The Texas Department of State Health Services (DSHS) has reported a significant increase in pertussis cases in 2024, with numbers tripling compared to the same period in 2023. This trend aligns with national data showing a more than fivefold increase in cases this year.
Pertussis, also known as whooping cough, is a highly contagious illness caused by the Bordetella pertussis bacteria. Early symptoms resemble those of a common cold, but can progress to severe coughing fits that may result in vomiting or a "whoop" sound during inhalation. Infants are particularly vulnerable and may experience gagging, gasping, or even stop breathing.
Vaccination remains the primary preventive measure against pertussis. However, DSHS emphasizes that immunized individuals can still contract the disease. "Immunized children and adults can still get pertussis," DSHS notes, advising clinicians to consider vaccination history when diagnosing.
Infants under one year old face the highest risk for severe complications from pertussis due to their developing immune systems. Approximately one-third of infants younger than 12 months require hospitalization if infected.
Reports indicate that both Texas and national case numbers had been lower during the COVID-19 pandemic but are now returning to pre-pandemic levels. On average, over 1,400 cases were reported annually in Texas before the pandemic.
To mitigate spread and severity of illness, early recognition and treatment are crucial. The Centers for Disease Control and Prevention advises keeping vaccinations up-to-date for all individuals. Testing via culture or PCR assay should be conducted prior to treatment initiation.
For treatment within three weeks after cough onset—six weeks for infants under one year and pregnant women near term—antibiotics such as azithromycin or erythromycin are recommended regardless of vaccination status.
Provisional data from DSHS reveals that more than half of 2024's cases involved individuals who had received at least one dose of vaccine; 33% had received five or more doses.
Healthcare settings should implement droplet precautions for suspected or confirmed cases until patients complete five days of antibiotic therapy. Exclusion guidelines suggest isolating affected individuals from public spaces until they finish appropriate treatment courses.
Close contacts at high risk should receive post-exposure prophylaxis (PEP) within specified timeframes based on exposure details. Routine preventive measures like hand washing remain essential alongside reviewing personal immunization histories with healthcare providers.
