
Making a deadly come-back: Pertussis, Whooping Cough, also known as "The 100 day Cough"
Pertussis, commonly known as whooping cough, is a highly contagious respiratory disease caused by the bacterium Bordetella pertussis. In the wake of recent global health challenges, health officials are increasingly concerned about a potential resurgence of this infection. With its alarming rise in cases, understanding pertussis and how to combat it is more important than ever.
It can result in rapid death in young children, protracted illness and death in the immunocompromised and elderly, and it is an easily treated infection.
The Rise of Pertussis: A Historical Perspective
Pertussis, whooping cough, now called the 100 day cough, has been around for centuries, with significant outbreaks documented even before vaccines were introduced. The widespread use of the pertussis vaccine in the 1940s dramatically reduced its prevalence. Unfortunately, in recent years, vaccination coverage has dipped. In 2019, more than 15,000 pertussis cases were reported in the United States alone, a number that was significantly higher than previous years. This resurgence especially affects infants and young children, who are at the highest risk for severe complications.
Why the Recent Surge?
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Several factors contribute to the recent increase in pertussis infections Those pesky inoculations (shots) only give immunity for 5 to 7 years.
Declining Vaccination Rates
One major reason for the rise in cases is the decline in vaccination rates. For instance, a 2021 study found that vaccination coverage among children dropped to 84%, down from 94% in previous years. Misinformation about vaccines and limited healthcare access contribute to this troubling trend. When a significant number of individuals within a community are unvaccinated, the risk of outbreaks increases, as seen in 2018 when several states in the U.S. experienced localized outbreaks.
Mutation of the Bacteria
Research indicates that Bordetella pertussis may be mutating, leading to new strains that might evade vaccine-induced immunity. A study published in 2020 indicated that recent strains could potentially increase the risk of infection among vaccinated individuals. This raises questions about the long-term effectiveness of current vaccines and highlights the need for vaccine updates.
Increased Awareness and Reporting
Heightened vigilance surrounding respiratory infections since COVID-19 could also explain the surge in reported cases. Healthcare providers are now more likely to recognize and diagnose pertussis. In the past year, many hospitals reported a 30% increase in the diagnosis of pertussis-related cases compared to before the pandemic.

Symptoms and Complications of Pertussis
Recognizing the symptoms of pertussis is key for early diagnosis and effective treatment.
Early Symptoms
Initially, pertussis may present with mild symptoms that resemble a cold, like a runny nose and slight cough. This can lead to misdiagnosis. In recent times, early detection has become increasingly crucial, as each week of delay can lead to worsening symptoms.
Paroxysmal Cough
After one to two weeks, patients often experience severe, uncontrollable coughing fits that characterize pertussis. These coughing spells can lead to vomiting or even broken ribs in extreme cases. A study indicated that up to 50% of patients experience complications so severe they require hospitalization.
Risks for Infants
Infants, particularly those under one year old, are at the highest risk for serious complications from pertussis. In 2017, approximately 90% of pertussis-related deaths occurred in infants in the U.S., underscoring the critical need for timely vaccination and awareness.
So, Just when you thought you have all bases covered....... You can catch pertussis from your Dog, as 'Kennel Cough.'

Preventative Measures and Vaccination
Prevention is pivotal in addressing the rise of pertussis infections. Get the DPT vaccine every 5 to 7 years.
Vaccination Strategies
Health professionals advocate for comprehensive vaccination strategies. This includes administering the DTP (Diphtheria, Tetanus, Pertussis) vaccine during childhood and a Tdap booster for older children and adults. Ensuring that individuals receive these vaccinations is essential for maintaining herd immunity. Data shows that maintaining an 80% vaccination rate can help prevent widespread outbreaks.
Public Awareness Campaigns
Raising awareness about the importance of vaccinations is crucial. Public health campaigns should focus on countering misinformation, providing clear data about vaccine safety and effectiveness, and encouraging vaccinations for all age groups. For example, community workshops can engage parents and correct misconceptions, potentially increasing local vaccination rates.
The Role of Healthcare Providers
Healthcare providers can significantly impact the fight against pertussis infections.
Diagnosing and Reporting
Healthcare professionals need to be vigilant in diagnosing pertussis, especially in patients with severe coughing who are unvaccinated or have known exposure. Implementing rapid tests and accurate reporting systems can help manage and reduce outbreaks effectively.
