Research and analysis

Confirmed cases of pertussis in England by month, 2025

Updated 13 March 2025

Applies to England

Confirmed cases of pertussis in England by month, to end January 2025

In England, provisionally there were 149 laboratory confirmed cases of pertussis reported to the UK Health Security Agency (UKHSA) in January 2025. There were 554 cases in January 2024 increasing by month to 3,038 in May and then decreasing by month to 179 in December ^{[footnote 1]} (Figure 1, Table 1) with 14,905 cases confirmed in total across 2024. This compares with 856 laboratory confirmed cases of pertussis reported throughout 2023. There were 10 reported deaths in infants who developed pertussis in 2024 ^{[footnote 2]}, with no infant deaths reported in January 2025.

Pertussis is a cyclical disease that peaks every 3 to 5 years, with the last cyclical increase occurring in 2016 and the last major outbreak occurring in 2012 (Figure 2, 3). Intervention measures implemented to help control the spread of COVID-19 between March 2020 and July 2021 also had an impact on other infectious diseases, including pertussis. Consequently, pertussis activity was exceptionally low across England from April 2020 and persisted at low levels until summer 2023 when case numbers began to increase (Figure 1). Overall numbers in 2023 remained lower than pre-pandemic years (Figure 2, Table 1). The high level of pertussis activity in 2024 was observed across all age groups and in every region in England. Case numbers rose across the first 5 months of 2024 to May, as expected based on usual seasonal patterns, and fell but remained elevated compared to recent pre-pandemic years between June and October. Total confirmed cases in November and December 2024 were similar to those observed in the same month in the years preceding the COVID-19 pandemic and lower than those in the last outbreak year in 2012 (1,089 and 782 cases respectively). Confirmed cases in the second quarter of 2024 were notably high, exceeding those in any quarter of the 2012 outbreak year and in the third and fourth quarters of 2024 fell to levels similar to those observed in Q3 and Q4 of 2012 (Figure 3). Monthly case numbers in January 2025 are in line with those reported in relatively low non-peak years.

Of the 149 cases confirmed in January 2025, 79.2% (118 cases) were in those aged 15 years or older with 9.4% in children aged between 10 and 14 years (14 cases), and 2.7% (4 cases) in children aged 5 to 9 years and 6.7% (10 cases) aged 1 to 4 years (Table 2).

The number of confirmed cases in infants under 3 months, who are at highest risk of severe disease and too young to be fully vaccinated, peaked at 407 cases in the earlier 2012 outbreak year then fell after the introduction of maternal vaccination. In recent years, cases in infants under 3 months increased from 2 cases in 2022 to 48 cases in 2023 but remained lower than pre-pandemic cyclical peak years; there were 83 cases in infants under 3 months in 2019 (Table 2). Incidence continued to be highest in infants under 3 months in 2024, 302.2 per 100,000 (433 cases) (Figure 2). The national incidence for all age groups based on laboratory confirmations in England in 2024 was 25.8 per 100,000. There was a single case confirmed in January 2025.

In the 12 years prior to the introduction of maternal pertussis vaccination in October 2012, 63 deaths occurred in babies aged under 1 year with confirmed pertussis. Since the introduction of pertussis vaccination in pregnancy, from 2013 to the end of January 2025, there have been 31 deaths in babies with confirmed pertussis who were all too young to be fully protected by infant vaccination. Of the 31 infants that died, 25 had mothers who were not vaccinated in pregnancy. No infant deaths were reported in January 2025 (provisional data) ^{[footnote 2]}.

Maternal vaccination is very effective against pertussis disease and hospitalisation (Optimization of Timing of Maternal Pertussis Immunization, Clinical Infectious Diseases 2023). Calculated maternal vaccine effectiveness against infant death was updated to include recent deaths to the end of August 2024 and remains very high at around 91% (unpublished UKHSA data).

