Whooping Cough (Pertussis) Is on the Rise

Main Title: Rising Whooping Cough Cases: Symptoms, Vaccination, and Prevention

Whooping cough cases have increased significantly in many countries in recent years. Whooping cough, or pertussis, is a highly contagious respiratory infection that can be prevented through vaccination but has not been completely eliminated from community circulation. It can cause serious outcomes such as pauses in breathing, pneumonia, and severe respiratory problems, particularly in infants who have not yet completed their vaccinations.

According to a report published by the European Centre for Disease Prevention and Control on April 20, 2026, 209,674 pertussis cases were reported in European Union and European Economic Area countries in 2024. This figure reflects the increase in Europe; national surveillance data must be examined separately to assess the current situation in Türkiye.

Recognizing the early signs of pertussis, ensuring that vaccines are administered on time, and seeking medical care when the infection is suspected can help protect both the patient and vulnerable people around them.

What Is Whooping Cough and How Does It Spread?

Whooping cough is an acute and contagious respiratory infection caused by the bacterium Bordetella pertussis. The illness may initially resemble an ordinary upper respiratory tract infection. As it progresses, repeated and difficult-to-control coughing fits may develop.

Pertussis can affect people of all ages. However, the risk of severe disease is higher among young infants, children with incomplete vaccinations, and people with certain chronic health conditions.

How Is Whooping Cough Transmitted?

Whooping cough spreads through respiratory droplets released when an infected person coughs, sneezes, or speaks at close range. Household members, caregivers, and people who remain in close contact for prolonged periods in enclosed spaces may face a greater risk of infection.

The disease may be most contagious during its early stage, when the characteristic coughing fits have not yet appeared and symptoms resemble a common cold. A person may therefore spread the infection without realizing that they have pertussis.

Vaccinated people may still become infected. However, vaccination plays an important role in reducing the risk of severe illness and complications. Because vaccine-induced immunity may decline over time, pertussis in adolescents and adults may present as a milder cough that is more difficult to recognize.

Why Are Whooping Cough Cases Increasing?

There is no single explanation for the rise in pertussis cases. Even communities with high vaccination coverage may experience periodic increases every few years. Waning immunity, delayed vaccine doses, renewed circulation after the pandemic, and improved diagnostic capacity may all contribute.

Changes in the bacterium are also being studied. However, it would not be accurate to attribute every increase solely to genetic changes in the bacterium or to assume that vaccines are no longer effective.

Waning Immunity

Neither previous pertussis infection nor vaccination provides lifelong immunity. Protection may decrease over time, allowing previously vaccinated adolescents and adults to become infected again.

The illness may be milder in these individuals. However, when a persistent cough is not recognized as possible pertussis, the infection may be transmitted to young infants living in the same household.

Delays in Routine Vaccination

The pandemic, natural disasters, migration, interruptions in access to healthcare, and vaccine hesitancy may delay routine childhood vaccinations in some regions. Gaps in vaccination schedules increase the number of people who remain vulnerable to infection.

Vaccination decisions should be based on the current national vaccination schedule and advice from qualified healthcare professionals rather than information shared on social media.

Renewed Circulation After the Pandemic

During the COVID-19 pandemic, face masks, physical distancing, and reduced social contact temporarily limited the circulation of many respiratory infections. As these measures ended and social contact increased, diseases including pertussis may have begun circulating more widely again.

The broader availability of PCR testing and greater awareness of pertussis in people with prolonged coughs have also allowed some previously undiagnosed cases to be identified.

What Are the Symptoms of Whooping Cough?

The symptoms of pertussis may vary according to a person’s age, vaccination status, and stage of illness. The infection generally begins with symptoms resembling a common cold, including a runny nose, mild fever, watery eyes, and a mild cough.

Within one or two weeks, the cough may become more severe. Repeated coughing fits, a high-pitched sound when breathing in after a coughing episode, vomiting, and marked tiredness may occur. Although the intensity of the cough decreases during recovery, symptoms may continue for several weeks.

Whooping Cough Symptoms in Infants

Infants do not always develop the typical forceful cough. Particularly during the first months of life, pertussis may present with short pauses in breathing or feeding difficulties.

Important warning signs include:

• Pauses in breathing: An infant who stops breathing for several seconds or longer requires urgent assessment.

• Bluish discoloration: Blue lips, tongue, or facial skin may indicate reduced oxygen levels.

• Feeding difficulty: Weak sucking, frequent vomiting, or an inability to take fluids may develop.

• Unusual drowsiness: The infant may appear sleepier, less responsive, or weaker than usual.

• Coughing fits: Repeated coughing may be followed by vomiting or difficulty breathing.

Because the illness can progress more severely in infants who have not completed their vaccinations, medical assessment should not be delayed.

Whooping Cough Symptoms in Adolescents and Adults

In adolescents and adults, pertussis often presents as a persistent cough lasting for several weeks. The classic high-pitched intake of breath does not occur in every patient.

The cough may worsen at night, interrupt sleep, cause vomiting after coughing, and lead to pain in the chest or abdominal muscles. Severe coughing episodes may occasionally result in urinary leakage, dizziness, or rib injuries.

