When there\u2019s an outbreak of a vaccine-preventable disease, state health officials typically take certain steps to alert residents and issue public updates about the growing threat. That\u2019s standard practice, public health and infectious disease experts told KFF Health News and NPR. The goal is to keep as many other vulnerable people as possible from getting sick and to remind the public about the benefits of vaccinations.<\/p>\n
But in Louisiana this year, public health officials appeared to have not followed that playbook during the state\u2019s worst whooping cough outbreak in 35 years.<\/p>\n
Whooping cough, also called pertussis, is a highly contagious, vaccine-preventable disease that\u2019s particularly dangerous for the youngest infants. It can cause vomiting and trouble breathing, and serious infections can lead to pneumonia, seizures, and, rarely, death.<\/p>\n
Madison Flake, a pediatric resident in Baton Rouge, cared for a baby who was hospitalized during this year\u2019s outbreak. Less than 2 months old, he was sent to the intensive care unit.<\/p>\n
\u201cHe would have these bouts of very dramatic coughing spells,\u201d Flake said. \u201cHe would stop breathing for several seconds to almost a minute.\u201d<\/p>\n
Infants are not eligible for their first pertussis vaccine until they are 2 months old<\/a>, but they can acquire immunity if the mother is immunized while pregnant.<\/p>\n By late January, two babies had died in Louisiana.<\/p>\n 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 even longer to issue a statewide health alert<\/a> to physicians, send out a press release, or hold a news conference.<\/p>\n That lag is not typical, according to Georges Benjamin<\/a>, the executive director of the American Public Health Association.<\/p>\n \u201cParticularly for these childhood diseases, we usually jump all over these,\u201d said Benjamin, a physician who has led health departments in Maryland and Washington, D.C. \u201cThese are preventable diseases and preventable deaths.\u201d<\/p>\n Because infectious diseases spread exponentially, if officials don\u2019t alert the public quickly, they lose a key chance to prevent further infections, said Abraar Karan<\/a>, an instructor at Stanford University who has worked on covid and mpox outbreaks.<\/p>\n \u201cTime is perhaps one of the most important currencies that you have,\u201d he added.<\/p>\n General Promotion of Vaccines Banned<\/strong><\/p>\n Because pertussis vaccine immunity wanes over time, cases can ebb and flow. But in September 2024, Louisiana health officials started seeing a \u201csubstantial\u201d increase in whooping cough cases, part of a national trend<\/a>.<\/p>\n In late January, physicians at one Louisiana hospital warned their colleagues that two infants had died in the outbreak.<\/p>\n On Feb. 13, the state\u2019s surgeon general, Ralph Abraham<\/a>, sent a memo to staff ending the general promotion of vaccines<\/a> and community vaccine events.<\/p>\n He sent that email a few hours after Robert F. Kennedy Jr., an anti-vaccine activist, won Senate confirmation as the new secretary of the U.S. Department of Health and Human Services.<\/p>\n Also that day, Abraham posted a public memo<\/a> on the state health department\u2019s website. In it, he said public health has overstepped with vaccine recommendations, driven by \u201ca one-size-fits-all, collectivist mentality.\u201d Abraham has called covid vaccines \u201cdangerous<\/a>\u201d and been a vocal supporter of Kennedy.<\/p>\n Four days later, in response to a request from WVUE Fox 8 News in New Orleans, the Louisiana Department of Health in an email confirmed the deaths of two infants from whooping cough for the first time. WVUE published the news<\/a> on Feb. 20.<\/p>\n But Louisiana\u2019s health department sent out no alerts, according to a review of external and internal communications by NPR and KFF Health News.<\/p>\n Over the next month, two more infants were hospitalized for whooping cough, according to internal health department emails obtained through a public records request.<\/p>\n In March, after inquiries from NPR and KFF Health News about the growing number of pertussis cases, the department put out its first social media communications about the outbreak and offered interviews to other journalists.