In a disturbing resurgence of a disease once thought to be largely under control, three infants in Kentucky have tragically succumbed to whooping cough, a condition dating back to the Victorian era that continues to spread across the United States.

The lives lost were those of three unnamed children, who fell victim to pertussis, commonly known as whooping cough. This marks the first time since 2018 that Kentucky has reported deaths linked to the disease. Notably, all three infants had not been vaccinated against pertussis.

Kentucky is currently grappling with its highest incidence of whooping cough in over ten years, with 566 cases reported so far—the most since 2012.

Kristina Bryant, a professor of pediatrics at the University of Louisville School of Medicine, shared her concerns with The BMJ last week. “We’re definitely seeing more cases. Earlier this year, two babies under one year old died in Kentucky, and today a third baby died. None of the infants or the mothers had been vaccinated,” she explained.

The tragic events in Kentucky are part of a broader pattern emerging across the country this year, with similar reports of infant deaths from pertussis in states such as Louisiana, Idaho, South Dakota, and Washington. These incidents highlight the severe threat the illness poses, particularly to young children and those who remain unvaccinated.

As whooping cough continues its troubling climb across the U.S., certain states have documented especially stark increases in cases, raising alarms among health professionals and public health officials.

In Texas, whooping cough cases have quadrupled compared to last year, while in Florida, officials warned that, as of September 27, the latest data available, the state had recorded 1,295 case, an 81 percent surge from the previous year.

Federal data shows more than 25,000 cases have been recorded so far this year, the second consecutive year of unusually high activity. Over recent years, the annual average has been around 20,000. 

Experts say the recent surge in whooping cough cases in the US is being driven in part by declining vaccination rates, along with waning immunity from earlier childhood vaccines. 

Three infants in Kentucky have died from an Victorian-era disease which is continuing to rip its way across the US (stock image)

Public health officials warn that unless vaccination coverage improves, especially for the DTaP series in children and the Tdap booster for adolescents, adults, and pregnant women, pertussis infections are likely to continue rising, putting infants and other vulnerable groups at increased risk. 

Dr Marcos Mestre, chief clinical operations officer at Nicklaus Children’s Health System in Miami, told CBS last year: ‘We have been seeing some increase in pertussis cases that are coming through our emergency departments.

‘Not necessarily requiring admission, but coming in for evaluation and treatment.

‘They’re coughing to the point that they can’t catch their breath. And those are the children we really worry about, when infants are getting infected and that could cause more severe illness.’ 

At this time last year, about 33,000 cases had been reported. Both years far exceed pre-pandemic levels, roughly 18,600 cases were counted in 2019, and approach totals last seen in 2014, when more than 32,900 cases were recorded. 

In Texas, it is the second consecutive year the states is experiencing high year-over-year increases in reported pertussis cases and the second consecutive year the state health department has issued a health alert. 

Whooping cough is a highly contagious respiratory disease caused by the bacteria Bordetella pertussis that spreads easily through tiny droplets in the air.

It often begins with cold-like symptoms and a mild cough, followed a week or two later by severe coughing that can last for several weeks. 

In serious cases, patients may suffer from prolonged coughing fits so fierce they suffer broken ribs, and may also suffer from pneumonia, seizures and brain damage. It is particularly dangerous for infants, with one in 50 unvaccinated children under six months old who are diagnosed with the disease not surviving the infection.

Whooping cough, or pertussis, is particularly dangerous for young children, experts say (stock image)

The disease can be prevented with the DTaP (tetanus, diphtheria, pertussis) vaccine, which is 98 percent effective at protecting against the illness. 

It is given in a five-dose series beginning at two months and six years old. Boosters are given as the Tdap vaccine to adolescents and adults.

But uptake of the vaccine has fallen nationwide amid surging vaccine skepticism. 

The share of kindergartners vaccinated with the DTaP shot has slipped to 92.1 percent in the 2024–2025 school year, down from roughly 95 percent before the pandemic, according to the CDC.

The decline reflects a broader national trend. 

CDC figures show that at least 77 percent of US counties and jurisdictions have reported drops in childhood vaccination rates since 2019.

Experts say that herd immunity, or when enough people have protection against a disease so that it no longer spreads, is only achieved when at least 95 percent of people are vaccinated against a disease such as whooping cough. 

Health officials warned that the infection is initially difficult to tell apart from a cold, as the first signs are a runny nose and sore throat. But around a week later, sufferers may develop coughing bouts that last minutes, struggle to breathe after coughing and make a ‘whoop’ sound between coughs

DTaP vaccination levels in Texas, for instance, have not been at 95 percent since at least 2012.

Meanwhile, in Florida, DTaP vaccination rates were down to 90.6 percent in 2024, the lowest in a decade.

Prior to the introduction of the whooping cough vaccine in 1948, the US saw as many as 250,000 cases of the disease and 7,300 to 9,000 deaths per year. 

Cases steadily dropped by more than 90 percent each year compared to the pre-vaccine era, the CDC states.

The CDC has also noted that the bacteria that cause whooping cough, Bordetella pertussis, is prone to mutations, which could make it able to evade vaccines.