The Texas Department of State Health Services (DSHS) has reported a significant increase in pertussis, also known as whooping cough, across the state in 2025. Provisional data show that more than 3,500 cases have been reported through October this year, which is about four times higher than the same period last year. This marks the second consecutive year of notable increases and the second year DSHS has issued a health alert.
Health officials stress that vaccination remains the most effective protection against pertussis. They advise parents to keep children current with immunizations and recommend booster shots for pregnant women and anyone who will be around newborns. Clinicians are urged to consider pertussis in patients with relevant symptoms and report suspected cases to local health departments within one work day.
Pertussis is caused by Bordetella pertussis bacteria and spreads easily between people. Early symptoms often resemble those of a common cold, but after one or two weeks, severe coughing fits may develop. These can lead to vomiting or cause a “whoop” sound when breathing in between coughs. Infants may not have typical coughing fits but could gag, gasp, vomit, stop breathing, or turn blue.
Vaccination is strongly recommended even though immunity from previous vaccination can fade over time. Immunized individuals can still contract pertussis but often experience milder symptoms without the classic “whoop.” The risk of severe complications is highest for infants under one year old; about one-third of babies younger than 12 months who contract pertussis require hospitalization.
Recent trends indicate that after lower case numbers during and just after the COVID-19 pandemic, both Texas and the United States have seen a quick resurgence in pertussis activity. In 2023, Texas recorded 340 cases; provisional data for last year show an increase to 1,907 cases—over half occurring in November and December. This year’s preliminary data indicate more than 3,500 cases so far, with approximately 85 percent involving children.
The Centers for Disease Control and Prevention recommends that all individuals stay up-to-date on their vaccinations because immunity wanes over time. Pregnant women should receive Tdap vaccine during each pregnancy between weeks 27 and 36 to transfer protective antibodies to their infants before birth—a measure shown to reduce risk for babies younger than two months by 78 percent. Adults expecting close contact with infants should also ensure they are vaccinated at least two weeks prior.
For symptomatic patients, testing should be conducted before starting treatment using nasopharyngeal culture or PCR assay methods available at hospitals and commercial labs. If clinical history suggests pertussis or if patients are at high risk—such as infants—or have known exposure without prophylaxis, treatment may begin before test results return.
Early antibiotic treatment is crucial for reducing severity and limiting transmission. Azithromycin is recommended as first-line therapy; alternatives include erythromycin, clarithromycin, or trimethoprim-sulfamethoxazole depending on patient needs.
Guidance on post-exposure prophylaxis (PEP) states it should be given regardless of vaccination history within specific timeframes: household contacts within 21 days of symptom onset in the index patient; infants under twelve months within three weeks of last exposure; people with pre-existing health conditions exacerbated by infection; pregnant women in their third trimester; others in high-risk settings such as neonatal intensive care units or childcare centers.
In healthcare environments, droplet precautions are advised until five full days of appropriate antibiotics have been administered to suspected or confirmed cases. Healthcare workers should use masks and face protection during close contact activities.
Suspected pertussis patients should remain home from work, school, daycare, or public outings until completing five days of antibiotic therapy as required by school exclusion guidelines.
Texas law mandates prompt reporting of suspected pertussis cases by healthcare providers and related facilities within one work day to local health departments.
During outbreaks in group settings like schools or hospitals, only household members and high-risk contacts typically receive prophylactic antibiotics unless special circumstances apply. Monitoring exposed individuals for symptoms over a three-week period remains important even if they do not initially display signs of illness.
Officials urge anyone who thinks they might have pertussis to isolate themselves immediately and call their healthcare provider ahead of visiting medical facilities to minimize potential exposure risks for others.
They further encourage reviewing personal immunization records—including those for children—and discussing any concerns about vaccines with healthcare providers. Frequent handwashing and covering coughs help prevent bacterial spread; sharing food or personal items should be avoided if someone is ill or exposed.
