster doses are then given between 15 and 18 months of age and between four and six years of age. Preteens are recommended to receive another booster between the ages of 11 and 12, and catch-up doses are available for teenagers and adults who have not been previously vaccinated. Furthermore, to maintain immunity against whooping cough and the other diseases covered by the combined vaccine, booster shots are recommended every ten years for adults. Vaccination is also crucial for pregnant women, who are typically offered the vaccine during the third trimester. This not only protects the mother but also provides passive immunity to the fetus, safeguarding the newborn during the first few months of life when they are most vulnerable and before they can receive their own vaccinations. This practice of vaccinating pregnant women has proven highly effective in reducing the incidence of whooping cough in newborns.
