Whooping Cough Cases Remain Elevated Across U.S. as Kentucky Reports Third Infant Death

On Nov. 24, the Kentucky Department for Public Health put out a notice with a grim count: three infants in the state have died of whooping cough since the start of the year. The department said that none of the babies had been vaccinated, and neither had their mothers. These are the first whooping cough deaths reported in the commonwealth since 2018.

The department described pertussis as a highly contagious respiratory infection that has become more common in communities across the country, in part because vaccination rates are declining. Kentucky's own numbers reflect that. Health officials there have recorded 566 cases, counted from Nov. 19, the largest spike the state has seen since 2012. The notice said more cases are expected before the year ends.

The national picture is somewhat more mixed. The Centers for Disease Control and Prevention reports that the number of cases nationwide has trended down since a peak in November 2024. But the agency also says cases remain elevated in 2025 compared with the period immediately before the pandemic.

The CDC has also documented a slide in protection among young children. Its report on the 2024-2025 school year found that kindergarten vaccination coverage fell for every reported vaccine compared with the year before. For the DTaP vaccine, which protects against pertussis, coverage was 92.1%.

Dr. Steven Stack, secretary of Kentucky's Cabinet for Health and Family Services, said in the notice that the state continues to urge residents to get the whooping cough vaccine and to keep up with all other recommended immunizations. Vaccination, he said, protects not only the individual but also the people around them.

Infants are the group most at risk. The CDC says babies younger than 12 months face the greatest danger of catching whooping cough and suffering severe complications, because their immune systems are still developing. They cannot be vaccinated until at least two months of age, and they can be exposed by family, friends and caretakers.

The illness can be hard to recognize early. Symptoms usually appear five to 10 days after exposure, though the incubation period can stretch to 21 days. They begin like a cold, with a runny nose, sneezing, congestion and a low-grade fever, then a mild, occasional cough that gradually worsens. It can progress to sudden fits of rapid coughing, difficulty catching one's breath, and a high-pitched "whoop" at the end of an attack. Other signs include vomiting, exhaustion, and a bluish tint to the skin and mucous membranes from too little oxygen. In infants, sudden pauses in breathing, known as apnea, are common. A typical infection can take up to 12 weeks to resolve from the onset of symptoms, with full recovery taking additional weeks or months. In vaccinated people the illness is often milder, and the cough and whoop may be absent.

There are two vaccines, chosen by age. DTaP is for children under 7 and is usually given in five doses. Tdap is for adults, teens and children over 7. Kentucky's health department says the vaccines are the best prevention, covering diphtheria and tetanus as well as pertussis. It also recommends washing hands often, covering coughs and sneezes, and staying home when sick. With more Kentucky cases expected by the end of the year, the state's final count is still to come.