Pertussis (Whooping Cough)

Pertussis, better known as whooping cough, is a highly infectious disease caused by the bacterium – Bordetella pertussis. Pertussis can lead to serious complications, including death, particularly among babies under the age of six months old and in early life before they are vaccinated.

Although pertussis is a major cause of infant death worldwide, the precise number of cases is unknown because many cases go undiagnosed. There is wide variation between the numbers of actual reported cases and data from models that make assumptions about actual infection rates, vaccination coverage and so for. For example, the World Health Organization reported around 151,000 cases worldwide in 2018, whereas an analysis of modelling data from the Global Burden of Disease study estimates that there were around 19 million cases, across all ages, for 2019.

What is clear is that parts of the world, including the UK, other European countries and the USA, are experiencing an uptick in the number of pertussis cases during 2024.  

In England, between January and May 2024, there were 7,599 confirmed cases reported to the UK Health Security Agency, with eight infant deaths over the same time. In all, there have been nine infant deaths since this outbreak began. By contrast, there were just 858 cases reported during the whole of 2023.

Pertussis is a cyclical disease, with outbreaks every three to five years. The last nationwide outbreak was in 2012, when there were over 9,300 cases in England alone – this was more than ten times as many as in recent years.

During the 2012 outbreak 14 babies under three months old died. There was a less marked increase in cases in 2016 but another 18 infants died between 2013 and 2016.

During the COVID-19 pandemic, the lockdowns resulted in less cases due to reduced transmission of the bacterium.

Vaccination of people who are pregnant with a pertussis vaccine generates antibodies, which then cross the placenta to the baby before birth. These protect the babies from pertussis infection in the weeks before they are old enough to get vaccinated.

However, the number of pregnant women, babies and young children getting vaccinated against pertussis has fallen in recent years across England. Maternal vaccine uptake fell from 74.7% of all pregnant women in December 2017 to 59.5% in December 2023.

See more information on the pertussis (whooping cough) vaccination programme for pregnant women. 

According to the World Health Organization, globally 84% of children under the age of one year received three doses of a pertussis-containing vaccine during 2023. This is 2% less than in 2019, although slightly up from the end of the COVID-19 pandemic.  The WHO target is 95%.

                                                Source: UK Health Security Agency. Pertussis epidemiology in England 2024.

It is not possible to develop natural immunity to pertussis without getting the disease itself. The only way to protect your child is through vaccination.

In the UK the pertussis vaccine is given to babies and young children as part of the 6-in-1 vaccine, and in the 4-in-1 pre-school booster. They are given three doses of the 6-in-1, and a booster as part of the 4-in-1.

Pregnant individuals are also offered the pertussis pre-school booster vaccine from week 16 of their pregnancy, to protect their infant once they are born but too young to be vaccinated. 

For more information about the pertussis vaccines, please go to the pertussis/whooping cough vaccine pages

Before a vaccine was introduced in the 1950s, the average number of suspected pertussis cases in England and Wales was over 100,000 each year, and in some years over 2000 people died from the disease. By 1972, when over 80% of children were vaccinated, this had fallen to 2069 suspected cases and two deaths.

In the mid-1970s in the UK there was a fall in vaccination rates from just under 80% in 1972 to only 37% in 1974. This was because of unfounded concerns about the safety of the vaccine. However, this resulted in major pertussis epidemics in 1977 to 1979 and 1981 to 1983, with some deaths from infection.

Since 1992, the UK vaccination rate has stayed around the 92% mark, some years a little higher, some a bit lower. As a result, the number of cases, and fatalities, has fallen greatly.

There are two types of pertussis vaccine used in global vaccination programmes – the whole cell pertussis vaccine (wP) and the acellular pertussis vaccine (aP). Neither vaccine contains live bacteria, and the vaccines cannot cause the disease itself. Both vaccines protect against pertussis infection.

The wP vaccine contains the killed whole cells of the pertussis bacteria. This was used in the UK infant vaccination programme until 2004 when it was replaced by the acellular pertussis vaccine (aP). The aP vaccine causes fewer side-effects when it is administered, such as fever and swelling at the injection site.

Some of the most serious cases of pertussis, requiring hospitalisation and intensive care, are in very young infants, before they are able to be immunised, who may be infected by unvaccinated older siblings or their parents. That is why vaccinating people when they’re pregnant is so important.

It is possible to catch pertussis more than once, and the protection given by vaccination fades over time. This means that older people who have had pertussis or been vaccinated can still catch the disease and pass it on to more vulnerable people, such as babies, in the community.

Losing a baby to pertussis: Gavin’s story

Natalie talks about losing her fourth son Gavin to pertussis when he was just a few weeks old. Grateful thanks to Natalie and Shot by Shot for permission to use this film.