Whooping cough cases on the rise with measles: Symptoms, what to know
As measles cases continue to crop up across the U.S., so too are cases of another highly contagious disease.
Whooping cough, known clinically as pertussis, has caused the death of at least five, according to a ProPublica report, and cases skyrocketed by 1,500% nationwide since a 2021 low point attributed to COVID-19 lockdowns and protocols.
Centers for Disease Control (CDC) data found that more than six times as many cases were reported in 2024 compared to 2023, making the total number of 35,435 infections, including 10 deaths, higher than what was seen in 2019 before the pandemic.
Here's what to know about whooping cough amid the growing cases.
Declining vaccine rates are contributing to rise of infectious diseases
The rise in pertussis infections has raised alarms for health experts who are already grappling with the ongoing outbreaks of measles nationwide. As of April 10, more than 700 cases of measles were confirmed across 24 states, resulting in at least three deaths. Texas accounts for 561 of those cases, with the epicenter of the outbreak, Gaines County in West Texas, claiming 364 infections.
The seven separate outbreaks, defined as 3 or more related cases by the CDC, have been largely attributed to declining MMR vaccination rates, which have resulted in a growing number of states losing herd immunity status. The vaccine-preventable disease was previously eradicated in the U.S. in 2000.
Vaccinations against whooping cough have also been on a steady decline, according to CDC data and the ProPublica report. The same vaccine hesitation that has fueled the measles outbreaks could also be contributing the resurgence of other infectious, vaccine-preventable and mitigated diseases that have previously been eliminated from or heavily controlled in the U.S.
What is whooping cough or pertussis?
Whooping cough, or pertussis, is a highly contagious bacterial infection that primarily affects the upper respiratory system, causing the intense coughing fits the disease is named after.
While both adults and children can get it, children under 1 year old are most likely to suffer serious illness or death as a result of contracting whooping cough, according to the CDC. It is most common in infants due to an underdeveloped immune system, inability to be vaccinated under the age of 2 months and exposure via friends, family and caretakers.
It is usually spread from person to person through respiratory droplets or contact with airborne droplets. Its signature "whoop" sound occurs as a result of infected people trying to catch their breath after or amidst a coughing fit.
Symptoms of whooping cough
Whooping cough occurs in three distinct stages, according to the CDC. Symptoms vary based on the stage of infection, age of the person infected and vaccination status.
The incubation period for the disease is typically 5 to 10 days after exposure, though it can be up to 21 days. The typical whooping cough infection can take 12 weeks to resolve from the time of symptom onset, though total resolution of symptoms could take months.
The three stages of a whooping cough infection are the catarrhal phase (inflammation of the mucus membranes) that lasts for the first week or two. The second is the paroxysmal phase, characterized by a sudden, episodic increase of symptoms, especially cough, and can last six weeks. Finally is the convalescent phase, or recovery phase, that can last weeks or even months.
Symptoms of whooping cough include:
- A common cold (also called Coryza), including typical symptoms of runny nose, sneezing and congestion.
- Low-grade fever.
- A mild, occasional cough that gradually becomes more severe.
- In infants, apnea, or a sudden interruption in breathing, is common. This may be the only symptom in some infants, who may not develop the signature cough.
- Sudden fits or attacks, known as paroxysms, of rapid coughs.
- Difficulty inhaling or "catching your breath" and a high-pitched "whoop" at the end of coughing fits.
- Cyanosis, or a blueish tint to the skin and mucus membranes, caused by inadequate oxygen in the blood.
- Exhaustion.
- Vomiting.
Recovery is usually a gradual process and most people will notice less persistent coughing and fewer coughing fits that disappear over the last two to three weeks of the infection.
The course of the illness and its symptoms are often milder in people who have been vaccinated, and the characteristic cough and "whoop" may be absent.
Potential complications of whooping cough
Whooping cough can be dangerous to anyone with a compromised immune system, but is specifically a concern in small children. The infectious disease can cause serious illness, complications and death in infants.
In fact, about a third of infants who contract whooping cough under the age of 1 need treatment in a hospital, according to the CDC. Hospitalization is most common in infants younger than 6 months of age.
Infants under 1 who are unvaccinated or incompletely vaccinated are at the highest risk for death and severe complications, such as inability or unwillingness to eat, difficulty sleeping and fainting.
More severe complications can include apnea (the sudden, temporary cessation of breathing), pneumonia, rib fractures from severe coughing, and even death.
Is there a whooping cough vaccine?
The most effective protection against whooping cough is vaccination. There are two different vaccines available based on age.
The DTaP vaccine (Diphtheria, Tetanus, Pertussis) is designed for children under the age of 7. DTaP vaccination is usually administered in five doses as part of a typical immunization routine. Doses are given at:
- 2 months
- 4 months
- 6 months
- 15–18 months
- 4–6 years
Can adults get whooping cough?
Adults can catch whooping cough, though symptoms tend to be milder than in children. The Tetanus, Diphtheria, Pertussis vaccine, known as Tdap, is designed to be given to adults, teens and children over the age of 7.
Protection given by the vaccine does lessen over time, meaning adults should regularly get booster shots.
- Adolescents should receive a single dose of Tdap, preferably at age 11 or 12 years. This applies even if they already had the above course of DTaP vaccines.
- Adults who have never received Tdap should get a dose. Adults who have had it should receive a booster every 10 years, or after 5 years in the case of a severe or dirty wound or burn.
- Pregnant women should get a dose of Tdap during every pregnancy, preferably during the early part of the third trimester, to help protect the newborn.
The CDC also emphasizes the importance of hygiene in limiting the spread of respiratory illness. Covering your mouth when you cough or sneeze, washing your hands often with soap and water and avoiding people who are showing symptoms are easy ways to help curb the number of cases.