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When there’s 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’s standard practice, public health and infectious disease experts told �鶹Ů�� 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.

But in Louisiana this year, public health officials appeared to have not followed that playbook during the state’s worst whooping cough outbreak in 35 years.

Whooping cough, also called pertussis, is a highly contagious, vaccine-preventable disease that’s particularly dangerous for the youngest infants. It can cause vomiting and trouble breathing, and serious infections can lead to pneumonia, seizures, and, rarely, death.

Madison Flake, a pediatric resident in Baton Rouge, cared for a baby who was hospitalized during this year’s outbreak. Less than 2 months old, he was sent to the intensive care unit.

“He would have these bouts of very dramatic coughing spells,” Flake said. “He would stop breathing for several seconds to almost a minute.”

Infants are not eligible for their first pertussis vaccine until they are , but they can acquire immunity if the mother is immunized while pregnant.

By late January, two babies had died in Louisiana.

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 to physicians, send out a press release, or hold a news conference.

That lag is not typical, according to , the executive director of the American Public Health Association.

“Particularly for these childhood diseases, we usually jump all over these,” said Benjamin, a physician who has led health departments in Maryland and Washington, D.C. “These are preventable diseases and preventable deaths.”

Because infectious diseases spread exponentially, if officials don’t alert the public quickly, they lose a key chance to prevent further infections, said , an instructor at Stanford University who has worked on covid and mpox outbreaks.

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

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General Promotion of Vaccines Banned

Because pertussis vaccine immunity wanes over time, cases can ebb and flow. But in September 2024, Louisiana health officials started seeing a “substantial” increase in whooping cough cases, part of a .

In late January, physicians at one Louisiana hospital warned their colleagues that two infants had died in the outbreak.

On Feb. 13, the state’s surgeon general, , sent a memo to staff and community vaccine events.

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.

Also that day, Abraham posted a on the state health department’s website. In it, he said public health has overstepped with vaccine recommendations, driven by “a one-size-fits-all, collectivist mentality.” Abraham has called covid vaccines “” and been a vocal supporter of Kennedy.

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 on Feb. 20.

But Louisiana’s health department sent out no alerts, according to a review of external and internal communications by NPR and �鶹Ů�� Health News.

Over the next month, two more infants were hospitalized for whooping cough, according to internal health department emails obtained through a public records request.

In March, after inquiries from NPR and �鶹Ů�� 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.

Then on May 1 — at least three months after the second infant death — the health department issued what appears to be its first and so far only to physicians. It put out its the next day and then held a news conference about pertussis on May 14.

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, .

More than two-thirds of those hospitalized were babies under the age of 1.

Throughout the summer, pertussis cases continued to climb in Louisiana. But there were no further public communications from the state health department.

NPR and �鶹Ů�� 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 by the state surgeon general.

In the post, Abraham said the department “consistently reported cases of pertussis and provided guidance to help residents stay protected” in 2025. He called the pertussis vaccine “one of the least controversial” and said he recommends it to his patients.

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 — one in late 2024 and the other in early 2025.

A ‘Train Wreck’ of Cases

Louisiana should have started warning the public within days of the first infant’s death instead of waiting months, said Stanford’s Karan.

“At minimum,” he said, “it should be like heavy promotion of: ‘Hey, infants are at high risk. They get infected by people who have waning immunity. If you haven’t gotten vaccinated, get vaccinated. If you have these symptoms, get tested.’”

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 , a former Maryland health secretary and now a professor at the Johns Hopkins Bloomberg School of Public Health.

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

Karan said that by not acting more quickly, the Louisiana Department of Health may have set itself up for a worse outbreak.

“Because then what we see is this train wreck thereafter, of like an insanely large outbreak, a lot of hospitalizations,” he said.

The Outbreak Continued

As of Sept. 20, the most recent date for which data is available, Louisiana had counted in 2025, according to the Centers for Disease Control and Prevention. In data going back to 1990, the was 214 cases, in 2013.

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.

The health department should be responding aggressively and consistently, said , the president of the Louisiana Chapter of the American Academy of Pediatrics.

Health officials should make sure “people are updated on a regular basis and reminded of what needs to be done,” he said. “Get your vaccines. Moms, if you’re pregnant, get vaccinated. And if you have a cough illness, see your doctor.”

Benjamin, with the American Public Health Association, said the ongoing goal of public health communication is to prevent the next hospitalization or death.

“The bottom line is, it’s not too late,” he said. “It’s not too late to be much more aggressive and proactive about dealing with pertussis.”

This article is from a partnership that includes , , and �鶹Ů�� Health News.