SAN ANTONIO – Texas is seeing the highest number of whooping cough cases in more than a decade.
More than 3,500 cases have been reported across the state through October this year, according to the Texas Department of State Health Services, the most Texas has seen in 11 years.
According to Metro Health, the cases across San Antonio are on the rise as well. Bexar County had 72 cases reported in 2024, and there have been 197 cases reported so far in 2025.
According to infectious disease specialist Dr. Jason Bowling with University Health and UT Health San Antonio, 44 cases have been recorded with University Health this year. Last year there were 17 cases, not including November and December cases, which is usually the busiest time for respiratory illnesses.
“So about 2.5 times what we saw last year,” Bowling said.
Bowling said for most people, pertussis, also known as whooping cough, is a mild illness and they won’t end up in the hospital.
However, older adults and especially infants are at the highest risk because it can shut down their respiratory system.
“And when they stop breathing, obviously their oxygen levels can drop,” Bowling said. “They can have serious outcomes, end up at the hospital, the ICU, and worst-case scenarios, even death.”
Bowling said there has been an increase for a couple of reasons.
“We do see some periodic variation, ups and downs with whooping cough over the years,” Bowling said. “But there’s also a concerning component that there might be some people that are behind on their vaccines that could protect against pertussis, or whooping cough.”
Here is the DTaP vaccine schedule for whooping cough, according to the CDC:
- 2 months
- 4 months
- 6 months
- 15 through 18 months
- 4 through 6 years old
- One more dose between 11-12 years old
- For adults, every 10 years, especially when around infants
- Recommended that pregnant women should get it in their third trimester to transfer antibodies to the baby
The good news is there is a treatment, and you can even get preventative medicine if exposed.
“Azithromycin, often times people call it a Z-Pak, is a very effective antibiotic against pertussis,” Bowling said. “I would say that if you know that you’re exposed to somebody, even if you’ve been vaccinated, you can talk to your provider because you can’t take antibiotics for post-exposure prophylaxis, which means reducing your risk of getting pertussis.”
The challenge is getting diagnosed.
“There’s three stages to it,” Bowling said. “It’s a long cough. It starts off with just respiratory symptoms that are nonspecific. Cough, runny nose, may look like you’re just having a viral respiratory infection, and that lasts for about one to two weeks before people start having that characteristic whooping cough, those coughing episodes where it can lead to a deep breath or even vomiting because you’re coughing so hard. That doesn’t happen until after about two weeks.”
“People are most transmissible to others, or contagious to others that first two-week time period,” Bowling said. “And so you can really spread to a lot of people before it’s recognized.”
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