Geographic differences are also emerging. A review of electronic medical records by Epic Research identified Nebraska, Idaho, Oregon and Hawaii as the states with the highest infection rates relative to population so far this year. While Texas leads the nation in absolute case counts, these four states show the greatest concentration of illness when adjusted for resident numbers, underscoring regional variability in disease pressure.
Despite the uptick in laboratory-confirmed cases, indicators of severe illness remain below the levels observed last winter. Epic Research reports that outpatient visits, emergency department encounters and hospital admissions linked to pertussis are all lower than the seasonal peak reached in late 2024. Clinicians caution, however, that hospitalizations can rise quickly if transmission spreads among very young children or individuals with underlying health conditions.
Pertussis is a highly contagious respiratory infection caused by the bacterium Bordetella pertussis. The illness often begins with symptoms similar to a common cold—runny nose, low-grade fever and mild cough—but can progress to prolonged bouts of coughing that last for weeks or even months. Infected individuals can transmit the bacteria from the onset of symptoms and for at least two weeks after coughing starts. Early antibiotic treatment can shorten the course of illness and reduce the likelihood of further spread.
Public health monitoring faced an additional hurdle this autumn when federal data reporting was interrupted during a government shutdown. While states continued submitting case counts, national databases were not updated in real time, leaving analysts with a temporary gap in consolidated figures. The most recent federal summary, issued at the end of September, therefore represents the latest officially confirmed U.S. tally until normal reporting resumes.
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In Texas, the current rise follows an already elevated year in 2024, suggesting ongoing community transmission. State officials have urged clinicians to consider pertussis in patients with persistent cough, especially in households with infants, pregnant women or unvaccinated individuals. Laboratories have been directed to expedite testing to ensure prompt initiation of antibiotics and contact tracing when cases are confirmed.
Vaccination remains the primary tool for preventing pertussis outbreaks. The CDC recommends a series of five doses of the DTaP vaccine for children, with booster doses of Tdap for adolescents and adults. Information on vaccine schedules is available from the CDC pertussis resource center. Health departments emphasize that vaccinated individuals can still contract the infection, but the illness is generally less severe and less likely to spread.
Health authorities will continue to monitor trends as winter approaches, a period when respiratory infections typically rise. For now, Texas and several other states remain well above historical baselines, underscoring the importance of maintaining up-to-date immunization and seeking medical advice when signs of a persistent cough appear.
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