Whooping cough treatment and prevention: How to navigate a pertussis outbreak

Whooping cough, also called pertussis, is making a comeback in many parts of the United States, including Texas. This highly contagious infection can cause a long-lasting cough in older kids and adults, and it can be especially dangerous for babies and young children.

As case numbers rise, public health officials are urging families to pay attention to coughs that don't seem to go away, especially in school-age children and adults who may not realize they're sick. 

By learning how pertussis spreads, symptoms to look for and staying up to date on the whooping cough vaccine, you can lower the risk of serious illness in your home, the classroom and the community.

What is whooping cough?

Whooping cough is an infection of the lungs and airways caused by bacteria called Bordetella pertussis. It spreads easily from person to person, mainly when someone who is infected coughs or sneezes and releases tiny droplets into the air.

Anyone can get whooping cough, but the infection tends to be most serious in:

• Babies younger than one year old
• Pregnant people and their unborn babies
• Older adults
• People with weakened immune systems

After being exposed, pertussis symptoms usually appear within five to 10 days, though it can take up to three weeks in some cases. This period, known as the incubation period, is when the infection is developing but symptoms are not yet noticeable. During this time, an infected person can already start spreading the bacteria to others, which is why early awareness and preventive measures are so important.

Why is there a whooping cough outbreak in Texas?

Texas is in the middle of a whooping cough outbreak. According to the Texas Department of State Health Services, provisional data show more than 3,500 pertussis cases reported through October 2025. That's about four times as many cases as the state saw during the same period in 2024, and roughly 10 times the total number reported in 2023. This is the highest level Texas has seen in more than a decade and the second year in a row the state has issued a health alert for whooping cough.

Most of these infections happen in younger people. State data suggests that around 85% of current Texas cases are in children, many of them school-age. Local health departments have reported clusters of whooping cough in schools and childcare settings.

Several factors are driving this outbreak:

• Falling vaccination rates.During and after the COVID-19 pandemic, some families delayed routine well-child visits, causing lower vaccine coverage in school-age children and making it easier for pertussis to spread.
• Waning immunity.Protection from childhood pertussis vaccines fades over time, so without boosters, teens and adults can still get sick and unknowingly transmit the infection to infants and older adults.
• Post-pandemic rebound.Whooping cough cases dropped during the height of COVID-19 but have surged as precautions eased. Nationally, the Centers for Disease Control and Prevention (CDC) reports that in 2024 pertussis cases were more than six times higher than in 2023, and case counts have stayed elevated in 2025.
• Better testing and reporting.Increased awareness, especially for children with prolonged coughs, has led to more cases being identified and reported.

Knowing your risk and making sure everyone in the household is current on whooping cough vaccines is one of the most important steps you can take to protect vulnerable infants, grandparents or anyone with chronic health conditions.

What are the symptoms of pertussis in adults and children?

Whooping cough usually develops in three stages. The early symptoms can look a lot like a common cold. Over time, the cough becomes more severe and can last for weeks.

Early symptoms (stage 1)

The first stage usually lasts one to two weeks and is when you are most contagious. During this time, symptoms are mild and may be mistaken for allergies or a regular cold. It's easy to keep going to work, school, practices or social events, which helps the infection spread.

You may have:

• Runny or stuffed-up nose
• Low-grade fever (less than 100.4°F)
• Mild, occasional cough
• Sneezing or watery eyes

Later symptoms (stage 2)

After about one to two weeks, symptoms typically worsen. This is when the classic “whooping” cough appears.

You may develop coughing fits that:

• Come in sudden bursts, one cough after another
• Make it hard to catch a breath
• End with a high-pitched “whoop” sound when you finally inhale
• Can lead to gagging or vomiting
• Leave you exhausted afterward

These coughing fits usually last anywhere from one to six weeks, but they can continue for up to 10 weeks or longer. The cough often gets worse and happens more frequently as the illness goes on.

It's important to note that babies may not have the classic “whoop” that older children and adults often show. Instead, they might pause their breathing, turn red or bluish (especially around the lips), have trouble feeding, or seem unusually tired or weak. Any of these signs in an infant should be treated as a medical emergency and require immediate medical attention.

