Australia’s whooping cough surge is not over – and it doesn’t just affect babies
Whooping cough (pertussis) is always circulating in Australia, and epidemics are expected every three to four years.
However, the numbers we’re seeing with the current surge – which started in 2024 – are higher than usual epidemics.
Vaccines for this highly infectious respiratory infection have been available in Australia for many decades. Yet it remains a challenging infection to control because immunity (due to prior infection, or vaccination) wanes with time.
In 2025, more than 14,000 cases have been recorded already. Some regions, including Queensland and Western Australia’s Kimberley region, are seeing a marked rise in cases.
In 2024, more than 57,000 cases of whooping cough were reported in Australia – the highest yearly total since 1991 – including 25,900 in NSW alone.
What’s causing this surge?
A few factors are driving numbers higher than we’d expect for an anticipated epidemic.
Covid lockdowns in 2020 and 2021 reduced natural immunity to many diseases, disrupted routine childhood vaccination services, and resulted in rising distrust in vaccines. This has meant higher-than-usual numbers for many infectious diseases.
And it’s not only Australia witnessing this surge.
In the US, whooping cough cases are at their highest since 1948, with deaths reported in several states, including two infants.
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In Australia, vaccine coverage remains relatively high but it is slipping and is below the national target of 95 per cent.
Even small declines may have a significant impact on infection rates.
Who is at risk?
Young babies, especially those under six weeks of age, are extremely vulnerable to whooping cough because they’re too young to be vaccinated.
Infants under six months of age are also more likely to require hospitalisation for breathing support or have severe outcomes such as pneumonia, seizures or brain inflammation. Some do not survive.
However, the greatest number of cases occurs in older children and adults. In fact, in 2024, more than 70 per cent of cases occurred in children 10 years and older, and adults.
Can you get whooping cough if you’re vaccinated?
The whooping cough vaccine works well, but its protection fades with time. Babies are immunised at six weeks, four months and six months, which gives good protection against severe illness.
But without extra (booster) doses, that protection drops, falling to less than 50 per cent by four years of age. That’s why booster doses at 18 months and four years are essential for maintaining protection against the disease.
A whooping cough vaccine is also recommended for any adult who wishes to reduce the likelihood of becoming ill with pertussis. Carers of young infants, in particular, should have a booster dose if they’ve not received one in the past 10 years.
A booster dose is also recommended every 10 years for health-care workers and early childhood educators.
One of the best ways we can protect babies from the life-threatening illness of whooping cough is vaccination during pregnancy, which transfers protective antibodies to the unborn baby.
If a woman hasn’t received a vaccine during pregnancy, they can be vaccinated as soon as possible after delivery (preferably before hospital discharge).
This won’t pass protective immunity to the baby, but reduces the likelihood of the mother getting whooping cough, providing some indirect protection to the infant.
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How contagious is whooping cough?
Whooping cough is extremely contagious – in fact, it is up to 10 times more contagious than the flu.
If you’re immunised against whooping cough, you’re likely to have milder symptoms. But you can still catch and spread it, including to babies who have not yet been immunised.
Data shows siblings (and not parents) are one of the most common sources of whooping cough infection in babies.
This highlights the importance of on-time vaccination not just during pregnancy, but also in siblings and other close contacts.
How do I know it’s not just a cold?
Early symptoms of whooping cough can look just like a cold: a runny nose, mild fever, and a persistent cough.
After about a week, the cough often worsens, coming in long fits that may end with a sharp “whoop” as the person gasps for breath.
In very young babies, there may be no whoop at all. They might briefly stop breathing (called an “apnoea”) or turn blue.
In teens and adults, the only sign may be a stubborn cough (the so-called “100-day” cough) that won’t go away.
If you have whooping cough, you may be infectious for up to three weeks after symptoms begin, unless treated with antibiotics (which can shorten this to five days).
You’ll need to stay home from work, school or childcare during this time to help protect others.
How do I reduce my risk?
Start by checking your vaccination record. This can be done through the myGov website, the Express Plus Medicare app or by asking your GP.
If you’re pregnant, get a whooping cough booster in your second trimester. A booster is also important if you’re planning to care for young infants or meet a newborn.
Got a cough that lasts more than a week or comes in fits? Ask your GP about testing.
One quick booster could help stop the next outbreak from reaching you or your loved ones.
Niall Johnston, Conjoint Associate Lecturer, Faculty of Medicine, UNSW Sydney; Helen Quinn, Senior Research Fellow, National Centre for Immunisation Research and Surveillance & Senior Lecturer, Children’s Hospital Westmead Clinical School, University of Sydney, and Phoebe Williams, Paediatrician & Infectious Diseases Physician; Senior Lecturer & NHMRC Fellow, Faculty of Medicine, University of Sydney
This article is republished from The Conversation under a Creative Commons licence. Read the original article.
