Nearly 28,000 cases and 13 deaths mark another concerning year for the bacterial infection, driven largely by declining vaccination rates nationwide
The United States recorded nearly 28,000 whooping cough cases in 2025, marking the second consecutive year surpassing 25,000 infections. While this represents a decrease from last year’s peak of 35,493 cases, it remains significantly higher than pre-pandemic levels. In 2023, only 7,063 cases were reported, making the current surge particularly alarming. The last time numbers reached similar heights was 2014, when 32,971 cases occurred. At least 13 people died from the infection this year, most of them children under 1 year old.
The respiratory infection, also known as pertussis, begins with cold-like symptoms including runny nose, fever and mild cough. These early signs can progress to violent coughing fits lasting weeks or months. The characteristic “whoop” sound when trying to catch breath between coughing spells gave the disease its common name. About one in three babies younger than 1 who contract whooping cough require hospital care, though experts believe much of the disease goes unrecognized and unreported.
Global patterns mirror American crisis
The whooping cough resurgence extends beyond American borders. Last year, 977,000 pertussis cases were reported to the World Health Organization, representing a five-fold increase over 2023. The Pan American Health Organization noted that vaccination coverage in the Americas region for the first and third doses of whooping cough vaccines dropped to its lowest level in two decades during the pandemic. In 2021, coverage rates fell to 87% for the first dose and 81% for the third dose.
Dr. Scott Roberts, associate medical director for infection prevention at Yale School of Medicine, attributes the American surge to falling vaccination rates combined with population-wide immunity loss during pandemic lockdowns. College campuses experienced multiple outbreaks as students who received childhood vaccines but skipped booster shots lost protection while living in close quarters where the disease spreads easily.
Understanding the bacterial threat
Whooping cough differs from flu and other respiratory illnesses because it stems from the bacterium Bordetella pertussis rather than a virus, despite similar early symptoms. The bacterial toxin damages airways, causing the severe coughing fits that define the illness. Dr. Shira Doron, chief infection control officer for Tufts Medicine, notes that some patients experience post-tussive emesis, vomiting during or after coughing spells accompanied by whooping sounds.
Antibiotics provide the primary treatment for whooping cough. When started early, medications can reduce contagiousness and break transmission chains, though they don’t change the illness course. Health care providers often prescribe a five-day azithromycin course based on symptoms alone, since rapid tests remain hard to find in clinics. The medication typically eliminates the bacteria quickly without requiring expensive testing.
Protecting vulnerable populations
Infants face the highest risk of severe illness or death because their respiratory and immune systems are still developing. Warning signs requiring immediate medical attention include struggling to catch breath or skin turning blue. Severe cases remain rare among vaccinated children, emphasizing the importance of completing the recommended vaccine series. The CDC recommends routine DTaP vaccination for all infants and children under 7 through a five-dose series beginning at 2 months of age.
Children who receive all five DTaP doses on schedule are 98% protected within the year after the last shot. About 70% remain fully protected five years after the final dose. Adults and adolescents need booster Tdap vaccinations every 10 years starting at age 11 or 12 to maintain immunity. Pregnant women should receive a Tdap booster between weeks 27 and 36 of pregnancy, allowing maternal antibodies to pass through the placenta and provide temporary protection for newborns.
Communities sound urgent warnings
South Carolina health officials urged residents to update vaccinations amid a concerning uptick in measles, whooping cough and chickenpox cases. Dr. Linda Bell, the state’s epidemiologist, linked the increases to declining vaccination coverage and called the trend both preventable and reversible. Mecklenburg County in North Carolina typically saw one or two whooping cough cases annually before numbers spiked to 68 in 2024. By October 2025, the county had recorded 48 cases.
Dallas County in Texas reported 40 cases in 2023, 160 in 2024 and at least 195 this year. Kindergarten vaccination rates against pertussis in Dallas dropped from nearly 94% in the 2023 to 2024 school year to less than 90% in 2024 to 2025. Dr. Phil Huang, director of Dallas County Health and Human Services, emphasized that ensuring children are fully vaccinated provides the best protection available.
Vaccine hesitancy drives crisis
Public health experts fear sustained high infection rates reflect declining vaccination acceptance nationwide. For children born in 2021, the most recent group with available data, only 79% had received four DTaP shots by age 2. Dr. Roberts worries vaccine hesitancy is playing a significant role in the resurgence of this preventable illness. Any decline in vaccination rates leads directly to increased pertussis infections, he noted.
The return to shared indoor spaces after pandemic restrictions may have contributed to the spike. Limited exposure to routine pathogens during lockdowns meant greater proportions of people encountered the bacterium simultaneously once restrictions lifted. Experts wonder whether the population is still recovering from lost immunity and hope rates will stabilize over coming years.