Louisiana officials waited to warn of whooping cough outbreak : Shots

When a vaccine-preventable disease outbreak occurs, state health officials typically take specific steps to warn residents and release public information about the growing threat.

This is standard practice, public health and infectious disease experts told NPR and KFF Health News. The goal is to protect as many other vulnerable people as possible from getting the disease and to remind the public about the benefits of vaccinations.

But in Louisiana this year, public health officials did not appear to be following that playbook during the state's worst whooping cough outbreak in 35 years.

Whooping cough, also called whooping cough, is a highly contagious, vaccine-preventable disease that is especially dangerous for very young children. It can cause vomiting and difficulty breathing, and serious infections can lead to pneumonia, seizures and, in rare cases, death.

Dr. Madison Flake, a pediatrician in Baton Rouge, Louisiana, cared for a child who was hospitalized during this year's outbreak. At less than 2 months he was sent to intensive care.

“He would have these very dramatic coughing spells,” Flake said. “He stopped breathing for periods ranging from a few seconds to almost a minute.”

Infants are not eligible for their first whooping cough vaccine until they reach 2 monthsbut they can acquire immunity if their mother was vaccinated during pregnancy.

By the end of January 2025, two babies had died in Louisiana.

But the Louisiana Department of Health waited two months to send out a message on social media inviting people to talk to their doctors about getting vaccinated.

It took the department even longer to issue a statewide order. health warning doctors, send out a press release or hold a press conference.

Experts say such delays are unusual. Dr. Georges Benjamincompany executive director American Public Health Association.

“Especially with these childhood diseases, we tend to talk about them all the time,” said Benjamin, who led the health departments in Maryland and the District of Columbia. “These are preventable diseases and preventable deaths.”

As infectious diseases spread exponentially, if officials don't warn the public quickly, they will miss a key chance to prevent further spread, he said. Dr. Abraar Karanprofessor of infectious diseases at Stanford University who has worked on outbreaks of COVID-19 and smallpox virus.

“Time is perhaps one of the most important currencies you have,” he added.

Amid the outbreak, the state's surgeon general has stopped promoting all vaccines in the state.

Because immunity to the whooping cough vaccine wanes over time, cases of the disease may come and go over time. But in September 2024, Louisiana health officials began seeing a “substantial” increase in whooping cough cases, part of a national health program. increase in cases.

In late January 2025, doctors at a Louisiana hospital warned their colleagues that two infants had died as a result of the outbreak.

February 13 State Surgeon General Ralph Abrahamsent a memo to employees stopping general vaccine promotion and public vaccination events.

He sent the email hours after Robert F. Kennedy Jr., an anti-vaccination activist, won Senate confirmation as the new U.S. Secretary of Health and Human Services.

Also on that day Abraham published public note on the Louisiana Department of Health website. In it, he said public health had exceeded vaccination recommendations, which he said were based on a “universal collectivist mentality.” Abraham named vaccines for COVID-19″dangerous“and there was active supporter Kennedy.

Four days later, in response to an inquiry from a television news station in New Orleans, the Louisiana Department of Health confirmed for the first time the deaths of two infants from whooping cough in an email. WVUE Fox 8 then published the news.

But the Louisiana Department of Health did not send out any warnings, according to a review of external and internal communications by NPR and KFF Health News.

Over the next month, two more infants were hospitalized with whooping cough, according to Internal Health Department emails obtained through a public records request.

In March, after inquiries from NPR and KFF Health News about the growing number of whooping cough cases, the health department posted its first report of the outbreak on social media and invited interviews with other journalists.

Then, in May—at least three months after the second child death—the health department issued what appeared to be its first, and so far only, official document. anxiety doctors. It released its first press releaseand then on May 14 she held a press conference about whooping cough.

By then, 42 people, three-quarters of whom had not been up-to-date with whooping cough vaccinations, had been hospitalized for whooping cough since the outbreak began. according to the Louisiana Department of Health.

More than two-thirds of those hospitalized were infants under 1 year of age.

Throughout the summer, the number of whooping cough cases in Louisiana continued to rise. But there has been no further public communication from the Louisiana Department of Health.

NPR and KFF reached out to the department for comment on September 25. The spokeswoman did not respond to specific questions about the lack of communication, but referred to the September 30 message. publish on X from the state surgeon general.

In his message, Abraham said the department “consistently reported cases of whooping cough and made recommendations to help residents stay protected” in 2025. He called the whooping cough vaccine “one of the least controversial” and said he recommends it to his patients.

The X post included a graph of whooping cough cases by year, excluding 2024 and 2025. The report also acknowledged for the first time that one of the child deaths occurred in late 2024.

“Trainwreck” of cases and hospitalizations

Louisiana should have started warning the public within days or weeks of the first baby's death, rather than waiting months, Stanford's Karan said.

“At a minimum, it should be like active advocacy: 'Hey, babies are at high risk. They become infected by people whose immune systems are weakened. If you have not been vaccinated, get vaccinated. If you have these symptoms, get tested,” Karan said.

While dying from vaccine-preventable diseases is tragic, it can also serve as an opportunity to educate the public about the benefits of vaccines and try to save lives, according to Dr. Joshua Sharfsteinformer Maryland Secretary of Health and professor at Johns Hopkins Bloomberg School of Public Health.

“The risk of whooping cough is always there, but when you have two child deaths, it's a really good opportunity to communicate that this is a real threat to children's health,” Sharfstein said.

By not acting faster, Karan believes the department may have prepared for a more serious outbreak.

“Because after that we see a train wreck, an insanely large outbreak and a lot of hospitalizations,” Karan said.

The outbreak continued

As of September 20, Louisiana counted 387 cases of whooping cough in 2025According to the Centers for Disease Control and Prevention. Previous 35 year high in 2013 there were 214 cases.

Prior to the Sept. 30 X publication, the Louisiana Department of Health did not appear to have issued any public reports on whooping cough in the previous four months as hospitalizations continued and incidence rates exceeded 2013 levels.

The health department must respond aggressively and consistently, he said. Dr. Joseph BocchiniPresident of the Louisiana Chapter of the American Academy of Pediatrics.

“Where people are regularly updated and reminded of what needs to be done,” he said. “Get vaccinated. Moms, if you are pregnant, get vaccinated. And if you have a cough, consult a doctor.”

This story comes from NPR's health reporting partnership with WWNO And KFF health news.