Whooping Cough Is on the Rise. Here’s What You Should Know
Constant coughing at the office, on public transportation, or at school is common during the winter months as respiratory illnesses peak. One particularly worrisome illness is on the rise: whooping cough. Rates of whooping cough, also known as pertussis, are up more than 500% compared to this time last year, with more than 23,000 Americans reporting contracting the illness so far in 2024.
The Centers for Disease Control and Prevention (CDC) reports that the surge is due to the disease rebounding after COVID-19-era disease prevention measures temporarily lowered whooping cough rates.
Shira Doron, professor at Tufts University School of Medicine and a healthcare epidemiologist and chief infection control officer at Tufts Medical Center, offered her advice for people trying to prevent whooping cough from affecting them or their families this season.
“Don’t be lulled into thinking that we’re still in that post-pandemic pattern of a lot of respiratory infection rates being lower,” she said. “It’s worth protecting yourself.”
A Painful, Long-Lasting Disease
Whooping cough is a respiratory infection caused by the bacteria Bordetella pertussis. Symptoms start out like a typical cold, with a runny nose, sore throat, and mild fever. But about a week later, an infected person will begin to experience violent coughing symptoms that tend to get worse over time, Doron said. Those coughing symptoms can last up to 10 weeks.
The disease gets its name from the whooping sound some people make when trying to breathe air back into their lungs between coughing fits. Sometimes, especially for pregnant women, violent coughing fits can even break ribs. Children may also have fits of vomiting after their intense coughs. “It’s very disruptive to your daily life if you’re having coughing fits throughout the day,” Doron said. “It’s really quite awful.”
While adults and children don’t typically have severe or life-threatening symptoms that require a visit to the hospital, infants can have so much difficulty breathing that they may turn blue and need to be hospitalized or put on a ventilator. About two thirds of infected infants younger than 12 months will have difficulty breathing (also known as apnea), while one third will need hospital treatment. If you’re a parent of an infant, head to the emergency room if you notice changes to your baby’s breathing, such as abnormal pauses in breathing, if their skin becomes very pale, or if their lips start to turn blue.
“Don’t be lulled into thinking that we’re still in that post-pandemic pattern of a lot of respiratory infection rates being lower. It’s worth protecting yourself.”
Shira Doron, professor at Tufts University School of Medicine and chief infection control officer at Tufts Medical Center
Detection and Treatment Can Help
Like many other respiratory illnesses, such as respiratory syncytial virus (RSV), whooping cough is very contagious. It spreads when an infected person coughs or sneezes, expelling droplets that others may breathe in or encounter on contaminated surfaces. It’s most contagious early in the infection, when symptoms are mild and the intense cough has yet to appear.
During the early stages of the illness, you can try home remedies, like fever reducers such as acetaminophen and ibuprofen, decongestants, humidifiers, and sleep to feel a bit better. There’s no treatment that will halt the violent cough, though—even over-the-counter cough suppressants don’t usually work.
Since whooping cough seems similar to other colds at first, it’s hard to know that you’re infected until it’s too late to stop the spread. While a doctor can provide a whooping cough test (usually a nasal swab), it’s “simply not feasible” to run to the doctor for testing each time you have cold symptoms, Doron said. Instead, Doron recommends going to the doctor for your symptoms if your cough lasts more than two weeks, if the cough is getting worse, or if the cough is so violent that you’re vomiting.
By that point, getting a whooping cough test from a doctor may not be helpful for you if you’re infected. But testing can still make a difference for those around you: If you know you’ve tested positive for whooping cough, those in your household can take antibiotics to prevent their own infections, Doron said. Antibiotics can be effective for whooping cough if administered in the first couple of days after you’re infected.
She also stresses that practicing basic respiratory illness hygiene whenever you feel sick, like covering your mouth when you cough and staying home when you don’t feel well, are important ways to keep those around you healthy. “There are things we can do to prevent other people from getting infected,” she said.
To prevent your own infection, Doron recommends frequent hand hygiene and maintaining your general health via a healthy diet, plenty of sleep, and stress management.
Vaccination Can Prevent the Spread
Though early treatment and detection can sometimes stop transmission, vaccination is the best way to prevent whooping cough, Doron said. While, like all vaccines, the whooping cough vaccine does not completely prevent illness, it does lower your chances of infection as well as lessen the severity of symptoms.
The CDC recommends that babies and children receive multiple whooping cough vaccinations and boosters between two months and six years of age, and that preteens should get another booster between the ages of 11 and 12.
Adults are recommended to get a tetanus vaccine (Td) or a combined tetanus and whooping cough vaccine (DTaP or Tdap) every 10 years. Doron recommends choosing the combined vaccine, especially in years with high rates of the disease. “Ask your doctor if you’re due for a booster,” she said.
Pregnant women, especially, need to ensure that they’re vaccinated, both since they’re at a higher risk of breaking their ribs and since their newborns are more susceptible to severe symptoms, Doron said.
Since the COVID-19 pandemic, there’s been a decrease in overall childhood vaccination rates, Doron said. During the 2023-24 school year, vaccine coverage among kindergarteners, for example, dropped to 92.7%, compared with 95% in 2019. A drop in vaccine coverage increases the risk for disease outbreaks such as this year’s whooping cough surge, Doron said.
Doron’s family once had their own outbreak, as three members of her family endured painful coughing fits for weeks. She said that she tells parents skeptical about the whooping cough vaccine that “if you can reduce the chance of getting pertussis even a little bit, do that, because I would never want to experience what I saw my loved ones experience.”
Department:
Immunology