Pertussis cases are on the rise locally. Here’s what to know

The Barnstable County Department of Health and Environment recently issued a press release to alert residents to a rise in cases of pertussis, also known as whooping cough, both locally and nationally. There were 26 cases reported in Barnstable County in 2024, making it the worst year for the disease in a decade. Nationally pertussis cases were six-times higher than the year before.

Cape Cod Hospital pediatric hospitalist Jevon Plunkett-Rondeau, MD, PhD, said she and her colleagues are very aware of the rising number of cases.

“I know outpatient clinics have been testing frequently and treating a lot of cases,” she said. “If they fit the profile for it, we’re sending testing to the state laboratory. It usually takes five days to get results back, so we treat it as though they have pertussis because early treatment with antibiotics makes a bigger difference in terms of (the severity of) symptoms.” 

The highest risk is for young babies because the first vaccine for pertussis is given at two months, she said. Newborns are only protected if the adults and older children around them have been vaccinated. For that reason, obstetricians automatically give pregnant women the Tdap booster during their last trimester.

That protects the moms from passing on pertussis, but dads, grandparents, older siblings, caregivers and day care providers should all get boosters as well. Protection from the booster generally lasts 10 years. If it’s been longer than that since you’ve had the Tdap booster, or if you don’t remember the last time you got one, Dr. Plunkett-Rondeau advises you to get one, to protect the infant.

“Pertussis in newborns can be quite scary because they will have apnea, where breathing pauses,” Dr. Plunkett-Rondeau said. “If not treated, that can lead to respiratory arrest and death.”

Possible Reasons for More Cases

Vaccine hesitancy is one of the reasons doctors like Dr. Plunkett-Rondeau think pertussis is becoming more widespread. She has definitely seen vaccine hesitancy steadily increase over her years in pediatrics, and she has seen a big uptick since the pandemic. She’s not sure if that is a result of a distrust of the COVID-19 vaccine trickling over into other vaccines, or if the pandemic closures interrupted kids’ regular vaccine schedule, which then made parents question if their kids even needed the vaccine.

Another factor is the frequency of the DTaP vaccine, which is given to children under the age of 7. It is administered as a series of five shots. Infants are given the vaccine at 2 months, 4 months and 6 months. They then get two more boosters before the age of 5. Since the schedule is so rigorous, it was easy for kids to fall behind during pandemic closures.

In older children and adults, pertussis can look like any other respiratory illness, so it’s hard initially to distinguish it from a viral illness. It can start with a runny nose and a mild cough, but then the cough becomes more drawn out. The reason pertussis is also called whooping cough is because people develop a “whoop” sound when they inhale at the end of the cough. But some people with pertussis have coughing spasms or coughing fits instead of the classic whoop, Dr. Plunkett-Rondeau said.

“Some people have mild symptoms and don't know they have whooping cough, but they can still spread the bacteria to others,” she said. “Many babies who get whooping cough are infected by older siblings, parents, or caregivers who don't know they have it.”

Testing for pertussis is done with a nasal swab similar to the one used to test for COVID, only slightly deeper in the nasal passage. It is treated with a five-day round of the antibiotic azithromycin, which is well-tolerated and works well at curing the disease.

“If people have a prolonged cough without other symptoms that they are worried might fit the description of whooping cough, then I would recommend them seeing either their primary care or go to Urgent Care to receive testing and antibiotics,” Dr. Plunkett-Rondeau said.

“If they are having difficulty getting a full breath in or having retractions where the skin pulls in with each breath, they should be evaluated in the Emergency Room. If at any point there are concerns about a child’s ability to breathe, they should go directly to the Emergency Room.”