Vaccine uptake levels in pregnant women, babies and young children have fallen in recent years across England. Maternal vaccine uptake fell from 74.7% in December 2017 to 58.9% in March 2024 but rose to 65.9% in September 2024. The mean coverage for 2024 quarter 3 (July to September) was 64.4%, which was 6.7 percentage points higher than the mean coverage for the same quarter in the 2023 to 2024 financial year and the second consecutive quarterly increase in coverage since quarter 4 of the 2019 to 2020 financial year. The annual coverage for 2023 to 2024 was 58.6%, 2.1 percentage points lower than the 2022 to 2023 financial year and 6.1 percentage points lower than the 2021 to 2020 financial year.

Vaccination in pregnancy is key to passively protecting babies before they can be directly protected by the infant vaccine programme. Pertussis vaccination is recommended in every pregnancy and women should normally receive their whooping cough vaccine around the time of their mid-pregnancy scan (usually 20 weeks) but can receive it from 16 weeks. To help provide optimal protection, the vaccine should be given before 32 weeks. Women who miss out can still have the vaccine later. It is also important that babies are vaccinated on time when they become eligible for infant doses at 8, 12 and 16 weeks of age and that those who miss vaccination are caught up at the earliest opportunity.

Guidance on public health management during periods of increased pertussis activity was updated in 2024 and includes details on the appropriate public health actions and laboratory investigation of suspected cases of pertussis. This public health advice is informed by the age of the suspected case and time since onset of their symptoms. Appropriate confirmatory testing allows the situation to be closely monitored, ensures public health action is undertaken where needed and supports appropriate clinical management.

Figure 1. Laboratory confirmed cases of pertussis by month in England: 2018 to January 2025 [note 1]

Figure 2. Annual incidence by age group of laboratory-confirmed cases of pertussis in England: 2011 to 2024 [note 1]

Figure 3. Laboratory confirmed cases of pertussis by quarter in England: 2011 to 2024 [note 1]

Table 1. Laboratory confirmed cases of pertussis by reporting month in England: 2023, 2024 and 2025 [note 1]

Month of reporting	Total number of cases reported, 2023	Cumulative total of cases for 2023	Total number of cases reported, 2024	Cumulative total of cases for 2024	Total number of cases reported, 2025	Cumulative total of cases for 2025
January	9	9	554	554	149	149
February	9	18	914	1,468
March	11	29	1,427	2,895
April	20	49	2,109	5,004
May	33	82	3,038	8,042
June	53	135	2,421	10,463
July	72	207	1,695	12,158
August	93	300	1,057	13,215
September	102	402	704	13,919
October	101	503	507	14,426
November	110	613	300	14,726
December	243	856	179	14,905

Table 2. Laboratory confirmed cases of pertussis by age group in England: 2018 to January 2025 [note 1] [note 2]

Age group	2018	2019	2020	2021	2022	2023	2024	2025
Under 3 months	49	83	30	1	2	48	433	1
3 to 5 months	26	32	15	1	3	23	231	0
6 to 11 months	17	21	5	0	0	25	230	2
1 to 4 years	87	147	49	3	10	52	889	10
5 to 9 years	139	222	52	2	3	78	1,659	4
10 to 14 years	288	467	150	3	3	177	2,707	14
15 years and over	2,342	2,706	693	39	47	453	8,756	118
Total	2,948	3,680	994	49	68	856	14,905	149

Note 1: Data for 2024 and 2025 is provisional.

Note 2: 2019 total excludes 2 cases where the age was not known.

1. Note that the number of laboratory confirmed cases presented are provisional and can increase as further test results are finalised but also decrease if cases are confirmed as vaccinated within a year of a positive serology or oral fluid test: both recent vaccination and/or recent infection will give a positive result using these test methods. ↩

2. Deaths are reported to the UKHSA pertussis enhanced surveillance programme from Health Protection Teams, Office of National Statistics or Patient Demographic Service. These are also provisional as there can be delays in reporting of deaths in babies with whooping cough. ↩ ↩²