I started here, yet another story about how whooping cough is on the rise in Texas.
Bexar County is seeing a dramatic rise in cases of whooping cough this year alongside potentially record-breaking increases statewide.
So far in 2025, San Antonio’s Metropolitan Health District has recorded a little over 200 cases of pertussis, more commonly known as whooping cough, a respiratory infection that mostly affects young children.
That’s well above the 72 cases in the county last year, and the pre-pandemic average of 50-70 cases, according to Miguel Cervantes, interim assistant director of communicable diseases at the city health department.
[…]
The state health department has recorded 3,762 annual cases of whooping cough in Texas — a significant jump from 1,907 cases last year.
Because December is typically a highly infectious month for pertussis, the department expects that the case count could exceed the state’s previous high of 3,985 in 2013, according to Lara Anton, senior press officer at DSHS.
Like many infectious diseases, whooping cough declined during the pandemic but cases have since rebounded nationwide and locally, prompting the state health department to issue health alerts two years in a row.
Two combination vaccines protect against whooping cough: DTaP for babies and children younger than 7, and Tdap for older children and adults. The vaccines effectiveness wears off over time, so young children and teens generally receive several booster shots.
A rebound in whooping cough cases post-pandemic isn’t unexpected, but lower vaccination rates also play a role in what could end up being a record-breaking year.
“Children during the COVID pandemic did not have as many opportunities to get caught up on vaccines, and we’ve had children that fell behind on staying up to date with their vaccines,” Cervantes said.
See here for the previous update. I’ve been following this for awhile, and the focus has mostly been on the huge rise in whooping cough from 2023 and 2024 to today. But this story has a chart in it showing the case counts since 2013, and it’s kind of wild how it plummeted from 3,985 that year to 340 in 2017, then after two years in the 1,100 – 1,300 range it went back down to 2017 levels for four years, all during COVID, then rocketed up to where we now are.
And I thought, what caused these swings? Why was it so high in 2013, and what did it look like before then? A little noodling around on the DSHS website led me to this:
Pertussis cases in Texas and the United States have been increasing. There are several important factors leading to the increased reporting of pertussis cases including waning immunity in adults and adolescents. Some of these include heightened awareness of the disease among clinicians, school nurses, parents, and the general public, better laboratory testing methodologies, and enhanced disease surveillance capabilities.
Pertussis is known to occur in three to five-year cycles. The last peak year in Texas was 2013 with 3,985 cases, the highest annual case count since 1959. There were 1,765 cases in 2017, and cases have remained relatively stable in 2018 and 2019, with 1,168 and 1,320 reported cases respectively.
Emphasis mine. That was not known to me, so I appreciate the info. I also was able to answer my question about what the case counts were before 2013 by going to the Annual Reports for the 2010s, clicking on the 2013 annual report, and looking at the Reported diseases table. There, under “Pertussis”, I found that from 2004 through 2013, the case count varied from 954 to that high-water mark of 3,985 in 2013, with a secondary high of 3,354 in 2009. It went up and down and did appear to follow a more or less three-year cycle. So there you have it.
But of course we are now in our “Let’s not vaccinate our children!” era, so it’s not at all clear to me that we will peak this year and see a downward trend in 2026 or 2027. While the cyclic nature of whooping cough will likely continue, I worry it will be from a new and higher baseline. Vaccination rates – congratulations to El Paso for having a higher-than-average one – will tell that story, if my suspicions are merited.
And on that score, I have more bad news.
Already this year, anti-vaccine activists have downplayed the risks of measles and polio. Now, they’re adding whooping cough to the list, even as cases of the disease surge, killing at least ten babies over the past two years. Two of those babies died in Louisiana, where a crusading state surgeon general, Dr. Ralph Abraham, waited months to warn the public about the outbreak and banned mass vaccination campaigns.
Instead of discipline, Abraham has been rewarded: Last month, he was appointed to the second-highest leadership role at the US Centers for Disease Control and Prevention.
Abraham will now be the highest-ranking scientist at the agency. His background is unusual for the role. He practiced veterinary medicine at first, and only later was a family physician. Abraham also served as a representative for Louisiana in Congress from 2015 to 2021. (During the pandemic, Abraham promoted the anti-parasite drug ivermectin as a Covid cure, despite evidence showing it didn’t work.)
Whooping cough, also called pertussis, is caused by bacteria that produce toxins that damage the respiratory lining, resulting in prolonged bouts of coughing. Such episodes are especially dangerous for infants, in whom they can lead to life-threatening respiratory distress. Pertussis has been on the rise since the pandemic—according to the CDC, last year, there were more than 35,000 cases, compared to fewer than 8,000 the year before.
One factor that may be contributing to the soaring pertussis case counts is declining rates of vaccination: Last year, the CDC reported that just over 92 percent of US kindergarteners were vaccinated against the disease, down from 95 percent in 2017. The dip occurred against a backdrop of increasing anti-vaccine activism, embraced by the US Department of Health and Human Services under Robert F. Kennedy, Jr. In Kentucky, three babies have died this year of the disease—none of them were vaccinated, nor were their mothers, according to Kentucky’s Center for Health and Family Services.
Since 2024, the pertussis surge has been especially acute in Abraham’s home state of Louisiana. But this didn’t prompt swift movement from him or other officials. Despite high case counts, it wasn’t until May of this year, by which time two babies in the state had died of the disease, that Louisiana finally issued a health alert. Physicians criticized Abraham for failing to warn residents of the disease’s dangers—and the critical importance of maternal vaccination during pregnancy, since babies can’t be vaccinated until they are two months old.
Abraham has a history of anti-vaccine rhetoric. In February, Louisiana’s Department of Health officially banned vaccine promotion events in the state. That same month, Abraham and his deputy surgeon general, Wyche Coleman, published a letter on the health department’s website decrying what they saw as an overbearing public health system. “For the past couple of decades, public health agencies at the state and federal level have viewed it as a primary role to push pharmaceutical products, particularly vaccines,” they wrote. “Government should admit the limitations of its role in people’s lives and pull back its tentacles from the practice of medicine.” (The Louisiana Department of Health didn’t respond to a request for comment from Mother Jones.)
Given Abraham’s vaccine skepticism, it is perhaps unsurprising that he has earned a leadership position under Kennedy. In his new role, Abraham will work on high-level agency strategy, as well as coordinate between divisions, and oversee both internal and external communication.
I don’t know what to tell you. It’s gonna be a rough few years. Keep your own vaccinations up to date and hope for the best.
Soft eugenics for the poor and the poorly educated.