Whooping cough is making a comeback, and medical providers say the highly contagious bacterial infection that causes severe coughing fits is preventable.

During the COVID-19 pandemic, whooping cough, also known as pertussis, declined dramatically.

“Cases have skyrocketed nationwide,” said Anthony Flores, MD, MPH, PhD, professor of Pediatrics and Edward Claiborne Stahlman Professor at Monroe Carell Jr. Children’s Hospital at Vanderbilt. “The levels that are being reported are higher than pre-pandemic.

“We have had a couple of cases, but the CDC has reported seeing record numbers. It’s a vaccine-preventable disease,” he said.

While it has been difficult to pinpoint the reason for the rise in cases, Flores, director of Pediatric Infectious Diseases at Monroe Carell, said waning immunity and vaccine hesitancy may be the likely culprits.

“Our vaccines are still very effective, and following the recommended booster schedule is by and large our biggest preventive measure,” said Flores. “If I could repeat anything over and over again, it would be to vaccinate, vaccinate, vaccinate. It will reduce the severity of what we are seeing.”

Initial symptoms of whooping cough are similar to that of a common cold — runny nose, fever and a mild cough. The illness is spread through respiratory droplets when an infected person sneezes or coughs. The cough often intensifies, lasting for several minutes at a time, making it difficult to breathe and causing a “whoop” sound when gasping to breathe.

Antibiotics are the standard treatment if the illness is diagnosed in time, but once the exhausting, hacking cough begins, comfort care with rest and fluids is the primary therapy.

According to the Centers for Disease Control (CDC), preliminary data show that more than five times as many cases have been reported as of Oct. 19, compared to the same time in 2023. The number of reported cases this year is higher than the same time in 2019.

The volume of cases reported in Tennessee is mirroring what is being seen nationwide and can be severe in infants and the unvaccinated.

“Babies are the most vulnerable, and they don’t present with the classic symptoms,” Flores said. “It is important for providers to know that we are seeing higher cases and when considering RSV, flu and other respiratory illnesses to consider pertussis as well if there is a high enough index of suspicion for it. It’s a pretty standard test, a nasal swab.”

“Of the cases that are resulting in hospitalizations, the majority of them are really young, less than 5 months old, and they are unvaccinated, or the mothers were not vaccinated.”

People with underlying immune deficiencies and the elderly are also at increased risk of complications from the disease.

Pregnant mothers are encouraged to get a booster in the third trimester to help provide some immunity to their child once they are born.

The first round of pertussis vaccinations begins at 2 months with subsequent shots at 4 and 6 months, then again before the age of 2 and at the start of kindergarten and teens.

Vaccines do not prevent infection nor provide lifelong protection. Boosters are recommended every 10 years throughout adulthood to help curb spread and severity of infection.