When a vaccine-preventable disease outbreak occurs, state public health officials routinely take specific steps to warn residents and spread the news 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 groups from getting sick and to remind the public about the benefits of vaccination.
But that protocol was not followed this year in Louisiana during the worst whooping cough outbreak in 35 years.
Whooping cough, also known as whooping cough, is a highly contagious, vaccine-preventable disease that is especially dangerous for young children. It can cause vomiting and difficulty breathing, and in severe cases can lead to pneumonia, seizures and even, although rarely, death.
Madison Flake, a Baton Rouge pediatrician, cared for a child who was hospitalized during the outbreak. A child under two months old was in intensive care.
“He was having really bad coughing fits,” Flake said. “He stopped breathing for a few seconds, almost a minute.”
Infants are not eligible to receive the first dose of whooping cough vaccine. up to 2 monthsbut they can develop immunity if the mother is vaccinated during pregnancy.
By the end of January, two infants 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.
The agency took even longer to issue state health alert contact doctors, send a statement or hold a press conference.
Georges Benjaminexecutive director of the American Public Health Association (APHA), said such a delay is not common.
“Especially with childhood illnesses, we tend to act immediately,” says Benjamin, a physician who led health departments in Maryland and Washington, D.C. “These are illnesses and deaths that are preventable.”
As infectious diseases spread exponentially, if authorities do not warn the public quickly, they are missing a key opportunity to prevent further spread of infection, he explained. Abraar Karanprofessor at Stanford University who worked on Covid and smallpox outbreaks.
“Time is perhaps one of the most important currencies we have,” he added.
General vaccine promotion is prohibited
Because the immunity provided by whooping cough vaccine wanes over time, the incidence of the disease may increase or decrease cyclically. But in September 2024, Louisiana health officials began noticing a “significant” increase in cases within national trend.
At the end of January, doctors at a public hospital warned colleagues that two infants had died during the outbreak.
February 13 State Director General of Health Ralph Abrahamsent a termination note to his employees general vaccine promotion and for vaccination activities among the population.
On the same day, hours after anti-vaccination 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 posted another note on the state department of health website.
In the document, he argued that public health had gone overboard with its vaccine recommendations, driven by a “one-size-fits-all collectivist mentality.” Abraham described Covid vaccines as “dangerous” and was Kennedy's public defender.
Four days later, in response to an inquiry from WVUE Fox 8 News in New Orleans, the Louisiana Department of Health confirmed for the first time via email the deaths of two infants from whooping cough. VVUE published the news on February 20.
But the department did not issue any warnings, according to a review of internal and external communications by NPR and KFF Health News.
Over the next month, two more infants were hospitalized with whooping cough, according to internal emails obtained through a public records request.
In March, after inquiries from NPR and KFF Health News about rising whooping cough cases, the department posted initial reports of the outbreak on social media and invited interviews with other media outlets.
Then, on May 1—at least three months after the death of the second child—the agency issued what appeared to be its first and, so far, only report. official warning aimed at doctors. The next day he published his first press release and then held a press conference on May 14 about the illness.
By then, 42 people had been hospitalized with whooping cough since the outbreak began. According to the departmentthree out of four were not up to date on their vaccines against the disease.
More than two-thirds of those hospitalized were infants under one year old.
Whooping cough rates continued to rise throughout the state over the summer. But the state health department did not release any more information about it.
NPR and KFF Health News reached out to the department for comment on Sept. 25. Spokeswoman Emma Herrock did not answer specific questions about the lack of communication, but referred to a Sept. 30 Channel X post by the state director of health.
In his message, Abraham said the department has “consistently reported cases of whooping cough and provided recommendations to help residents stay protected” in 2025. He said the whooping cough vaccine is “one of the least controversial” and that he recommends it to his patients.
Publication in
“Declared catastrophe” cases
Louisiana should have started warning the public within days of the first child's death, rather than waiting months, Stanford's Karan said.
“At a minimum,” he said, “there should have been intensive propaganda of the message: “Children are at high risk. They become infected from people who have reduced immunity. If you have not been vaccinated, get vaccinated. If you have these symptoms, get tested.”
Deaths from vaccine-preventable diseases are tragic, but they can also serve as an opportunity to educate the public about the life-saving benefits of vaccination, he said. Joshua Sharfsteinformer Maryland Secretary of Health and now a professor at the Johns Hopkins Bloomberg School of Public Health.
“The risk of whooping cough is always present, but when two children die, this is an opportunity to communicate that this is a real threat to children's health,” Sharfstein said.
Karan said that by not acting quickly, the Louisiana Department of Health could have led to a more severe outbreak.
“What we see next is a disaster, a huge outbreak, a lot of hospitalizations,” he said.
The outbreak continued
As of September 20, the most recent date for which data is available, Louisiana has recorded 387 cases of whooping cough According to the Centers for Disease Control and Prevention (CDC), in 2025. Based on data available since 1990. greatest number there were 214 cases in 2013.
The health department must respond aggressively and consistently, he said. Joseph BocchiniPresident of the Louisiana Chapter of the American Academy of Pediatrics.
Authorities must ensure that “people are regularly informed and reminded of what they need to do,” he said. “Get vaccinated. If you are pregnant, get vaccinated. And if you have an illness with a cough, consult a doctor.”
Benjamin of the American Public Health Association said the enduring goal of public health communication is to prevent the next hospitalization or death.
“The bottom line is it's not too late,” he said. “You can still be more aggressive and proactive in controlling whooping cough.”
This article is part of an alliance that includes WWNO, NPR th KFF health news.
