The Pan American Health Organization (PAHO) is urging countries across the Americas to urgently strengthen routine immunization as whooping cough continues to surge region-wide, according to a new epidemiological update released Monday.
The respiratory disease, officially known as pertussis, has risen sharply worldwide. Global cases climbed to 977,000 in 2024, nearly six times the 167,407 recorded in 2023. The Western Pacific reported the majority of infections (591,193), followed by Europe (296,543).
A similar rise is unfolding in the Americas. After reaching a historic low of 3,284 cases in 2022, regional infections jumped to 11,202 in 2023 and climbed again to 66,184 in 2024. Between January and November 2025, ten countries included in PAHO’s analysis reported additional increases. Full regional totals for 2025 will be published next year.
“Whooping cough is a vaccine-preventable disease, but its resurgence highlights gaps in immunization and epidemiological surveillance,” said Dr. Daniel Salas, Executive Manager of PAHO’s Special Program on Integrated Immunization. “It is urgent that countries ensure high and consistent vaccination coverage, especially among children under five, to protect the most vulnerable and prevent outbreaks,” he added.
Vaccination setbacks and high-risk groups
PAHO noted that immunization coverage in the Americas fell to its lowest point in 20 years during the COVID-19 pandemic—87% for the first DTP dose (DTP1) and 81% for the third dose (DTP3). Coverage improved in 2024 to 89% and 87%, respectively, but significant disparities persist between and within countries.
The organization recommends all countries reach at least 95% coverage with the full three-dose DTP series in children under one year old and ensure booster doses through childhood and adolescence. But in 2024, only 21 countries met the 95% benchmark for DTP1; ten fell between 90–94%, another ten between 80–89%, and four reported coverage below 80%.
Children under 12 months remain the most vulnerable, representing 30–40% of cases in Argentina, Brazil, and Colombia. Outbreaks have also emerged in rural and Indigenous communities where vaccination rates are lower.
PAHO’s recommendations for countries
PAHO is calling on governments to:
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Strengthen epidemiological surveillance and laboratory confirmation of cases.
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Ensure vaccination coverage above 95% in children and provide boosters for pregnant women and healthcare workers, especially maternity staff and infant caregivers.
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Implement respiratory isolation for suspected or confirmed cases and provide timely antibiotic treatment.
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Promote early diagnosis and public awareness among health workers and communities.
“Timely and complete vaccination, together with robust surveillance, is the most effective strategy to prevent whooping cough, a disease that can cause severe illness, complications, or even death, especially in unvaccinated children under one year,” Dr. Salas emphasized.
