The Texas Department of State Health Services (DSHS) has reported a notable increase in pertussis, commonly known as whooping cough, across the state in 2025. Provisional data shows that more than 3,500 cases have been reported through October, which is about four times higher than the same period last year. This marks the second consecutive year of significant increases and repeated health alerts from DSHS.
Pertussis is a highly contagious respiratory illness caused by Bordetella pertussis bacteria. Early symptoms resemble those of a common cold, but within one to two weeks can progress to severe coughing fits. In some cases, these fits cause vomiting or a “whoop” sound when breathing in. Infants may show different symptoms such as gagging, gasping, or even stopping breathing.
“Parents should ensure children are up-to-date on pertussis immunizations, and pregnant women and others who will be around newborns should get a booster dose to protect babies from what can be a deadly infection,” DSHS advised. “Clinicians should consider pertussis in people with compatible symptoms and report all suspected cases to the local health department within one work day.”
Health officials emphasize that vaccination remains the most effective way to prevent pertussis infection. Immunization is especially important for infants and pregnant women, as young children face higher risks for severe complications. Data indicates about one-third of babies under 12 months old with pertussis require hospitalization.
While vaccination significantly reduces risk, it does not guarantee complete immunity; immunized individuals can still contract and transmit pertussis but often experience milder symptoms.
Recent trends reveal that after unusually low numbers during and following the COVID-19 pandemic—Texas saw just 340 cases in 2023—the number increased to 1,907 last year with more than half occurring late in the year. So far this year’s case count exceeds 3,500, with preliminary figures showing approximately 85 percent of these affecting children.
The Centers for Disease Control and Prevention recommends staying current on vaccinations since protection fades over time. Pregnant women are encouraged to receive Tdap vaccine between weeks 27 and 36 of pregnancy to transfer protective antibodies to their infants before birth—a measure shown to reduce risk for newborns by up to 78 percent.
Testing for suspected cases should occur before starting any treatment using nasopharyngeal culture or PCR assay methods. Treatment should begin early—even before test results—especially if clinical history strongly suggests pertussis or if patients are at high risk for complications.
Antibiotic therapy is recommended within three weeks after cough onset for most patients; infants under one year and pregnant women near term may need treatment within six weeks. Azithromycin is considered first-line therapy; alternatives include erythromycin, clarithromycin, or TMP-SMX based on individual needs.
Prophylactic antibiotics are advised for household contacts and those at high risk—including infants under one year old—within specific timeframes after exposure regardless of vaccination status.
In healthcare settings, droplet precautions are necessary until patients complete five days of appropriate antibiotic therapy. Healthcare workers involved in close contact activities must use masks and face protection.
People suspected of having pertussis should remain isolated from public places until they finish five days of antibiotics as required by state exclusion policies in schools and childcare facilities.
Healthcare providers are legally obligated under Texas law to report suspected cases within one work day to their local health departments.
During outbreaks in group settings such as schools or hospitals, only household members and high-risk contacts receive prophylaxis while others are monitored for symptoms over three weeks post-exposure unless new signs develop.
For prevention beyond vaccination, officials recommend regular handwashing, covering mouth and nose when coughing or sneezing, avoiding close contact with sick individuals, not sharing personal items like utensils or toothbrushes—and contacting healthcare providers promptly if exposed or symptomatic.
