It’s back—the Texas Department of State Health Services (DSHS) reported 772 cases of pertussis (also called whooping cough) in 2024, compared to 264 cases in the state in 2023. That is a nearly tripling of cases of the serious disease in the state, something that is being repeated in several other states.

This article will briefly describe what pertussis is and what is happening in Texas.

What is pertussis?

Pertussis, or whooping cough, is an infectious bacterial disease caused by the Bordetella pertussis bacteria. The infection leads to uncontrollable coughing, with a “whooping” sound when you take a breath after the coughing spell. The disease is very contagious and although it is more common in infants and children, it can attack adults.

The coughing can be so difficult for infants and babies that they can choke or vomit. The coughing spells can be so problematic that it can be difficult for infants to eat, drink, or breathe.

The treatment for whooping cough is usually antibiotics. Early treatment is critical. It may make your infection less serious, and it can also help prevent spreading the disease to others.

Whooping cough is a dangerous disease with serious complications. According to the CDC, the most dangerous complications for babies younger than one year old who are treated in in the hospital are:

• 1 out of 5 (22%) get pneumonia (lung infection)
• 1 out of 50 (2%) will have convulsions (violent, uncontrolled shaking)
• 2 out of 3 (68%) will have apnea (slowed or stopped breathing)
• 1 out of 150 (0.6%) will have encephalopathy (disease of the brain)
• 1 out of 100 (1%) will die

About 1 in 3 babies younger than 1 year old who get whooping cough need hospital care. The younger the baby, the more likely that they will need hospital treatment.

I know that a lot of the anti-vaccine world would try to convince you that whooping cough is a trivial disease making the vaccine unnecessary – they’d be wrong.

Pertussis vaccine

There is one easy way to prevent pertussis, and it is the pertussis vaccine. The DTaP vaccine, which prevents diphtheria, tetanus, and pertussis, is usually given in five doses at 2 months, 4 months, 6 months, 15-18 months, and 4-6 years of age. Children older than six years and adults receive a different version of the vaccine called Tdap.

The vaccine is over 98% effective in preventing whooping cough in children who have received all five doses. Unfortunately, there is waning immunity from the vaccine especially compared to the previous versions of the vaccine that were available up through the 1990s. Nevertheless, even with waning immunity the vaccine is still very effective in preventing and reducing hospitalization from the disease.

Before widespread vaccination, whooping cough epidemics were a regular occurrence, with thousands of deaths reported each year. Once again, nearly all vaccine-preventable diseases are dangerous and with increases in cases of pertussis, we could go back to the pre-vaccine epidemics.

Unfortunately, the vaccination rate for DTaP has dropped from 95.3% in 2017-18 to 91.7% in 2023-24. That leaves the overall vaccination rate for pertussis at just above the herd immunity level. Worse yet, the non-medical exemption rate among US children entering school has nearly doubled from 2.0% to 3.7% in the same time frame.

Pertussis in Texas

The Texas DSHS has not pinpointed exactly why the huge increase, but they imply that the COVID pandemic mitigation efforts, such as masking and remote learning, greatly reduced the incidence of pertussis. Now, they are increasing to pre-pandemic levels, where an average of 1400 cases are reported annually.

One might argue that this isn’t so bad, since it’s going back to the historical levels of pertussis, but that’s not the point. Over 1400 cases are way too many, especially since the DTaP vaccine (and boosters at the recommended ages) is highly effective in preventing the infection.

This is just not Texas. As of week #44, the CDC reported on November 2, 2024, CDC data show that more than five times (22,240) as many pertussis cases were reported compared to (4,209) at the same time in 2023. States like Pennsylvania are reporting 500% increases in pertussis cases for 2024 over 2023.

Whooping cough is not a trivial disease. Get the vaccine for your children. Pregnant women should get the vaccine to keep their newborns safe. Adults who are around newborns and infants should get the vaccine. It’s safe. And it’s effective.