When vaccine-preventable diseases occur, state public health officials regularly take specific steps to warn residents and disseminate updates about the growing threat.
This is standard practice, according to public health and infectious disease experts consulted by KFF Health News and NPR. The goal is to prevent more vulnerable people from getting sick and to remind the public of the benefits of vaccination.
But that protocol was not followed in Louisiana this year during the worst whooping cough outbreak in 35 years.
Pertussis, also known as whooping cough, is a highly contagious, vaccine-preventable disease that is especially dangerous for young babies. It can cause vomiting and difficulty breathing, and in severe cases it can lead to pneumonia, seizures and, in rare cases, death.
Madison Flake, a pediatrics resident in Baton Rouge, cared for a baby hospitalized during the outbreak. The child, who was less than two months old, was hospitalized in the intensive care unit.
“He had really bad coughing fits,” Flake said. “He stopped breathing for a few seconds, almost a minute.”
Infants cannot receive the first dose of pertussis vaccine. Up to 2 monthsHowever, immunity may develop if the mother is vaccinated during pregnancy.
By the end of January, two babies had died in the state.
But it took two months for the Louisiana Department of Health to post a message on social media suggesting people talk to their doctors about getting vaccinated.
It took longer for the agency to issue it. state health alert Speak to doctors, send a statement, or hold a press conference.
george benjamin“Delays like this are not uncommon,” said the executive director of the American Public Health Association (APHA).
“Especially with childhood illnesses, we tend to act immediately. These are preventable illnesses and deaths,” said Benjamin, a physician who has led health departments in Maryland and Washington, D.C.
Because infectious diseases spread exponentially, he explained, if authorities do not quickly warn the public, they miss a critical opportunity to prevent further infections. Abra KaranI am a professor at Stanford University who studied coronavirus and M-Fox outbreaks.
“Time is probably one of the most important currencies we have,” he added.
Ban on general promotion of vaccines
Because the immunity provided by the whooping cough vaccine wanes over time, cases may periodically increase or decrease. However, in September 2024, Louisiana health officials began seeing a “significant” increase in cases as part of measures to: national trend.
In late January, doctors at a state hospital warned colleagues that two babies had died during an outbreak.
On February 13, the state health commissioner said: Ralph AbrahamA termination note was sent to the employee. General promotion of vaccines Participate in community vaccination events.
On the same day, hours after anti-vaccine activist Robert F. Kennedy Jr. was confirmed by the Senate as the new secretary of the U.S. Department of Health and Human Services (HHS), Abraham I posted another note From the state Department of Health website.
In the document, he argued that public health has over-applied vaccination recommendations based on a “one-size-fits-all collectivist mentality.” Abraham described the covid vaccine as follows: “dangerous” He was Kennedy’s public defender.
Four days later, at the request of WVUE Fox 8 News in New Orleans, the Louisiana Department of Health confirmed in an email for the first time that two babies had died from whooping cough. WVUE The news was announced on February 20th..
However, a review of internal and external communications by NPR and KFF Health News found that the department did not issue any warnings.
In the following months, two more babies were hospitalized with whooping cough, according to internal emails obtained through an open access information request.
Last March, after receiving inquiries from NPR and KFF Health News about the increase in pertussis cases, the health department posted its first social media message about the outbreak and provided interviews to other media outlets.
Then on May 1 – at least three months after the second child’s death – the department made its first, and so far only, announcement. official alert Targeted at doctors. The next day he published his writing. first press release And on May 14th, we held a press conference about this disease.
By then, 42 people had been hospitalized with whooping cough since the outbreak began. According to the departmentThree out of four people were not up to date with their vaccines for the disease.
More than two-thirds of the hospitalized patients were infants under 1 year of age.
Throughout the summer, the state continued to see an increase in whooping cough cases. However, the state health department again did not release this information.
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 the state health director’s post about X on Sept. 30.
In the post, Abraham said the department “continued to report pertussis cases and provide guidance to ensure residents are protected” in 2025. He said the pertussis vaccine was “one of the least controversial” and that he recommended it to his patients.
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The ‘anticipated disaster’ of the incident.
Louisiana should have started warning the public within days of the first child’s death rather than waiting months, said Stanford University’s Karan.
He said, “At the very least, we should have actively promoted the message, ‘Babies are at high risk. They get infected from people with weakened immune systems. If you haven’t been vaccinated, get vaccinated, and if you experience 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 getting vaccinated to 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 two children die, this is an opportunity to communicate that it poses a real threat to children’s health,” Sharfstein said.
Karan said if the Louisiana Department of Health had not acted quickly, it could have led to a more serious outbreak.
“What we’re going to see next is a disaster, a large outbreak, a lot of hospitalizations,” he said.
The outbreak continued
As of September 20, the most recent date with available data, Louisiana’s records are as follows: 387 cases of whooping cough By 2025, according to the Centers for Disease Control and Prevention (CDC). According to data obtained since 1990, highest number There were 214 cases in 2013.
“Health authorities must respond actively and consistently,” he said. Joseph BocciniPresident, Louisiana Chapter, American Academy of Pediatrics.
Authorities must “regularly inform people and remind them of what they need to do,” he said. “Get vaccinated. If you are pregnant, get vaccinated. And if you have a disease that causes coughing, consult your doctor.”
The ongoing goal of public health communication is to prevent the next hospitalization or death, said Benjamin of the American Public Health Association.
“The bottom line is it’s not too late,” he said. “We can act more aggressively and proactively to combat whooping cough.”
This article is part of an alliance that includes: WWNO, NPR y KFF Health News.
