Whooping Cough Surge Now Worst in Nearly a Decade During Back-to-School

Recent data from the Centers for Disease Control and Prevention (CDC) reveals that whooping cough cases in the U.S. have surged at an unprecedented rate, marking the fastest increase in nearly a decade. As the back-to-school season unfolds, the number of pertussis infections is once again on the rise nationwide.

For the week ending September 14, there were 291 reported cases, with New York leading the states with 44 infections. Other states like Ohio, Pennsylvania, and Oklahoma have also reported significant numbers, each with at least 38 cases.

This spike reflects the highest weekly tally of Bordatella pertussis infections reported to the CDC since 2015, a year that followed a previous surge. The uptick in whooping cough cases this year is particularly alarming, as a total of 14,569 infections have been reported so far, which is more than four times the number counted during the same period last year.

Cases have also surpassed the more than 10,000 reported at this time in 2019, a period before the COVID-19 pandemic led to a decline in various infections, including pertussis, due to widespread public health measures.

Despite the availability of vaccines, unvaccinated children, especially infants born to unvaccinated mothers, remain the most vulnerable to severe outcomes from whooping cough. Federal health officials have warned that older children and adults could also experience a resurgence of breakthrough infections.

The increase in pertussis cases over recent decades can largely be attributed to a shift in vaccination practices that took place after the 1970s. The newer pertussis vaccines, while associated with fewer side effects, are reportedly less effective at preventing disease and further transmission.

Pennsylvania has been notably impacted by the current outbreaks, which health officials attribute predominantly to high school students. This has raised concerns about the continued spread of disease despite the closure of most schools throughout the summer months. Recent statements from the state’s health department urge healthcare providers to be vigilant as students return to classroom settings.

In New York, where 40% of reported cases outside New York City affect teenagers aged 15 to 19, there is no indication of a specific outbreak location. Cases have emerged across various regions and settings, emphasizing the widespread nature of the current situation.

Oklahoma has also experienced a significant spike, with a noteworthy number of cases reported among older individuals, including an 86-year-old patient. So far this year, Oklahoma has documented 162 cases of whooping cough—the highest count since 2017, when the total reached 207.

As the situation escalates, the Food and Drug Administration (FDA) is exploring the possibility of conducting human challenge trials. These studies would intentionally expose vaccinated volunteers to the pertussis bacteria, aiming to expedite the development of more effective vaccines.

A panel of FDA advisors is set to convene to discuss these trials, which may ultimately lead to the introduction of new booster vaccines intended for adults. Currently, the CDC suggests a series of pertussis vaccinations for both children and adults, including a Tdap booster every decade.

However, data from a 2022 CDC survey indicates that only about 39% of adults have received a pertussis booster within the last ten years. Experts are considering other factors contributing to the increased number of cases, such as potential mutations in circulating strains of the bacteria and the rapid decrease of immunity in vaccinated individuals.

Although the rise in whooping cough cases is concerning, the FDA maintains that the current “acellular pertussis” vaccines continue to deliver substantial public health benefits by helping prevent severe disease. In their pre-meeting briefing documents, agency officials compared the current whooping cough rates to those seen during the pre-vaccine era, highlighting that the present rates remain relatively low.