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In China, it's called the 100-day cough. In the United States, it's whooping cough, a nod to the gasping sound babies and young children make when trying to catch their breath during a fit of coughing. Technically, it's pertussis, a highly contagious bacterial infection that is surging across the country right now.
That is bad news for babies.
Pertussis is particularly dangerous to infants, who are at high risk of hospitalization and death if they are infected. Around a third of babies under six months old infected with whooping cough in 2024 were hospitalized. Dr. Jason Bowling, professor and interim chief of the Division of Infectious Diseases at UT Health San Antonio and director of hospital epidemiology at University Health, said there are also long-term complications associated with the disease.
"This coughing is from inflammation, and when you have a lot of inflammation causing bad coughing spells, you worry about some residual scarring from prolonged inflammation," Bowling said, "Which is why, particularly in infants, it could affect their development as they get older." Lung scarring from pertussis could increase risks for asthma and COPD later in life.
Infant deaths from pertussis in 2025 have been reported in Kentucky, Mississippi, Louisiana, South Dakota, Idaho, and Oregon. Dr. Bowling said there are several reasons for this deadly surge. Among them, he said, is that vaccination rates have declined.
Pertussis is included in the DTaP vaccine, which also protects against diphtheria and tetanus. It's given in a five-dose series over the first five years of life, so even children of parents who vaccinate on the recommended schedule are not protected when they're at their highest risk from the bacterial infection. Bowling said that's why doctors recommend that those who are pregnant update their DTaP vaccine during their third trimester.
"Hopefully there's passive transfer of antibodies," Bowling explained, "So when the baby comes out, they may have at least some protection until they're able to form their own antibodies from their vaccine schedule."
Bowling also recommended a strategy called 'cocooning,' which involves keeping the new baby away from people who have not updated their TDaP, and requiring all of an infant's caretakers to update their vaccinations. He acknowledged that a policy of cocooning can be difficult to implement.
"I think it's hard for parents to tell people who want to visit a newborn not to show up if they're sick or unvaccinated," he said, "But parents should feel empowered to do so because there can be serious complications for the child."
Bowling is also concerned that even well-intentioned parents don't always complete the five-shot series for pertussis. In fact, a recent survey from the Annenberg Public Policy Center found more than a third of Americans surveyed were not aware that a vaccine against whooping cough exists.
Texas has seen one of the largest spikes in pertussis cases since COVID mitigation strategies ended. In 2024, there were nearly 2000 cases of pertussis in the state, up from just 340 the year before. In November of this year, the Texas Department of State Health Services issued a health alert after nearly doubling that number, recording more than 3500 cases of whooping cough through October.
