The Centers for Disease Control and Prevention (CDC) has reported a significant surge in whooping cough cases, marking the fastest increase in nearly ten years. As the back-to-school season unfolds, infections are climbing across the United States. A total of 291 cases were reported for the week ending September 14, with New York leading the nation with 44 reported infections.
Comparison to Previous Years
This surge is the highest weekly count of Bordatella pertussis infections since 2015, when the country was recovering from a notable resurgence. This year alone, 14,569 cases have been reported—over four times the number of infections reported at the same point last year. Notably, this figure surpasses the over 10,000 cases reported by the same time in 2019, prior to the COVID-19 pandemic, which had also contributed to a decline in various infectious diseases.
Unvaccinated young children and newborns remain the most vulnerable to severe whooping cough. However, health officials have cautioned that older children and adults may experience breakthrough infections as vaccination rates remain lower than necessary. Since the shift to acellular pertussis vaccines in the 1970s, which aimed to reduce side effects but may have decreased overall effectiveness, whooping cough cases have risen.
In Pennsylvania, one of the states experiencing a severe outbreak, health officials noted that many infections are linked to high school students. They warned that outbreaks persisted even during the summer months when schools were closed, advising doctors to prepare for a possible increase in cases as schools reopened.
Demographics of Infections
In New York, nearly 40% of reported cases outside New York City involve teenagers aged 15 to 19. The state’s health department indicated that these cases are widely distributed, with no specific cluster or event identified. Similarly, Oklahoma has seen a sharp rise in cases, including individuals as old as 86. As of mid-September, the median age of infected individuals in Oklahoma is reported to be 9 years old, with a total of 162 cases recorded since January 1, 2024—the highest number since 2017.
The current situation has prompted discussions about potential human challenge trials by the Food and Drug Administration (FDA). These studies would intentionally infect vaccinated volunteers with the pertussis bacteria to expedite the development of more effective vaccines. An FDA advisory panel is set to meet to discuss this prospect, which could lead to new booster vaccinations for adults.
The CDC recommends a series of pertussis vaccinations for both children and adults, including Tdap boosters every ten years. However, data from 2022 reveals that only 39% of adults have received a pertussis booster in the last decade.
Underlying Factors for Resurgence
In addition to vaccination gaps, the FDA has suggested that the rise in whooping cough cases may also be influenced by mutations in circulating strains and a rapid waning of immunity. Despite this resurgence, current rates of whooping cough remain low compared to the pre-vaccine era, indicating that existing vaccines still provide considerable public health benefits.
As health officials continue to monitor the situation, the resurgence of whooping cough serves as a reminder of the importance of vaccination and ongoing public health vigilance.
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