Whooping Cough Surge Signals Urgent Call for Improved Surveillance and Vaccination Strategies

A nationwide resurgence of whooping cough is straining pathology and microbiology laboratories as vaccination coverage falls and immunity wanes. This increase is attributed to declining vaccine uptake and waning immunity and notes rising diagnostic demand.

Reports document upticks across multiple states, including Texas, Florida, and California, with rising hospitalization and severity indicators that point to true increases in transmission rather than solely enhanced detection. Declining routine vaccine uptake and widening immunity gaps are the principal drivers of this geographic pattern and the sustained operational burden on labs and public-health teams.

The report also notes that PCR testing has improved pertussis detection and is shifting case-finding dynamics in clinical laboratories.

Policy changes easing nonmedical exemptions and falling vaccination rates have widened local immunity gaps and increased outbreak risk. Vaccination during pregnancy transfers protective antibodies to newborns and remains a key strategy to protect infants; strengthening access to maternal immunization programs will reduce infant risk.

During a surge, clinicians should prioritize rapid laboratory-to-public-health reporting, temporarily broaden testing criteria in affected regions, and accelerate case investigation to limit spread. Laboratories should ensure LIS flags for pertussis results, expedite result transmission, and coordinate specimen referral with local health departments for culture confirmation or typing when needed—measures that sharpen situational awareness and support containment.

Key Takeaways:

• The surge appears driven primarily by declining vaccination coverage and waning immunity; rising hospitalizations—including infant admissions—support that transmission has increased.
• Infants, unvaccinated children and adults, and communities with high exemption rates face the highest risk; maternal vaccination continues to provide important newborn protection.
• Immediate laboratory and public-health actions include confirming PCR testing protocols and specimen workflows, accelerating lab reporting and result flags, and prioritizing maternal vaccination outreach.