The absence of a high fever does not rule out pertussis. A cough approaching three weeks in duration or becoming progressively worse should be medically assessed, particularly when the person has close contact with an infant.

Which Symptoms Require Emergency Assessment?

Emergency medical care is required when an infant has pauses in breathing, bluish discoloration, severe breathing difficulty, an inability to feed, or marked lethargy. An online consultation is not sufficient when these symptoms are present.

Severe shortness of breath, altered consciousness, fainting, chest pain, bloody sputum, uncontrolled vomiting, dehydration, or rapidly worsening general health in children or adults also requires urgent assessment.

A person with possible pertussis should avoid close contact with infants, pregnant people, and immunocompromised individuals whenever possible. Informing the healthcare facility about a prolonged cough and possible exposure before arrival can help staff take appropriate infection-control precautions.

How Is Whooping Cough Diagnosed?

The diagnosis of pertussis is based on the duration of symptoms, the patient’s age, vaccination history, and possible contact with a confirmed case. A definite diagnosis cannot be made solely from the sound or pattern of the cough.

Because infants may not develop the characteristic cough, signs such as pauses in breathing or feeding difficulties may be particularly important.

PCR and Culture Testing

When pertussis is suspected, a sample may be collected from the back of the nose, known as the nasopharynx, for PCR testing. PCR looks for genetic material from the bacterium and is particularly useful during the earlier stages of illness.

A culture test attempts to grow the bacterium in a laboratory. Results may take longer, but a positive culture supports the diagnosis. The likelihood of obtaining an accurate result may depend on collecting the sample from the correct location, using an appropriate technique, and, where possible, collecting it before antibiotics are started.

The most appropriate test may depend on how long the cough has been present. A healthcare professional should therefore decide which test should be performed and when.

Can Blood Tests Diagnose Pertussis?

General blood tests such as a complete blood count or C-reactive protein are not specific to pertussis. Changes in these results may provide supporting information about an infection but cannot diagnose whooping cough on their own.

Antibody-based serological tests may be considered in some patients, particularly when symptoms have been present for a longer period. However, results must be interpreted according to the test used, the patient’s vaccination history, and the stage of illness.

How Is Whooping Cough Treated?

Treatment is planned according to the patient’s age, duration of illness, severity of symptoms, and risk of complications. Antibiotics may be used, but the medication, dose, and duration must be determined by a healthcare professional.

In infants, pregnant people, and individuals at high risk of severe disease, treatment may sometimes be considered before test results are available. People should not use antibiotics prescribed for someone else or begin treatment without medical advice.

The Purpose of Antibiotic Treatment

When started early, antibiotics may help reduce the severity of the illness. Another important aim of treatment is to reduce the risk of transmitting the bacterium to other people.

When treatment begins after coughing fits are already established, antibiotics may not stop the cough immediately. This is because coughing may persist for some time due to irritation and damage in the respiratory tract caused by the infection.

Supportive Care

Young infants may require oxygen, intravenous fluids, close monitoring of feeding, and hospital observation. Patients with severe respiratory distress may need assessment in an intensive care setting.

For people considered suitable for home care, adequate fluid intake, rest, and avoidance of cigarette smoke and strong odors are important. Over-the-counter cough medicines should not be given to young children unless recommended by a healthcare professional.

Close Contacts and Infectiousness

Household members of a person diagnosed with pertussis, as well as individuals who have had close contact with an infant, a pregnant person, or someone who is immunocompromised, should be assessed by a healthcare professional. Preventive antibiotics are not automatically required for every contact; the nature of the exposure and the individual’s risk must be considered.

Infection-control precautions generally continue through the first five days after effective antibiotic treatment begins. In untreated patients, infectiousness may continue for several weeks after the cough starts. Instructions from the healthcare facility regarding isolation and returning to work or school should be followed.

Who Should Receive a Whooping Cough Vaccine and When?

The most effective approach to preventing pertussis is to receive pertussis-containing vaccines according to the current national vaccination schedule. Vaccination may not prevent every infection, but it reduces the risk of severe disease, hospitalization, and complications, particularly in infants.

In Türkiye, pertussis vaccination is included in the childhood immunization programme as part of combination vaccines that also protect against diphtheria, tetanus, and other diseases. Completing doses on time is important.

Childhood Vaccinations

When an infant or child has missed vaccine doses, it may not always be necessary to restart the entire schedule. A family physician or pediatrician can plan a catch-up schedule based on the child’s age, previous doses, and the time that has passed.

Keeping vaccination records and reviewing them during routine health visits can help identify missed or delayed doses.

Whooping Cough Vaccination During Pregnancy

The Tdap vaccine administered during pregnancy allows antibodies produced by the mother to pass to the baby through the placenta. This can provide some protection during the vulnerable period before the infant begins receiving their own pertussis vaccines.

Under the updated practice in Türkiye, Tdap vaccination is planned between weeks 18 and 24 of pregnancy. Additional tetanus and diphtheria doses for people who have never been vaccinated are arranged according to their previous vaccination history. An individual vaccination plan should be discussed with an obstetrician or family physician.

