why are cases of whooping cough and pneumonia on the rise?

In recent months, you’ve likely seen on the news, received a communication from your child’s school or experienced it firsthand—whooping cough and pneumonia cases are on the rise, particularly among children. These respiratory illnesses, while preventable, can be serious, especially for young kids and those with underlying health conditions.  

Michael Klatte, MD, chief of pediatric infectious disease at Dayton Children’s Hospital explores why these illnesses are on the rise, the symptoms to watch for and how you can protect your family. 

The Centers for Disease Control (CDC) is reporting increases in whooping cough and walking pneumonia in kids. Why are we seeing these increases in cases, especially in younger kids?  
Infections with mycoplasma (the germ that causes walking pneumonia) typically peak every 3-7 years. From 2020 - 2023, cases of whooping cough in the U.S. were much lower compared to the numbers of yearly cases seen prior to that time. So far in 2024, we've seen a return to pre-pandemic numbers of whooping cough cases. We suspect measures used to prevent the spread of COVID also affected the spread of these infections.           

Who is at risk for complications from whooping cough and why? 
Infants < 6 months old have the highest risk of severe infection and most pertussis infections in this age group are initially treated in the hospital. Complications of whooping cough in infants can include gagging and gasping spells, apneic episodes (when an infant will stop breathing), severe pneumonia, seizures and even heart failure.  

Who is at risk for complications from walking pneumonia and why?  
Children with medical conditions like asthma, kidney disease, sickle cell disease and immune system problems have an increased risk of complications from a walking pneumonia infection.  

What are some signs of whooping cough and what should parents do as soon as they recognize them?  The most well-known symptom of these infections in children is a prolonged cough. The cough of pertussis is known as the "100-day cough," and can last for 1.5 - 2.5 months before resolving. Kids with whooping cough usually start out with symptoms similar to a common cold, such as runny or stuffy nose and a mild cough. After about 1-2 weeks of these symptoms, they develop frequent coughing fits. Some kids will make a "whooping" sound as they inhale at the end of a coughing fit.  

What about walking pneumonia? 
The cough of walking pneumonia may last for 3-4 weeks before resolving. This cough generally starts out sounding dry, and then over time will sound more phlegmy.     

How is whooping cough diagnosed?  
Whooping cough is diagnosed through a combination of clinical evaluation, where doctors assess symptoms and potential exposure, and diagnostic tests such as a nasal swab. Early testing within the first few weeks of symptoms provides the most accurate results. 

How is pneumonia diagnosed? 
Pneumonia is diagnosed by checking symptoms like cough, fever and trouble breathing, along with a physical exam. Doctors use tests like chest X-rays, blood tests and sputum (mucus) samples to see if there is an infection in the lungs and what might be causing it. The infection that causes walking pneumonia can sometimes be diagnosed by a nasal swab test, as well.

What can parents do to prevent these conditions in their kids?  
All adults should be vaccinated against whooping cough once every 10 years. Pregnant women need a dose of Tdap vaccine during the second or third trimester of each and every pregnancy.  

Babies should be getting shots to prevent whooping cough during visits with the pediatrician at 2 months, 4 months, 6 months and 15 months old. It's just as important to ensure school-age siblings are up to date with their whooping cough shots. Whooping cough vaccine doses are also needed between ages 4-6 years and 11-12 years.