The cacophony of coughs you’ll hear over the next few months will be caused by a cocktail of respiratory bugs. Common causes include the common cold, coronavirus, influenza, and more recently respiratory syncytial virus (RSV). However, the number of coughs caused by a bacterial infection called whooping cough will continue to increase.
Whooping cough, called pertussis because of its most common symptom, can be devastating, especially for babies who aren’t strong enough to endure the severe chest spasms. Infants may be hospitalized, but death is unlikely. The pertussis vaccine has been part of children’s routine immunization schedules for decades, and the number of cases has declined by about 90 percent compared to the pre-vaccine era. Although the coronavirus pandemic has dramatically reduced the incidence of infections, cases are now on the rise again, with more than 16,000 cases reported this year in the United States as of September 28. This is more than four times the total number of infections reported at this time last year.
“The United States is beginning to return to pre-pandemic patterns, with typically more than 10,000 cases of pertussis reported each year,” a spokesperson for the Centers for Disease Control and Prevention says.
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Here’s what you need to know about whooping cough and how to protect yourself and your family from infection.
What is pertussis?
Whooping cough is caused by bacteria called Bordetella pertussis and is easily transmitted between people through direct contact or droplets from the mouth or nose. Bacteria colonize the lining of the respiratory tract, where they produce and excrete toxins. These toxins appear to be the most damaging in infections, so administering antibiotics early, before the bacteria excretes large amounts of toxins, is key to managing the disease.
However, Flor Muñoz, a pediatric infectious disease expert at Baylor College of Medicine, said the first stage of pertussis infection can be easily mistaken for other respiratory illnesses, making early treatment difficult. “At first you’ll have cold-like symptoms, a stuffy nose, just not feeling well, and maybe a sore throat,” she says. In many healthy adults, whooping cough may be limited to a persistent cough, while older children may only have nonspecific symptoms, such as a runny nose or cough, Muñoz added. “A lot of times it gets overlooked,” she says.
Whooping cough is highly contagious, so even people with mild symptoms can spread it to particularly vulnerable people, such as young children and the elderly, who may become more seriously ill. .
As the disease progresses to severe disease, whooping cough causes bouts of violent coughing punctuated by a distinctive wheezing sound caused by inhaling forcefully in an effort to catch your breath. Munoz said the coughing during hoops is bad. “They’re unstoppable,” she says. “It’s so strong that I’m actually going to vomit.”
Very young babies are especially vulnerable because they can’t breathe through their mouths yet and may not be able to get enough oxygen through mucus or violent coughs. In 2023, more than one in five children under six months of age with pertussis will be hospitalized. Treatment often includes IV fluids to keep you hydrated and breathing assistance, Muñoz says.
The infection is not complete even after the whooping cough stage is over. During treatment, people may have a cough that lasts for months, giving the infection the nickname “100-day cough.” And starting antibiotics at this stage will not speed recovery. Bacterial toxins are already widespread.
Whooping cough case rate
The total number of pertussis cases reported to the CDC so far this year has exceeded 16,000, likely fewer than the actual number of infections because mild infections often go undiagnosed. It will be done. New York, Pennsylvania, Illinois, and California have the highest number of reported cases, with each state exceeding 1,000.
Worryingly, the recent increase in whooping cough cases is not limited to the United States, with England, for example, experiencing more than 10,000 cases in the first half of 2024 alone, more than the equivalent annual total in more than a decade. Ta. “These numbers are large, so it’s not just that we were in the red[in cases]we’re paying the price now,” said Pageman Lohani, an epidemiological modeler at the University of Georgia. “I think something is going on. I don’t know what it is.”
In the United States this century, the number of cases has generally hovered between 10,000 and 20,000, but some years have been worse—particularly in 2012, when there were nearly 50,000 cases. It occurred. A notable drop began in 2020, with the incidence in 2021 remaining at just over 2,000. But with a few months left in 2024, infection rates are already in line with typical pre-pandemic infection rates in a year.
Vaccination against whooping cough
The vaccine, which initially caused whooping cough rates to plummet, is no longer in use because it contained the entire bacteria and caused rare but severe side effects, such as limping and convulsions. Since the 1990s, the United States has instead used something called acellular vaccines, which contain only some of the bacteria’s components, such as surface proteins and pertussis toxin. These substances are used to prevent tetanus in two single vaccines: DTaP (used in infants and young children over 2 months of age) and Tdap (used in older children and adults, and people in the last trimester of pregnancy). and combined with diphtheria vaccination. ).
Professor Rohani said that while these new vaccines are safer than whole-cell versions, they may not offer as strong or long-lasting protection as they do not contain as many parts of the bacteria that can trigger an immune system response. It says that there is a sex. It’s difficult to fully assess this concern, he says. But Muñoz said there are estimates that immunity from infection or vaccines lasts about six years. This could lead to new infections, as the United States recommends a tetanus booster only every 10 years, regardless of whooping cough.
The U.S. has the highest vaccine uptake rate among children at 94% and 89% among teenagers, a CDC spokesperson said. However, coverage is lower in adults. A 2022 CDC study suggests that about 40 percent of U.S. adults have received a Tdap vaccine or booster in the past 10 years. Another study conducted in early 2023 found that only about 55% of women who recently had a baby received the Tdap vaccine during pregnancy. Doctors recommend that pregnant women receive a new vaccination for each pregnancy. Muñoz attributed the low vaccination rate among adults to disruptions to health care access in the early stages of the coronavirus pandemic and increased hesitancy toward vaccination.
Although these adults themselves may not have a serious whooping cough infection, they are at risk of transmitting the bacteria to more vulnerable children. And Muñoz said the low vaccination rate among pregnant people is even more concerning. The immunity acquired during pregnancy is the only protection your baby has until he or she reaches two months of age and is able to begin receiving vaccines on his own. “It’s unfair for babies to die from whooping cough now that we have the tools we have,” she said, noting that vaccinations are effective and medical professionals have experience controlling whooping cough. did. “We’ve done it before. We got too loose.”