Recovery (stage 3)

The final stage is the recovery phase, also called the convalescent stage.

• Recovery is often slow, with the cough becoming milder and less common.
• Coughing fits may stop for a while but can return if you catch another respiratory infection, such as a cold or the flu.
• For some, coughing spells can come and go for many months after the original illness started.

Because of this long-lasting cough, pertussis is sometimes nicknamed the “100-day cough.” Even after you're no longer contagious, you may feel like you can't quite kick the cough.

When should you take your child to the doctor for whooping cough?

Call your child's pediatrician if you know they've been around someone with whooping cough. In some cases, your provider may recommend antibiotics to lower the chances of your child getting sick or to treat the infection earlier. You should also schedule a visit if your child has a nagging cough that lasts more than 10 days, especially if it's keeping them up at night, even if you're not aware of any known pertussis exposure.

Preventing whooping cough: When to get vaccinated for pertussis

The most effective way to prevent whooping cough is through vaccination. In the US, the vaccines that protect against pertussis also protect against diphtheria and tetanus. They’re called:

• DTaP for infants and young children
• Tdap for preteens, teens and adults

Staying on schedule with these vaccines is important, especially with cases surging in Texas.

DTaP schedule for children

It is recommended that children receive a 5-dose series of DTaP at the following ages:

• 2 months
• 4 months
• 6 months
• 15 – 18 months
• 4 – 6 years

These doses help build strong protection during the early years of life, when children are at highest risk for serious complications from whooping cough.

If your child has missed a dose or fallen behind during the pandemic or for other reasons, your pediatrician can help you catch up. It’s never too late to talk with your child’s doctor about getting back on track.

Tdap booster recommendations for adolescents and adults

Protection from childhood vaccines fades over time, so older kids and adults may need boosters. Current recommendations include:

• One dose of Tdap at ages 11 – 12 years
• One dose of Tdap for adults who have never received it, followed by a tetanus booster (Td or Tdap) every 10 years
• A Tdap dose for any adult who has never had one, especially if they are around infants or work in healthcare or childcare settings

In Texas, many schools require proof of a Tdap booster for middle school entry. If you’re not sure whether your preteen or teen has received this shot, check their vaccination record or ask your pediatrician.

Why adults need the Tdap booster

It’s easy for adults to think of whooping cough as a childhood illness, but adults can and do get pertussis. In fact, adults and teens often have milder, lingering coughs and may not realize they’re infected, spreading the bacteria to vulnerable infants and older adults.

Studies show that immunity from pertussis vaccines starts to wane about four to 12 years after your last dose. That means someone who was vaccinated as a child may no longer have strong protection by the time they are in high school, college or adulthood.

If you’re a parent, grandparent, teacher, healthcare worker or childcare provider, ask your doctor or pharmacist if you’re due for a Tdap booster.

Tdap during pregnancy

Pregnancy is a key window of time to protect both the parent and the baby.

It is recommended that every pregnant person receives a Tdap vaccine between 27 and 36 weeks of each pregnancy, regardless of when they last had a tetanus booster.

Getting the Tdap vaccine during pregnancy helps your body produce antibodies against pertussis, which can then be passed through the placenta to the developing baby. This transfer of antibodies gives newborns some protection during their first weeks of life, a critical period before they are old enough to receive their own DTaP shots.

Vaccinating the pregnant parent, along with close family members and caregivers, creates a protective shield around the infant. This is especially important because newborns are at the highest risk for severe complications and hospitalization from whooping cough.

Take action today on whooping cough treatment and vaccines

While whooping cough cases are climbing in Texas, you are not helpless in the face of these headlines. By knowing the symptoms, understanding how pertussis spreads and staying up to date on vaccines like DTaP and Tdap, you can greatly reduce your family’s risk.

If you’re unsure whether you or your child is current on whooping cough vaccines, reach out to your healthcare provider or your child’s pediatrician. A simple review of your immunization record can go a long way toward keeping you, your family and your Texas community healthy this season and beyond.

Have you or a loved one been exposed to whooping cough? Use the Help Me Decide tool in the MyBSWHealth app to check your symptoms or schedule a virtual care visit.