Counseling Patients
Doctors should proactively discuss vaccination benefits with their patients. Educating families about the importance of maintaining vaccination schedules and addressing myths is key to fostering compliance and awareness. A study indicated that where discussions about vaccines occurred routinely, vaccination rates increased by 25%.
Preparing for the Future
As concerns about pertussis continue to grow, preparedness becomes increasingly crucial. Understanding factors behind the rise in infections will enable public health officials and communities to respond effectively.
Everyone plays a role in building herd immunity, staying informed, and promoting vaccination efforts. By working together, we can address the challenges posed by infectious diseases like pertussis. An informed community is one of the best defenses against future health crises.
Adopting proactive measures today will pave the way for a healthier tomorrow. Staying informed and following public health guidelines will remain our best strategy against emerging infections.
Clinical notes from the Doc:
Diagnosis is Key: Ask your physician for a Respiratory Panel PCR that includes Pertussis.
Use your resources. Get the DPT shot.
NAC and Guaifenesin are helpful to loosen up the thick, miserable secretions that can persist with this infection.
Drink more water than you ever did. It helps loosen the secretions.
Antibiotics most useful to treat:
Erythromycin (EES is a good one, 400 mg taken three times daily for 3 weeks
Sulfamethoxazole (Septra DS) taken twice daily for 14 days
You will be tempted to try a Z- pack, but repeated regimens, that is, you will most likely need multiple prescriptions of the z-pak to make it work.
References:
Centers for Disease Control and Prevention (CDC). (n.d.). Pertussis (whooping cough). Retrieved January 2025, from https://www.cdc.gov/pertussis/index.html
Florida Department of Health. (n.d.).
Pertussis (whooping cough). Retrieved January 2025, from https://www.floridahealth.gov/diseases-and-conditions/vaccine-preventable-disease/pertussis/index.html
Journal of Pulmonology. (2024). Unraveling the resurgence of pertussis: Insights into epidemiological trends. Pulmonology, 253(10), 123-130. Retrieved from https://www.journalpulmonology.org/
Newsweek. (2024, November 10). Whooping cough cases soar in the U.S.: Tracking the resurgence. Retrieved from https://www.newsweek.com/pertussis-whooping-cough-cases-map-locations-2006367
CIDRAP. (2024, December). US whooping cough cases soar as public awareness remains low. Retrieved from https://www.cidrap.umn.edu/pertussis/us-whooping-cough-cases-soar-public-knowledge-contagious-disease-remains-low
The Times. (2024, November 28). Vaccine plea as three more babies die of whooping cough. Retrieved from https://www.thetimes.co.uk/
JAMA Network. (2024). Advances in pertussis vaccine development: Moving beyond acellular vaccines. JAMA, 382(7), 453-460. Retrieved from https://jamanetwork.com/
American Academy of Family Physicians (AAFP). (2021). Diagnosis and management of pertussis in adolescents and adults. American Family Physician, 104(3), 186-192. Retrieved from https://www.aafp.org/
Centers for Disease Control and Prevention (CDC). (n.d.). Pertussis outbreaks: Strategies for control. Retrieved January 2025, from https://www.cdc.gov/pertussis/outbreaks/index.html
World Health Organization (WHO). (2023). Pertussis vaccines: Global recommendations and implementation. WHO Bulletin, 101(8), 569-575. Retrieved from https://www.who.int/
Mayo Clinic. (n.d.). Whooping cough (pertussis): Symptoms, treatment, and prevention. Retrieved January 2025, from https://www.mayoclinic.org/
National Institute of Allergy and Infectious Diseases (NIAID). (2023). Research on pertussis immunity and vaccine development. NIAID Report, 45(6), 30-37. Retrieved from https://www.niaid.nih.gov/
Vaccine Hesitancy Research Group. (2023). Addressing vaccine hesitancy in the context of pertussis outbreaks. Journal of Vaccine Studies, 12(4), 211-218. Retrieved from https://www.journalvaccinestudies.org/
European Centre for Disease Prevention and Control (ECDC). (2023). Monitoring pertussis resurgence in Europe: Challenges and strategies. ECDC Bulletin, 15(7), 87-94. Retrieved from https://www.ecdc.europa.eu/
David S. Klein, MD, FACA, FACPM
1917 Boothe Circle, Suite 171
Longwood, Florida 32750
Tel: 407-679-3337
Fax: 407-678-7246