The Resurgence of Whooping Cough: Understanding the Disease and How to Combat It
Whooping cough, or pertussis, is a highly contagious and serious infection characterized by severe coughing fits that can make it difficult to breathe, eat, or sleep. Before vaccines were available, the disease—caused by the Bordetella pertussis bacteria—was so lethal that it killed one in ten children affected, leading to twice as many childhood deaths as measles and polio combined..
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Whooping cough
Currently, falling vaccination rates in some middle- and high-income countries have led to a troubling resurgence of the disease. Here are six key facts about whooping cough, why it is spreading, and how it can be prevented:
1. The name comes from the distinctive whooping sound at the end of a coughing fit. Early symptoms of pertussis resemble those of a common cold but progress to violent coughing fits that can last several minutes, punctuated with a loud, high-pitched ‘whoop’ as people try to draw breath. (Click here to listen to what it sounds like.) These fits of coughing can persist for three months, hence the name ‘the 100-day cough.’
2. Vaccines are highly effective at preventing infection. The diphtheria, tetanus, and acellular pertussis (DTaP) vaccine protects 98% of children for the first year following the last dose, falling to 71% after five years. Other vaccine formulations, like the pentavalent vaccine, also protect against hepatitis B and Haemophilus influenzae type B (Hib) disease. With Gavi’s support, this vaccine is available in the world’s 73 lowest-income countries.
The World Health Organization (WHO) recommends all infants receive three doses of the pertussis vaccine, with one booster dose in children one to six years old. Some countries also offer booster doses to adolescents and adults, as well as to pregnant women to protect their newborns before they’ve had their vaccinations.
3. Infections are rising in countries where it had been under control. Cases of whooping cough have increased in England, with monthly infections now higher than the total 858 cases reported in 2023. The UK Health Security Agency (UKHSA) data shows the UK falls below the WHO target of 95% vaccination for under-fives. In the US, reported cases have tripled compared to the same period in 2023.
4. Falling vaccination rates are sometimes more about access than hesitancy. While lower vaccine uptake is concerning, experts argue it’s not solely due to vaccine hesitancy. In the US, many low-income families lost access to free vaccines after policy changes. Similarly, in the UK, systemic issues and fragmented healthcare pathways have created barriers to immunization despite high parental confidence in vaccines.
5. It mostly affects children and babies, but can affect people of any age. Babies and young children are most at risk, especially before they are vaccinated. Pregnant women are urged to get the vaccine to protect their babies. While antibiotics can treat the infection, early symptoms resembling a common cold can delay diagnosis, resulting in severe cases and deaths.
6. Whooping cough can be confused with other viral infections that cause violent coughing. The resurgence of whooping cough in the UK coincided with a cold, wet start to the year and the circulation of other respiratory viruses. Parainfluenza viruses, adenoviruses, and respiratory syncytial virus (RSV) can all cause persistent, severe coughing similar to whooping cough.
