The United States is grappling with the highest number of whooping cough cases in a decade, with over 32,000 reported by mid-December, marking a dramatic increase compared to the 5,100 cases recorded at the same time in 2023. The uptick follows a noticeable shift in disease patterns, fueled by factors such as waning vaccine protection, lower vaccination rates, and improved diagnostic methods.
Whooping cough, also known as pertussis, is a bacterial infection that primarily affects the upper respiratory system. Although cases had significantly declined during the Covid-19 pandemic due to social distancing measures and lockdowns, experts anticipated a return to pre-pandemic patterns. However, the 2023-2024 spike has far exceeded pre-pandemic levels, indicating that multiple factors are at play.
One of the major contributors to the surge is declining vaccine coverage. While the United States has generally seen high vaccination rates, they have dropped over the last few years. According to a CDC report, more than 94% of children born between 2018 and 2019 received the full series of DTaP vaccines by their second birthday. By comparison, only 92.5% of children born between 2020 and 2021 were similarly vaccinated.
The Vulnerable: Infants at Greatest Risk
Infants, particularly those under six months of age, are at the highest risk for severe outcomes from whooping cough. These children can experience life-threatening complications due to their still-developing immune systems. Dr. Dean Blumberg, a pediatric infectious disease expert at UC Davis Children’s Hospital, noted that many of the severe cases he has treated involve unvaccinated children. Unfortunately, some infants have succumbed to the disease, while others required intensive care.
“The severity of the illness can lead to children being placed on ventilators,” said Dr. Blumberg. “The lack of time between coughing fits can leave them gasping for breath, and if left untreated, it can be fatal.”
Decline in Vaccine Coverage and Waning Immunity
Vaccination is the best defense against whooping cough. The DTaP vaccine, which protects against pertussis, diphtheria, and tetanus, is recommended for infants starting at two months old. However, the protection provided by the vaccine wanes over time, leaving older children and adults more susceptible. As Dr. Santina Wheat, a professor at Northwestern University, explained, “We’re probably seeing the impact of waning immunity in vaccinated individuals, particularly tweens and adults.”
The CDC continues to recommend the DTaP vaccine for young children and a booster shot, the Tdap vaccine, for adolescents and adults every 10 years. Despite these recommendations, vaccine hesitancy and misinformation have led to fewer children receiving the necessary vaccinations.
Improved Diagnostics Play a Role
Another factor contributing to the increase in reported cases is enhanced testing capabilities. The advent of more accurate diagnostic tools means that pertussis is now detected more frequently. Dr. Wheat noted that improved testing panels, which can identify a variety of respiratory infections, have made it easier for doctors to confirm whooping cough, even in older patients.
“We’re recognizing the disease more often, and that may explain some of the rising numbers,” Wheat explained.
A Call for Vigilance and Vaccination
Experts stress the importance of vaccination to prevent further outbreaks, especially as the disease tends to peak during fall and winter months. While many people underestimate the dangers of whooping cough, the disease can have severe consequences, particularly for vulnerable populations like infants.
Dr. Blumberg urged parents to ensure their children are up to date with their vaccinations. “We need clear and consistent messaging about vaccines,” he said. “Pertussis is more than just a cough it can lead to serious complications.”
In conclusion, while whooping cough remains a preventable illness, the rising number of cases underscores the need for continued vigilance and adherence to vaccination guidelines. With proper immunization and awareness, the U.S. can curb the spread of this dangerous disease.