<\/p>\n Then on May 1 \u2014 at least three months after the second infant death \u2014 the health department issued what appears to be its first and so far only official alert<\/a> to physicians. It put out its first press release<\/a> the next day and then held a news conference about pertussis on May 14.<\/p>\n By then, 42 people had been hospitalized for whooping cough since the outbreak began, three-quarters of whom were not up to date on their whooping cough immunizations, according to the Louisiana Department of Health<\/a>.<\/p>\n More than two-thirds of those hospitalized were babies under the age of 1.<\/p>\n Throughout the summer, pertussis cases continued to climb in Louisiana. But there were no further public communications from the state health department.<\/p>\n NPR and KFF Health News contacted the department for comment on Sept. 25. Emma Herrock, a spokesperson, did not answer specific questions about the lack of communications but referred to a Sept. 30 post on X<\/a> by the state surgeon general.<\/p>\n In the post, Abraham said the department \u201cconsistently reported cases of pertussis and provided guidance to help residents stay protected\u201d in 2025. He called the pertussis vaccine \u201cone of the least controversial\u201d and said he recommends it to his patients.<\/p>\n The X post included a year-by-year graphic of pertussis cases that omitted 2024 and 2025. The post also provided a more specific timeframe for when the infant deaths occurred \u2014 one in late 2024 and the other in early 2025.<\/p>\n A \u2018Train Wreck\u2019 of Cases<\/strong><\/p>\n Louisiana should have started warning the public within days of the first infant\u2019s death instead of waiting months, said Stanford\u2019s Karan.<\/p>\n \u201cAt minimum,\u201d he said, \u201cit should be like heavy promotion of: \u2018Hey, infants are at high risk. They get infected by people who have waning immunity. If you haven\u2019t gotten vaccinated, get vaccinated. If you have these symptoms, get tested.\u2019\u201d<\/p>\n Deaths from a vaccine-preventable illness are tragic, but they can also serve as an opportunity to educate the public about the benefits of vaccines and try to save lives, said Joshua Sharfstein<\/a>, a former Maryland health secretary and now a professor at the Johns Hopkins Bloomberg School of Public Health.<\/p>\n \u201cThe risk of pertussis is always there, but when you have two infant deaths it\u2019s a really good opportunity to communicate that this is a real threat to the health of children,\u201d Sharfstein said.<\/p>\n Karan said that by not acting more quickly, the Louisiana Department of Health may have set itself up for a worse outbreak.<\/p>\n \u201cBecause then what we see is this train wreck thereafter, of like an insanely large outbreak, a lot of hospitalizations,\u201d he said.<\/p>\n The Outbreak Continued<\/strong><\/p>\n As of Sept. 20, the most recent date for which data is available, Louisiana had counted 387 cases of whooping cough<\/a> in 2025, according to the Centers for Disease Control and Prevention. In data going back to 1990, the previous high<\/a> was 214 cases, in 2013.<\/p>\n Until the Sept. 30 post on X, the Louisiana Department of Health did not appear to put out any public communications about pertussis over the preceding four months, though hospitalizations continued and case levels surpassed the 2013 levels.<\/p>\n The health department should be responding aggressively and consistently, said Joseph Bocchini<\/a>, the president of the Louisiana Chapter of the American Academy of Pediatrics.<\/p>\n Health officials should make sure \u201cpeople are updated on a regular basis and reminded of what needs to be done,\u201d he said. \u201cGet your vaccines. Moms, if you\u2019re pregnant, get vaccinated. And if you have a cough illness, see your doctor.\u201d<\/p>\n Benjamin, with the American Public Health Association, said the ongoing goal of public health communication is to prevent the next hospitalization or death.<\/p>\n \u201cThe bottom line is, it\u2019s not too late,\u201d he said. \u201cIt\u2019s not too late to be much more aggressive and proactive about dealing with pertussis.\u201d<\/p>\n This article is from a partnership that includes WWNO<\/a>, NPR<\/a>, and KFF Health News.<\/em><\/em><\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\nUSE OUR CONTENT<\/h3>\n