Whooping Cough Cases Rising In NJ; Doctors Say Infants Most Vulnerable

NEW JERSEY — Along with a summer spike in COVID-19, health officials are alerting residents about a rise in whooping cough infections around New Jersey as students head back to school.

The highly-contagious respiratory illness is spread from person to person, typically through the air. Cases of whooping cough (pertussis) were lower than usual over the past several years but have begun to climb to pre-pandemic levels, according to the Centers for Disease Control and Prevention.

Nationally, the number of cases has more than tripled since this time last year, CDC data shows.

In New Jersey, there have been 128 whooping cough cases reported as of Aug. 17, compared to 110 cases at the same point in 2023.

"It’s likely that preventative actions used during the pandemic (e.g., good hygiene, distancing) lowered transmission of this disease," the CDC said in its latest report. "We’re now beginning to return to pre-pandemic levels, where we typically see more than 10,000 cases of people with whooping cough each year. The number of reported cases this year is close to what was seen at the same time in 2019."

The New Jersey Department of Health is encouraging all residents to ensure they are up-to-date with their routine vaccines, maintain good hygiene practices, and to stay home when ill.

Dr. Uzma Hasan, Division Chief of Pediatric Infectious Diseases at RWJBarnabas Health, said she has been fielding "a boatload of calls” from community pediatricians in the past several weeks about increased cases.

Hasan also said that part of the increase is due to a decline in vaccination rates, and the fact that most people are not as vigilant with hand-washing and wearing face masks as during the height of the COVID-19 pandemic.

“With COVID measures in place…you weren’t seeing a rapid spread of vaccine-preventable illnesses,” she said.

Whooping cough is caused by a bacteria that attaches to the tiny, hair-like cilia that line the upper respiratory system. These bacteria release toxins which damage the cilia, and cause airways to swell. At first, Hasan said, symptoms may be similar to those of the common cold or other upper respiratory infections, but will progress to include a cough that could last for weeks and months.

Hasan said that whooping cough is a highly-transmissible illness that babies under 6 months old, and those who are born prematurely, are especially susceptible to. Half of infants who get whooping cough will have to be hospitalized, Hasan said.

Health experts encourage pregnant women to be sure they are properly vaccinated against whooping cough, to lessen any symptoms they or the baby might experience if they get sick.

“If there is a new baby, all adults must be vaccinated, because they can bring it home,” she said.

And, babies and children under 10 years old may present with different symptoms than adults and older children. Symptoms of pertussis in infants include fever, trouble breathing, a change of skin color due to loss of oxygen, and even seizures, she said. In children under 10, excessive coughing can also cause the child to vomit.

Hasan said there have been hotspots reported in Elizabeth and West Orange. Dr. Ericka Hayes, professor of clinical pediatrics of the Children’s Hospital of Philadelphia, added that cases are rising in Burlington County.

Hayes said that adults need boosters for the TDaP vaccine, which protects against tetanus, diphtheria, and pertussis, to protect themselves and others in their household.

The current TDaP vaccine is acellular and contains an inactivated pertussis toxin, which Hayes said does not provide as much “durable immunity” as past vaccines– before 1991, the pertussis vaccine used whole cells, but also had more side effects, she said.

Hasan also said because whooping cough is so easily transmitted, doctors will prescribe a course of antibiotics not just for the sick person, but for anyone who lives in the same household as them.

"It's highly contagious," she said. "If I have a household with a case of pertussis, 8 to 10 people will get it."

A typical case of pertussis starts with a cough and runny nose for one to two weeks, followed by weeks to months of rapid coughing fits. These coughing spells sometimes end with a whooping sound as the person gasps for air, hence the name "whooping cough." Fever, if present, is usually mild.

Symptoms can vary for people based on their age and if they've been vaccinated or not, and health experts say that antibiotics can lessen the severity of symptoms and prevent the spread of disease to others.

As stated above, health officials strongly urge pregnant women and people who come into close contact with young infants to get vaccinated. Newborns are at the greatest risk of getting whooping cough, since they are too young to be fully vaccinated.

The CDC recommends the following schedule for the TDaP (diphtheria, tetanus, and acellular pertussis) vaccination that helps protect people from whooping cough:

• A TDaP booster is recommended for pregnant women early in their third trimester and during each pregnancy to protect their newborns.
• Young children need five TDaP doses by kindergarten: at 2 months, 4 months, 6 months, 15 to 18 months, and 4 to 6 years.
• After that, the first TDaP booster is due at age 11. All students entering seventh grade are required to have proof of a whooping cough booster immunization.
• One dose of TDaP is recommended for adults 19 years of age and older who did not get TDaP as a teenager.
• After that, getting TDaP instead of the standard tetanus shot every 10 years will also reduce infections.