Whooping cough cases in Florida increase eightfold from 2023 to 2024, state says
The number of whooping cough cases in Florida soared in 2024.
From Jan. 1, 2024 to Dec. 31, 2024, the Florida Department of Health reported 715 cases of pertussis – an eight-fold increase over the year before, which had 85 cases.
Following a nationwide trend, incidences of pertussis, commonly known as whooping cough, have been increasing to pre-pandemic levels. But in 2024 in Florida, the number of cases was still almost double that of 2019, which recorded 359 cases.
The preventative measures used to combat COVID-19, like masks and social distancing, also stopped other respiratory viruses, like pertussis, said Jerne Shapiro, a professor specializing in epidemiology at the University of Florida's College of Public Health and Health Professions.
Those measures are now gone. Coupled with a vaccination rate in Florida that doesn't hit herd immunity, that's why the number of pertussis cases is on the rise in the state.
The age group with the most pertussis cases in 2024 was children up to 4 years old.
Whooping cough, also known as pertussis, is an infection caused by a type of bacteria called Bordetella pertussis. Babies and small children are particularly vulnerable, and may experience apnea (or pauses in breathing), pneumonia, seizures and brain damage, leading to death.
Last October, the U.S. Centers for Disease Control and Prevention reported more than five times as many whooping cough cases in the country than the year before.
While one COVID-infected person usually infects about two people, with pertussis one infected person can spread the bacteria to as many as 15 people with no immunity.
"We have pockets of community members that have very low vaccination rates," Shapiro said. If pertussis "makes its way into one of those communities that has low vaccination rates, we are much more likely to see an outbreak occur in that population group."
DOH reported Taylor and Madison counties with the highest incidence of pertussis from July 2024 to October 2024.
Currently in Florida, the vaccination rate for those who have completed all five doses of the tdap vaccine, which prevents tetanus, diphtheria and pertussis, is about 88.1 percent, Shapiro said. Herd immunity for pertussis requires 92 to 94 percent.
"We don't have the high enough levels to prevent community transmission," Shapiro said. A request for comment with DOH is still pending.
What is whooping cough?
The illness is called whooping cough because the bacteria produces a toxin that causes inflammation in the respiratory tract and paralysis of the larynx, or voice box, which can make it difficult to cough.
The person cannot breathe until the larynx relaxes, Shapiro said, and the inhalation is what causes that "whoop" sound.
"So it's cough, cough, cough, and then you hear from the patient as they try to breathe back in, and that is where the term whoop comes from," Shapiro said. "If you've ever seen someone who's had it and you watch them and they cannot breathe, it is scary."
Pertussis is sneaky. It starts as a regular cough and then develops into a more insidious illness. "... It's not until after one or two weeks that the second stage of pertussis begins, and people realize just how sick they are," she said.
Pertussis can be treated early with antibiotics, and a person can be given preventative antibiotics if they know they've been in contact with someone who was sick, though it gets misdiagnosed quite frequently.
"They just think, you know, a respiratory illness, you'll be okay, and then, unfortunately, it is pertussis," she said. "They're around a young child or someone who has other adverse medical conditions, and in that person, we see a totally different disease presentation."
About the tdap vaccine
To prevent pertussis, there is a series of five vaccinations given from 2 months the the age of 4 to 6. Even those with one vaccine will still have partial protection with less severe outcomes.
"Our youngest children don't have fully developed immune systems to begin with, and they have more difficulty clearing mucus. They don't have very good, strong sneezing and coughing mechanisms built up," Shapiro said.
What's known as the tdap vaccine (short for tetanus, diphtheria and pertussis) can wane over time, Shapiro said, and she recommends getting a booster every 10 years., especially if you're pregnant or elderly.
"It's also important that close contacts to our under 1 population, so our grandmas, our grandpas, anyone that also might be a caregiver, gets updated on their vaccine as well," she said.
Florida requires children entering a public school in kindergarten through 12th grade to have at least four doses of the tdap vaccine, though the state does allow for religious exemptions "if immunizations are in conflict with the religious tenets and practices of the child's parent or guardian," according to the state health department.
Medical providers in Florida say vaccine hesitancy has contributed to the rising number of cases of pertussis and other diseases like measles. Especially since the COVID-19 pandemic, state officials like Gov. Ron DeSantis and Dr. Joseph Ladapo, the state's surgeon general, have supported messaging that some doctors say contains misinformation about mRNA vaccines.
According to a Florida Department of Health report for July 2024 , the proportion of children 5-17 with new religious exemptions are increasing each month. St. John's, Flagler, Sarasota and Walton counties have the highest number of children with religious exemptions, according to that data.
Ana Goñi-Lessan, state watchdog reporter for the USA TODAY Network – Florida, can be reached at agonilessan@gannett.com .
This article originally appeared on Tallahassee Democrat: Whooping cough in Florida sees eight-time increase from 2023 to 2024
