As of 5 October 2024, a total of 17,579 pertussis cases had been reported in residents in the US (excluding territories). The US Centers for Disease Control and Prevention (CDC) recorded 18,617 reported cases in 2019, which is likely to be surpassed by the end of 2024. Surveillance by CDC shows that this is the first year to have surpassed 10,000 pertussis cases since before the Covid-19 pandemic.
The intervening years have seen drastically reduced pertussis cases. In 2020, there were 6,124 reported cases, followed by 2,116 cases in 2021, 3,044 cases in 2022, and 5,611 cases in 2023. The relatively low burden of pertussis from 2020-23 has been attributed to infection control measures taken due to the Covid-19 pandemic. Experts suggest that the recent rise in pertussis is due to the relaxation of these measures.
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Pertussis, known colloquially as ‘whooping cough’, is caused by the bacteria Bordetella pertussis. The disease is named for the characteristic gasp for air following a coughing fit. Pertussis can infect people of all ages but is most likely to develop as a serious disease in infants. Pertussis is transmitted by coughing or sneezing.
Symptoms appear anywhere from five days to three weeks after infection. Early symptoms of whooping cough include runny nose, cough, and low fever. Babies may experience trouble breathing and develop a blue tint in their face due to a lack of oxygen, called cyanosis. Later symptoms include intense coughing fits, which may result in vomiting, fractured ribs, difficulty breathing and sleeping, and the characteristic ‘whoop’ for air. The disease eventually resolves about 12 weeks after infection. Complications are seen in one out of three babies and include pneumonia, encephalopathy, and death. The risk of severe symptoms is reduced with vaccination, which is also the best means of prevention.
The diphtheria, tetanus, acellular pertussis vaccine is recommended for those aged two months and older and is scheduled to be readministered every ten years after turning 19, as well as in response to wounds and pregnancy. The vaccine is 98% effective at preventing serious illness in children one year after their last dose, which lowers to 71% at five years. Other prevention measures include hygiene and post-exposure prophylaxis, which comprises antibiotics given to people with confirmed exposure to pertussis.
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The vaccination schedule published by CDC recommends doses at ages two months, four months, six months, 15-18 months, and four to six years. In 2024, leading data and analytics company GlobalData epidemiologists forecast that more than seven million people aged one to two years have been fully vaccinated (receiving four or more doses) against pertussis in the US, representing 79.8% coverage. At least 90% coverage is required to establish herd immunity.
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