Adults and Close Contacts of Infants

Recommendations for pertussis-containing booster doses in adults may vary according to the country, age, occupational risk, pregnancy status, and previous vaccination history. Healthcare workers, infant caregivers, and people living with a newborn may review their vaccination status with their doctor.

Keeping the vaccinations of people who will have close contact with an infant up to date is sometimes called the “cocooning approach.” However, vaccination of close contacts does not replace Tdap vaccination during pregnancy or the infant’s own vaccination schedule. It is a complementary measure.

How Can Whooping Cough Be Prevented?

Vaccination is the foundation of protection against pertussis. Early recognition of possible symptoms and everyday measures that limit transmission are also important.

The following steps may help reduce risk:

• Review vaccination records: The vaccination status of children, pregnant people, and high-risk groups should be assessed with a healthcare professional.

• Do not ignore a prolonged cough: A cough lasting for weeks should be evaluated, particularly in people who have close contact with an infant.

• Follow cough hygiene: Cover the mouth and nose with a tissue or the inside of the elbow when coughing, and wash the hands afterward.

• Ventilate enclosed spaces: Transmission may be more likely in crowded and poorly ventilated settings.

• Keep symptomatic people away from vulnerable groups: A person with possible pertussis should avoid close contact with young infants.

• Follow medical advice: Antibiotic treatment, the duration of isolation, and the appropriate time to return to school or work should be determined individually.

Children should not return to daycare or school until the period in which they may transmit the infection has ended. When someone in the household is diagnosed with pertussis, contact with infants, pregnant people, and immunocompromised individuals should be reported to a healthcare provider.

What Complications Can Whooping Cough Cause?

Pertussis may cause serious complications in infants younger than six months, including pneumonia, pauses in breathing, low oxygen levels, dehydration, and feeding difficulties. Prolonged or severe respiratory problems may require hospital monitoring.

Complications are less common in adolescents and adults. However, forceful coughing may cause rib injuries, abdominal muscle strain, urinary leakage, fainting, or worsening of an existing lung condition.

Groups at the highest risk include:

• Infants younger than six months who have not completed their vaccinations

• Infants born prematurely

• Pregnant people and individuals living with a newborn

• People with weakened immune systems

• People with serious heart or lung conditions

• Children and adults with incomplete vaccinations

Assessment should not be delayed when a high-risk person has possible exposure or symptoms.

Plan an Online Doctor Consultation With Happ Health

An online doctor consultation may be planned as an initial step when a person has a cough lasting for several weeks, coughing fits that worsen at night, or close contact with someone diagnosed with pertussis. The doctor can review the duration of symptoms, vaccination history, current medications, and contact with vulnerable people before directing the patient to an appropriate specialty or in-person assessment.

Because suspected pertussis may require nasopharyngeal sampling, a physical lung examination, or measurement of oxygen levels, an online consultation may not be sufficient in every case. Guided by the principle “Health Everywhere, for Everyone, Always,” Happ Health aims to make access to professional assessment and appropriate healthcare services easier for non-emergency health concerns.

An online doctor consultation is not sufficient when an infant has pauses in breathing, bluish discoloration, severe breathing difficulty, or an inability to feed, or when a child or adult has altered consciousness, chest pain, or rapidly worsening general health. Emergency medical care should be sought.

This content is intended for general information only. It does not replace a diagnosis or personalized treatment advice.

References

• Republic of Türkiye Ministry of Health, General Directorate of Public Health. National Childhood Immunization Schedule.
  https://asi.saglik.gov.tr/bagisiklama-programi-ve-asi-takvimi/asi-takvimi.html
• Republic of Türkiye Ministry of Health, General Directorate of Public Health. Latest Updates to the Vaccination Schedule.
  https://asi.saglik.gov.tr/bagisiklama-programi-ve-asi-takvimi/asi-takvimindeki-son-guencellemeler.html
• European Centre for Disease Prevention and Control. Pertussis: Annual Epidemiological Report for 2024.
  https://www.ecdc.europa.eu/en/publications-data/pertussis-annual-epidemiological-report-2024
• European Centre for Disease Prevention and Control. Increase of Pertussis Cases in the EU/EEA.
  https://www.ecdc.europa.eu/en/publications-data/increase-pertussis-cases-eueea
• World Health Organization. Pertussis.
  https://www.who.int/health-topics/pertussis
• World Health Organization Regional Office for Europe. Pertussis: What You Need to Know.
  https://www.who.int/europe/publications/m/item/pertussis-what-you-need-to-know
• Centers for Disease Control and Prevention. Clinical Features of Pertussis.
  https://www.cdc.gov/pertussis/hcp/clinical-signs/index.html
• Centers for Disease Control and Prevention. Laboratory Testing for Pertussis.
  https://www.cdc.gov/pertussis/php/laboratories/index.html
• Centers for Disease Control and Prevention. Treatment of Pertussis.
  https://www.cdc.gov/pertussis/hcp/clinical-care/index.html
• Centers for Disease Control and Prevention. Pertussis Infection Control Guidance.
  https://www.cdc.gov/infection-control/hcp/healthcare-personnel-epidemiology-control/pertussis.html