Whooping Cough Cases in the U.S. Rise in 2025: Symptoms, Risks, and Vaccination

In 2025, the United States recorded 28,783 cases of pertussis, commonly known as whooping cough, marking a notable public health concern despite a 34% decline from the 43,321 cases in 2024. This respiratory illness, caused by Bordetella pertussis bacteria, poses severe risks especially to infants and young children, underscoring the need for robust vaccination efforts and awareness.

Current Landscape of Pertussis in America

Pertussis cases surged post-COVID-19, returning to pre-pandemic levels with over 10,000 annual reports typical before 2020. In 2024, cases exceeded six times those of 2023’s 7,063, peaking in late fall before trending downward into 2025, though numbers remain elevated. Factors driving this resurgence include waning vaccine immunity, improved diagnostics, and heightened surveillance.

State variations highlight regional challenges. Leading states by case volume include Washington (2,127), Texas (1,805), California (1,703), Oregon (1,560), and Florida (1,521). Sharp increases occurred in West Virginia (272%), Mississippi (206%), Hawaii (194%), Louisiana (173%), and Montana (142%), while decreases were seen in Rhode Island (99%), Missouri (88%), and others. Local examples, like Alameda County’s 91 cases in 2025 with 44% among 14-18-year-olds, reflect adolescent vulnerabilities.

This table summarizes the highest-burden areas, emphasizing the need for targeted interventions.

Recognizing Whooping Cough Symptoms Across Age Groups

Whooping cough progresses in stages. The initial catarrhal phase mimics a common cold with mild cough, runny nose, and low fever lasting 1-2 weeks. The paroxysmal stage brings intense coughing fits, often ending in a high-pitched “whoop” as patients gasp for air, potentially causing vomiting, exhaustion, and apnea—particularly dangerous for infants.

• Infants under 6 months: May not whoop but exhibit apnea, cyanosis (bluish skin), or gagging without the classic sound.
• Children and adults: Persistent cough lasting weeks, worsening at night, with fewer complications but high contagiousness.
• Complications: Pneumonia, seizures, encephalopathy, and in rare cases, death, mostly in young infants.

Diagnosis involves PCR testing from nasopharyngeal swabs, especially early in illness, as culture confirmation is less sensitive later.

Why Infants and Teens Face the Greatest Threats

Infants under one year have the highest incidence and mortality rates due to immature immune systems. They depend on maternal antibodies and herd immunity. Adolescents and adults, with waning acellular vaccine protection (DTaP/Tdap), often experience milder cases but spread the disease efficiently.

In 2025, high school-aged youth comprised significant portions in areas like Alameda County, signaling gaps in adolescent boosters. Pre-vaccine era saw over 200,000 annual U.S. cases with high childhood fatalities; vaccines reduced this dramatically, but resurgence demands vigilance.

Vaccination: The Cornerstone of Protection

Vaccines remain the primary defense. DTaP is given to children at 2, 4, 6 months, 15-18 months, and 4-6 years. Tdap boosters are recommended at 11-12 years, every 10 years for adults, and during each pregnancy (27-36 weeks) to pass antibodies to newborns.

Despite efficacy, protection wanes after 4-12 years, contributing to outbreaks. A recent poll revealed confusion: only 57% know a whooping cough vaccine exists (down from 63% in 2023), 43% link it to Tdap, and just 46% recommend it for pregnant women versus 83% for children. Public messaging should emphasize “whooping cough vaccine” over technical terms like pertussis or DTaP/Tdap.

This schedule, per CDC, maximizes immunity.

Prevention Tactics for Households and Communities

Beyond vaccination, strategies include:

• Isolation of cases for 5 days post-antibiotics (azithromycin, erythromycin) or 3 weeks untreated.
• Prophylactic antibiotics for close contacts, especially infants.
• Good hygiene: Cover coughs, handwashing, avoiding sick contacts.
• Cocooning: Vaccinate caregivers around newborns.

Emerging macrolide-resistant strains globally raise concerns; CDC monitors U.S. cases via enhanced surveillance. Health departments implement control measures efficiently amid rising trends.

Addressing Vaccine Hesitancy and Awareness Gaps

Vaccine awareness lags despite surges. Polls show messaging failures; clear communication linking Tdap to whooping cough protection is vital. Over 26,000 cases in early 2025 (four times 2023) highlight urgency. Education targets pregnant women, whose vaccination halves infant risk.

Community efforts, school mandates, and provider recognition boost reporting and prevention.

Frequently Asked Questions About Whooping Cough

Is whooping cough still a threat in vaccinated populations?

Yes, due to waning immunity; boosters are essential, and vaccinated individuals can contract milder cases but spread less.

Can pregnant women safely get the Tdap vaccine?

Absolutely, ideally 27-36 weeks, providing passive immunity to newborns.

How contagious is pertussis?

Highly, via respiratory droplets; peak contagiousness in catarrhal stage before cough.

What if antibiotics fail due to resistance?

Vaccination prevents; monitor via CDC surveillance; alternatives under study.

Why the 2024-2025 surge?

Post-pandemic return to patterns, better detection, waning vaccines.

Outlook and Action Steps for Families

With 2025 cases down but elevated, sustained vaccination, surveillance, and education are key. Parents should verify records, discuss boosters with providers, and recognize symptoms early. Public health stresses: Vaccines work best collectively.

Families with newborns: Prioritize maternal Tdap, cocooning. Teens: Ensure boosters. Communities: Advocate awareness. By addressing gaps, we mitigate future surges.