Whooping cough, known medically as pertussis, is experiencing a notable resurgence in North Carolina, raising alarm among health officials and communities. Recent reports have highlighted a dramatic increase in cases, particularly affecting children and infants, underscoring the importance of vaccination and awareness.
Understanding Whooping Cough
Whooping cough is caused by the bacterium Bordetella pertussis and is a highly contagious respiratory illness. The disease is characterized by severe coughing fits that can lead to a distinctive "whoop" sound when the person inhales. Early symptoms can mimic those of a common cold, including a runny nose, low-grade fever, and mild cough. However, as the disease progresses, the cough can become so intense that it results in vomiting, fainting, or even fractured ribs.
Historically, prior to the widespread use of vaccines in the 1940s, whooping cough was a leading cause of childhood morbidity and mortality. The introduction of the pertussis vaccine drastically reduced the incidence of the disease, dropping annual cases from approximately 200,000 to fewer than 19,000 by 2019. Yet, in the past two years, North Carolina has seen a troubling rise in cases.
Current Situation in North Carolina
According to reports from the North Carolina Department of Health and Human Services (NCDHHS), the state recorded 661 whooping cough cases by September 2025, with expectations to meet or exceed last year’s total of 831 cases. Buncombe County has been particularly hard hit, with an increase in cases from 6 annually to 84 confirmed by mid-September 2025. The resurgence is attributed partly to waning immunity from vaccinations and the lifting of COVID-19 related restrictions that previously kept people isolated.
Health officials indicate that the vaccine’s effectiveness decreases, particularly between ages 3-4 and again around ages 9-10, right before the next scheduled booster shot. This gap has likely contributed to the increased susceptibility among older children and teenagers.
Importance of Vaccination
The vaccination schedule for pertussis is crucial for building and maintaining immunity. Infants receive a series of DTaP vaccines starting at 2 months, with subsequent doses followed at 4 months and 6 months. Boosters are administered at 15-18 months and again between ages 4-6, then a Tdap booster for preteens and teens aged 11-12 years.
Despite some improvement in vaccination rates—up to 94% for DTaP in the past school year—non-medical exemptions are rising. Approximately 3.1% of kindergarten students sought exemptions for non-medical reasons last year, up from 0.9% a decade ago. Maintaining a high vaccination rate is vital for achieving herd immunity, essential for protecting those who cannot be vaccinated, including infants and immunocompromised individuals.
Community Response and Awareness
To combat the surge in whooping cough, local health authorities have been proactive in encouraging vaccination and awareness. Schools have been issuing notifications to families when cases are identified, advising parents to seek medical attention for any respiratory symptoms. Public health campaigns have focused on the importance of being vigilant and getting tested, especially for children who have had close contact with confirmed cases.
The story of the Corbin family in Chapel Hill epitomizes the challenges faced by families. After their 11-year-old son, Alex, contracted whooping cough despite being vaccinated, they learned firsthand the severe impact of the disease. His symptoms, which persisted for months and included violent coughing fits, serve as a reminder that vaccination does not guarantee absolute immunity.
Diagnosis and Treatment
Early diagnosis is crucial for effective treatment of whooping cough. Unfortunately, many cases go unrecognized, as the symptoms can be mistaken for a common cold. Only a small window exists when the bacteria are detectable, making it essential for healthcare providers to consider whooping cough in patients with persistent coughs.
Antibiotics can help reduce the severity of the illness if administered promptly. However, even individuals who are vaccinated can spread the disease, which complicates efforts to control outbreaks. Parents and caregivers are urged to remain vigilant and seek medical advice if symptoms arise, especially in children.
Conclusion
The increase in whooping cough cases in North Carolina is a concerning public health issue that highlights the importance of vaccination and community awareness. With the state experiencing one of its worst outbreaks in decades, it is imperative for families to adhere to vaccination schedules and for healthcare providers to maintain vigilance in diagnosing and treating the disease.
By ensuring a high rate of immunization and fostering community awareness, the public can help protect the most vulnerable populations—especially infants who are at the highest risk for severe complications from this illness. The resurgence of whooping cough serves as a potent reminder of the ongoing need for diligence in public health efforts, especially as we navigate into a post-pandemic world.
