When a vaccine-preventable disease occurs, state health officials typically take specific steps to warn residents and provide updates to the public about the growing threat. This is standard practice, public health and infectious disease experts told KFF Health News and NPR. The goal is to prevent as many vulnerable people as possible from getting sick and to remind the public of the benefits of vaccination.
But public health officials appear not to have followed that guidance this year during Louisiana’s worst whooping cough outbreak in 35 years.
Pertussis, also called whooping cough, is a highly contagious, vaccine-preventable disease that is especially dangerous to young infants. It can cause vomiting and difficulty breathing, and serious infections can lead to pneumonia, seizures and, in rare cases, death.
Madison Flake, a pediatrics resident in Baton Rouge, cared for a baby hospitalized during this year’s outbreak. He was sent to the intensive care unit when he was less than two months old.
“He would have very dramatic coughing fits,” Flake said. “He stopped breathing for anywhere from a few seconds to almost a minute.”
Infants cannot receive their first whooping cough vaccine until they are fully vaccinated. 2 monthsHowever, immunity can be achieved if the mother is vaccinated during pregnancy.
By the end of January, two babies had died in Louisiana.
But the Louisiana Department of Health waited two months to send out a social media post suggesting people talk to their doctors about getting vaccinated. The department took longer to issue orders statewide. health warning Send a press release to your doctor or hold a press conference.
According to , this delay is not typical. george benjaminExecutive Director, American Public Health Association.
“Especially for these childhood diseases, we typically leapfrog all of this,” said Benjamin, a physician who has led health departments in Maryland and Washington, D.C. “These are preventable diseases and preventable deaths.”
Because infectious diseases spread exponentially, he said, if authorities don’t warn the public quickly, they lose a critical opportunity to prevent further infections. Abra KaranHe is a lecturer at Stanford University who studied coronavirus and M-Fox outbreaks.
“Time is probably one of the most important currencies you have,” he added.
Ban general anti-vaccine promotions
Because whooping cough vaccine immunity wanes over time, cases may decrease or decrease. But in September 2024, Louisiana health officials began seeing a “significant” increase in whooping cough cases. national trends.
In late January, doctors at a Louisiana hospital alerted colleagues that the outbreak had killed two infants.
On February 13, the Provincial Surgeon General Ralph AbrahamA note was sent to staff A general halt in the promotion of vaccines. and community vaccination events.
He sent the email hours after anti-vaccination activist Robert F. Kennedy Jr. won Senate confirmation as the new secretary of the U.S. Department of Health and Human Services.
Also that day, Abraham posted the following: public note From the state Department of Health website. He said in the report that public health had gone beyond vaccine recommendations based on a “one-size-fits-all, collectivist mentality.” Abraham said the coronavirus vaccine “dangerous“And he was a huge supporter of Kennedy.
Four days later, at the request of WVUE Fox 8 News in New Orleans, the Louisiana Department of Health confirmed in an email that two infants had died from whooping cough for the first time. WVUE announced the news February 20th.
However, a review of external and internal communications by NPR and KFF Health News found that the Louisiana Department of Health did not issue any alerts.
In the following months, two more infants were hospitalized with whooping cough, according to Interior Department emails obtained through a public records request.
Last March, after NPR and KFF Health News inquired about the increase in pertussis cases, the health department issued its first social media communication about the outbreak and provided interviews with other journalists.
Then, on May 1 (at least three months after the second infant death), the Department of Health made its first, and so far only, announcement. official alert To the doctor. it came up with it first press release The next day, May 14, a press conference was held regarding whooping cough.
By then, 42 people had been hospitalized with whooping cough since the outbreak began, three-quarters of whom were not up to date with their pertussis vaccination. According to the Louisiana Department of Health.
More than two-thirds of hospitalized patients were infants under 1 year of age.
Cases of whooping cough continued to rise in Louisiana throughout the summer. However, the state health department made no further public communications.
NPR and KFF Health News reached out to the Department of Health for comment on September 25. Spokesperson Emma Herrock did not answer specific questions about the lack of communication, but referred to Sept. 30. post to By the State Surgeon.
In the post, Abraham said the department “continued to report pertussis cases and provide guidance to ensure residents are protected” in 2025. He called the pertussis vaccine “one of the least controversial” and said he recommends it to his patients.
X The post includes a graphic by year of pertussis cases, omitting 2024 and 2025. The posts also provided more specific time frames for when the infant deaths occurred – one in late 2024 and the other in early 2025.
The ‘train wreck’ of the incident
Louisiana should have started warning the public within days of the first infant death rather than waiting months, said Stanford University’s Karan.
“At the very least, it should be something like, ‘Infants are at high risk. They get infected by people with weakened immune systems. If you haven’t been vaccinated, get vaccinated. If you have these symptoms, get tested.'”
Deaths from vaccine-preventable diseases are tragic, he said, but they can also be an opportunity to educate the public about the benefits of vaccines and save lives. Joshua SharpsteinHe is a former Maryland health secretary and current professor at the Johns Hopkins Bloomberg School of Public Health.
“The risk of whooping cough is always there, but when you have two infant deaths, it’s a really good opportunity to communicate that this is a real threat to children’s health,” Sharfstein said.
Karan said the Louisiana Department of Health could be preparing for a more serious outbreak if it doesn’t act sooner.
“Because what we’re seeing is it’s like a train wreck leading to an insanely large outbreak and a lot of hospitalizations,” he said.
ongoing outbreak
As of September 20, the most recent date for which data is available, Louisiana’s tally is as follows: 387 cases of whooping cough 2025, according to the Centers for Disease Control and Prevention (CDC). Looking at data since 1990, previous high In 2013, there were 214 cases.
As of the September 30 post in
He said health authorities must respond proactively and consistently. Joseph BocciniPresident, Louisiana Chapter, American Academy of Pediatrics.
He said health officials “need to regularly update people and remind them what they need to do.” “Get the vaccine. Mom, if you’re pregnant, get the vaccine. And if you have a coughing illness, see a doctor.”
Benjamin, of the American Public Health Association, said the ongoing goal of public health communication is to prevent the next hospitalization or death.
“The bottom line is it’s not too late,” he said. “It is not too late to be much more proactive and proactive in tackling whooping cough.”
This article was produced in partnership with: WWNO, NPRKFF Health News.
