'100-day' whooping cough: why are cases surging

Five babies in England have died this year from whooping cough – the first such deaths since 2019 – amid a sharp rise in cases across the UK and Europe. 

All five were under three months old, according to the UK Health Security Agency (UKHSA). There have been about 2,800 reported cases in England so far this year (mostly among teenagers) – more than three times the amount for the whole of last year (858), said Sky News. In February alone there were 918 cases. The last "peak year", 2016, had almost 6,000 cases in England, said the BBC. 

"The retro infection, a staple of Charles Dickens' novels, is the latest Victorian-era ailment to stage a comeback in the West," said Politico, after an increase in measles, gout and leprosy. Cases of whooping cough are at their highest rate in 60 years in the Czech Republic, according to the European Centre for Disease Prevention and Control (ECDC). There have also been "sharp rises" in Denmark, Belgium and Spain, as well as China and the US. 

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What is whooping cough?

Whooping cough – scientifically known as pertussis – is a bacterial infection of the lungs and respiratory system, which spreads easily. Also called the 100-day-cough, it can be mistaken for a cold in its early stages, according to the NHS. Sufferers might develop a runny nose and sore throat, before the tell-tale symptoms take hold. These include coughing bouts which last several minutes and are worse at night, often featuring a distinctive "whoop" sound as people gasp for air. Symptoms can last for months.

Whooping cough is "as infectious as measles, and more infectious than Covid-19", Dr Michael Head, senior research fellow in global health at the University of Southampton, told Sky News. Because of that, doctors have a legal duty to report any infection to the local authority. 

Whooping cough affects people of all ages, but can be "extremely serious" for babies, UKHSA epidemiologist Gayatri Amirthalingam told Sky News. Infants under six months old have a "higher chance of suffering from pneumonia, breathing difficulties and seizures", said Euronews. Pertussis was "once a common childhood infection and cause of death among babies", said The Guardian, "but a vaccine introduced in the 1950s changed that", causing an immediate and dramatic reduction in infections. 

In most of Europe, babies get their first two doses of a combined whooping cough, diphtheria and tetanus vaccine between two months old and a year, with another dose at two years old and a third between the ages of three and seven.

It's also possible to protect newborn babies from the disease by offering the pertussis vaccine to pregnant women. In this way, they can "pass on protection to their babies", which should last until the infants are old enough to be vaccinated themselves, said Sky News.

Why is whooping cough on the rise?

Health officials describe it as a "cyclical disease", said Sky News, meaning it peaks every three to five years, with the last peak in 2016. 

Cases of whooping cough decreased over the pandemic due to social distancing and lockdown measures. But the pandemic also featured a "suboptimal vaccination uptake", wrote ECDC in a report published in March, partly due to missed appointments but also exacerbated by rising scepticism.

"We saw a lot of misinformation from the anti-vax lobby across the pandemic," Head told Politico. The concern was that this would "spread into hesitancy around routine immunization".

This year, a British Medical Journal report said that uptake for the vaccine among pregnant women had fallen from more than 70% in September 2017 to 58% in September 2023. In September 2023, the number of two-year-olds who had completed their routine vaccinations was 92.9%, said the BBC, down from 96.3% in 2014.

What next?

This year it looks as though "we may see more cases than we have seen in any of the last 40 years", Paul Hunter, professor in medicine at the University of East Anglia (UEA), told Sky News.

Pregnant women are being urged to take up the vaccine to protect newborns. It is also "vital that families come forward" to get their children vaccinated, said Professor Stephen Powis, the NHS national medical director. People should check their vaccination status for missed appointments and contact their GP "as soon as possible" to arrange them. If they or their children are showing symptoms, they should ask for an urgent appointment or get help from NHS 111.

Vaccination is "key to stemming the outbreak", said Politico, "but that's becoming easier said than done".