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Whooping cough cases are sweeping in the U.S., with tens of thousands infected and at least 13 people dead from the bacterial infection this year. While the infection rate is lower than last year, it remains above typical prepandemic years, and the number of deaths has risen.

The respiratory infection, also known as pertussis, is characterized by a severe, violent cough that can leave people—especially infants—struggling to breathe. Although rarely fatal, its lingering symptoms have earned it the moniker of the “100-day cough.”

The disease is caused by the bacterium Bordetella pertussis, which emits toxins into a person’s respiratory tract, making early treatment with antibiotics vital to managing the infection. The bacterium is easily spread between people, both through direct contact and droplets from the mouth or nose.

As of December 20, the U.S. and its territories has seen 27,871 diagnosed cases of whooping cough so far this year, according to the Centers for Disease Control and Prevention. Last year at this time, the number was 41,922, a staggering increase after four years of less than 10,000 cases annually during the peak of the COVID pandemic. In the years between 2003 and 2019, the U.S. typically saw between 10,000 to 20,000 cases annually; the highest rate during that time was in 2012, with 48,277 cases.

At least 13 people have died of pertussis so far this year, according to a recent report from the Pan American Health Organization. Provisional CDC data from last year noted 10 deaths from the infection.

Public health experts fear that the sustained high rates of whooping cough this year, after last year’s spike, may be a symptom of declining vaccination levels.

The DTaP vaccine protects infants and young children from pertussis, while the Tdap vaccination offers protection for older children and adults. Both shots also protect against tetanus and diphtheria. The CDC has traditionally recommended these vaccinations from the age of two months; under the agency’s guidelines, children should receive four doses in their first two years and a total of six doses before reaching age 13. But for children born in 2021, the most recent group for whom data are available, only 79 percent had received four shots of DTaP by the age of two.

Whooping cough is most dangerous among infants under a year old, and public health experts also recommend that pregnant people get a Tdap vaccine to transfer antibodies to newborns. All adults are also advised to get a Tdap vaccine every 10 years to ensure continued protection.

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