The Texas Department of State Health Services (DSHS) has reported a notable increase in pertussis, also known as whooping cough, cases across the state in 2025. Provisional data shows that more than 3,500 cases have been recorded through October, which is about four times higher than the number seen during the same period last year. This marks the second consecutive year with significant increases and the second year DSHS has issued a health alert.
Health officials emphasize immunization as the primary defense against pertussis. They urge parents to keep children’s vaccinations current and recommend booster doses for pregnant women and others who will be around newborns. “The best way to protect against pertussis is immunization. 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. Clinicians should consider pertussis in people with compatible symptoms and report all suspected cases to the local health department within one work day,” according to DSHS.
Pertussis is caused by Bordetella pertussis bacteria and spreads easily from person to person. Early symptoms resemble those of a common cold, but severe coughing fits may develop after one or two weeks. In infants, symptoms can include gagging or difficulty breathing rather than coughing fits.
Although vaccination is recommended for all age groups—including specific timing for pregnant women—immunity can decrease over time, so even vaccinated individuals may contract the illness, often with milder symptoms.
Infants under one year old face the highest risk of severe complications from pertussis; about one-third of babies younger than 12 months with confirmed infections require hospitalization.
After low case numbers during and just after the COVID-19 pandemic, both Texas and national figures have rebounded sharply. Texas saw 340 cases in 2023; provisional data shows this rose to 1,907 last year—with more than half occurring late in the year—and over 3,500 already reported in 2025. Preliminary findings indicate that approximately 85 percent of this year’s cases involve children.
Vaccination remains central to prevention efforts. The Centers for Disease Control and Prevention (CDC) recommends that everyone stay up-to-date on their vaccinations since protection fades over time. Pregnant women are advised to receive Tdap vaccine between weeks 27 and 36 of gestation during each pregnancy to help transfer protective antibodies to their babies before birth—a measure shown to reduce risk for infants under two months old by nearly 80 percent.
Testing for symptomatic patients involves collecting specimens before starting treatment using nasopharyngeal culture or PCR assays—methods widely available at hospitals and commercial labs.
Early antibiotic treatment helps lessen illness severity and reduces transmission risk. Azithromycin is considered first-line therapy; other options include erythromycin, clarithromycin, or trimethoprim-sulfamethoxazole depending on patient needs.
Public health guidance calls for post-exposure prophylaxis (PEP) within three weeks of exposure for household contacts, infants under one year old, people with certain pre-existing conditions, pregnant women in their third trimester, and individuals in high-risk settings such as neonatal intensive care units or childcare centers.
Healthcare workers treating suspected or confirmed cases are advised to use droplet precautions until patients complete five days of appropriate antibiotics.
Suspected pertussis patients should remain home from work, school, daycare, or public events until they finish five days of antibiotic therapy as required by state exclusion policies.
Texas law mandates that healthcare providers report suspected pertussis cases within one working day to local health departments.
During outbreaks in group settings like schools or hospitals, active screening may be implemented but broad antibiotic use is limited mainly to household members or those at high risk due to ongoing transmission concerns.
People concerned about exposure are encouraged to contact healthcare providers regarding preventive medication options. Hand hygiene practices—such as frequent handwashing and covering coughs—are also recommended measures alongside avoiding close contact with sick individuals.
