Whooping cough is not just a childhood disease. Adults get it too — but they often do not recognize it. What feels like a persistent cold or a lingering cough after a respiratory infection can be pertussis, the bacterium that causes whooping cough. And while most healthy adults weather it without serious consequence, they can unknowingly transmit the infection to the people most vulnerable to its worst outcomes: newborn infants.
The CDC's June 22, 2026 respiratory data update confirmed that whooping cough is still circulating across the United States. Preliminary surveillance data show that while 2026 case counts are lower than the same period in 2025, pertussis is moving back toward pre-pandemic patterns in which more than 10,000 cases are reported each year — and researchers believe the true case count is significantly higher due to underdiagnosis.
Why This Matters
Infants under two months of age cannot receive the DTaP vaccine that protects older babies. They are entirely dependent on the immunity of the people around them — parents, grandparents, siblings, and visitors — to avoid exposure to pertussis.
According to Johns Hopkins Medicine, many babies infected with pertussis catch it from an adult. The disease starts in adults as the common cold. Adults rarely experience the characteristic "whoop" of pertussis — that desperate gasp for air after a coughing fit that gives the illness its name. Instead, they have a prolonged cough that can last weeks or months, which they attribute to allergies, post-viral illness, or a slow-resolving cold.
Meanwhile, the newborn in the house — or the grandchild they visit — has no protection.
What We Know So Far
Pertussis immunity wanes. This is a known limitation of both the DTaP vaccine given in childhood and the Tdap booster given in adolescence. According to the CDC, "protection fades over time" after both versions of the vaccine. For adults who received their last pertussis-containing vaccine in adolescence — as is the case for most adults who are not around newborns and have not had a Tdap recently — immunity may be minimal after a decade.
The CDC recommends a single dose of Tdap for all adults who have never received it. There is no current recommendation for routine repeat adult pertussis boosters after Tdap, but the vaccine's effectiveness declines over years.
For pregnant women, the recommendation is more specific: the CDC advises Tdap during the early part of the third trimester of every pregnancy, primarily to pass pertussis antibodies to the newborn before birth. This maternal strategy — called cocooning — is the most effective way to protect babies too young to be vaccinated themselves.
Where the Risk Is Highest
Any household with an infant too young to be fully vaccinated — children under six months have not yet completed the three-dose DTaP primary series — is at elevated risk if adults in the home or regular visitors have not had recent Tdap protection.
Pertussis outbreaks in the United States have historically been linked to childcare settings, schools, and communities with clusters of unvaccinated or under-vaccinated children. A 2024–2025 outbreak in Grand Traverse County, Michigan highlighted the economic and social disruption caused by school closures and healthcare overutilization, reinforcing the value of timely vaccination.
Major cities with high concentrations of new parents — including New York, Los Angeles, Chicago, Houston, Atlanta, and Seattle — see pertussis cases each year.
What Doctors and Experts Say
The American Medical Association notes that whooping cough is endemic in the United States, with peaks in reported cases every few years. The United States is now beginning to return to pre-pandemic patterns where more than 10,000 cases are typically reported annually.
Clinicians note that diagnosis is often missed in adults because the clinical presentation is atypical. Adults rarely develop the characteristic inspiratory "whoop," and the illness is frequently attributed to other causes. Pertussis should be considered in any adult with a cough lasting longer than two weeks, particularly if they have had contact with an infant or live in a community with a known outbreak.
Antibiotics — azithromycin is the preferred agent — are effective at eliminating the bacteria and reducing transmission if started in the first one to two weeks of illness, before the coughing paroxysms intensify. After that window, antibiotics reduce transmission risk but do not significantly shorten illness duration.
What the Evidence Shows — and What It Does Not
MedicalDaily Evidence Check
- Vaccine: Tdap (tetanus, diphtheria, acellular pertussis) — for adults and adolescents over 7 years; DTaP for children under 7
- CDC recommendation: Single Tdap dose for adults who have never received it; Tdap during every pregnancy (third trimester preferred)
- Immunity waning: Known; no current recommendation for routine adult repeat boosters for pertussis specifically
- What maternal Tdap does: Transfers pertussis antibodies to the newborn, providing protection in the first weeks of life before vaccination can begin
- What it does not prevent: Pertussis in all exposed adults; repeat boosters are not currently recommended for the general adult population
Who Faces the Greatest Risk?
- Newborns under two months of age, who cannot be vaccinated yet
- Infants between two and six months, who have begun but not completed the three-dose primary series
- Infants born to mothers who did not receive Tdap during pregnancy
- Adults who have never received Tdap or whose last pertussis-containing vaccine was more than a decade ago
- Grandparents, childcare workers, and other regular caregivers of infants who have not had Tdap recently
Symptoms and Warning Signs to Watch For
In adults, whooping cough typically begins with:
- Cold-like symptoms: runny nose, low-grade fever, mild cough
- Progression over one to two weeks to severe coughing fits
- Coughing spells that may end in a high-pitched whoop, vomiting, or gasping
- In some adults, only a prolonged cough without the dramatic paroxysms
In infants, the symptoms can be more severe from the outset and may include choking, turning blue during coughing fits, apnea (pauses in breathing), and inability to feed normally. Infants under six months are at highest risk for pneumonia, brain damage, and death.
Any infant who develops coughing spells — particularly if accompanied by a change in skin color, difficulty breathing, or feeding difficulty — should receive immediate medical evaluation.
What You Can Do Now
- Ask your doctor or pharmacist whether you have received a Tdap booster as an adult. If you have never had one, get it now.
- If you are pregnant, make sure you receive Tdap between weeks 27 and 36 of your pregnancy. This is recommended during every pregnancy, even if you have had Tdap before.
- If you have a newborn or infant at home, ask that all adult household members and regular visitors confirm they have had Tdap. This includes grandparents, childcare workers, and regular babysitters.
- If you have had a cough lasting more than two weeks, especially without a clear explanation, ask your health care provider whether pertussis testing is appropriate — particularly if you have had contact with an infant.
- Contact your pediatrician if your infant develops coughing fits or any difficulty breathing.
Cost and Access: What Patients Should Know
Tdap vaccine is covered at no cost under most private insurance plans and Medicare as a preventive service. The Vaccines for Children (VFC) program covers DTaP for eligible children. Adults without insurance can access Tdap at local health departments and federally qualified health centers, typically at low or no cost.
What Happens Next
The CDC will continue updating pertussis surveillance data. The agency's preliminary 2026 data will be finalized later in the year and will provide a clearer picture of whether cases are tracking toward a peak cycle year. MedicalDaily will report any significant increases in case counts or changes to vaccine guidance.
The Bottom Line
Adults can carry and spread whooping cough without knowing it — and newborns cannot protect themselves. A single Tdap booster for every adult who has not had one, plus Tdap during every pregnancy, is the most powerful tool available to protect the babies most vulnerable to this disease. Check your vaccination status today. It takes minutes, and it matters.
