Research and analysis

Laboratory confirmed cases of pertussis in England: April to June 2025

Published 28 August 2025

Applies to England

Introduction

This report summarises data on laboratory-confirmed cases of pertussis reported in England between April and June 2025. This report covers confirmed case numbers and their distribution, information on deaths related to pertussis, and data on vaccination uptake through the childhood and maternal programmes. Data for 2024 and January to March 2025 have previously been published.

Pertussis is a cyclical disease, with increases occurring every 3 to 5 years, and seasonal activity usually peaking each year in quarter 3 (July to September). Prior to the COVID-19 pandemic the last major outbreak occurred in 2012 and cyclical increase in 2016. Intervention measures implemented to help control the spread of COVID-19 also had an impact on other infectious diseases, including pertussis. Consequently, pertussis activity was exceptionally low across England from April 2020 and persisted at very low levels until summer 2023 when case numbers began to increase (Figure 1).

This increase continued into 2024 peaking in May and then fell but remained elevated compared to recent pre-pandemic years between June and October 2024. Total confirmed cases in November and December 2024 were similar to those observed in the same months in the years preceding the COVID-19 pandemic. Monthly case numbers between January and March 2025 continued to decrease and were in line with those reported in relatively low non-peak years (Figure 1).

Laboratory confirmed cases and incidence

In England, there were 169 laboratory confirmed cases of pertussis – culture, PCR, serology or oral fluid (OF) – reported to the UKHSA pertussis enhanced surveillance programme in the second quarter of 2025, from April to June (table 1). Total number of cases in this quarter were half of the 333 cases reported in the first quarter of 2025 ^{[footnote 1]} and substantially lower than the 7,554 cases reported in the second quarter of 2024 (Figure 1 and Table 2).

Of the 169 cases confirmed between April and June 2025, 72.8% (123 cases) were in those aged 15 years or older with 9.5% in children aged between 10 and 14 years (16 cases), 5.9% (10 cases) in children aged 5 to 9 years, 6.5% (11 cases) aged 1 to 4 years and 5.3.% (9 cases) under one year of age (Table 1).

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 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 and reached 433 cases in 2024. Incidence continued to be highest in infants under 3 months in 2024 at 301.8 per 100,000.  The national incidence for all age groups based on laboratory confirmations in England in 2024 was 25.4 per 100,000 (figure 3). Only 3 cases were confirmed in infants aged under 3 months between January and March 2025 and 5 cases between April and June 2025.

Deaths

In the 12 years prior to the introduction of maternal pertussis vaccination in October 2012, 64 deaths occurred in babies aged under one year with confirmed pertussis.

Since the introduction of pertussis vaccination in pregnancy, from 2013 to the end of June 2025, there have been 33 deaths in babies with confirmed pertussis who were all too young to be fully protected by infant vaccination, some of whom had coinfections and/or underlying health complications. Of the 33 infants that died, 27 had mothers who were not vaccinated in pregnancy. Sadly this includes one infant death reported between January and June 2025 ^{[footnote 2]}.

Maternal vaccination programme

Maternal vaccination is very effective against pertussis disease and hospitalisation in young infants (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 had 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 72.6% in March 2025. Coverage for 2025 quarter 1 (January to March) was 71.3%, which was 12.1 percentage points higher than the coverage for the same quarter in the 2023 to 2024 financial year. Monthly coverage has been steadily increasing since April 2024, although it remains below the historic peak of 76.2% reported in December 2016. The increase in coverage may be partially explained by improved data flows ^{[footnote 3]}.

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.

Childhood vaccination programme

The national vaccination schedule recommends pertussis vaccination at 8, 12 and 16 weeks of age and a pre-school booster at 3 years and 4 months. Children born on or after 1 July 2024 will also have an appointment at 18 months of age when they will be offered a fourth dose of DTaP/IPV/Hib/HepB vaccine.

Vaccine coverage estimates for 2025, evaluated between January and March 2025 for DTaP/IPV/Hib/HepB immunisation across England, was 91.5% for 3 doses at 12 months of age, 0.1 percentage point increase from the previous quarter. Coverage estimates for DTaP/IPV (pre-school booster) by fifth birthday increased by 1.0 percentage point to 82.7.

Guidance

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 quarter in England: 2011 to June 2025 (Q2) [note 1]

Table 1. Laboratory confirmed cases of pertussis by laboratory test method in England: April to June 2025 [note 1] [note 2]

Age group	Culture	PCR	Serology	Oral fluid only	Total
Under 3 months	1	4	0	0	5
3 to 5 months	0	0	0	0	0
6 to 11 months	1	3	0	0	4
1 to 4 years	0	7	1	3	11
5 to 9 years	0	0	3	7	10
10 to 14 years	1	1	5	9	16
15 years and over	0	13	108	2	123
Total	3	28	117	21	169

Figure 2. Laboratory confirmed cases of pertussis by month in England: 2018 to June 2025 [note 1]

Table 2. Laboratory-confirmed cases of pertussis, by age and year, in England: April to June, 2018 to 2025 [note 1] [note 3]

Age group	2018	2019	2020	2021	2022	2023	2024	2025
Under 3 months	10	23	13	0	1	8	219	5
3 to 5 months	7	8	6	0	0	11	119	0
6 to 11 months	2	8	2	0	0	10	116	4
1 to 4 years	16	29	10	2	4	11	438	11
5 to 9 years	42	65	7	0	0	7	965	10
10 to 14 years	82	155	22	0	1	15	1,384	16
15 years and over	521	681	73	7	7	44	4,313	123
Total	680	969	133	9	13	106	7,554	169

Figure 3. Annual incidence by age group of laboratory-confirmed cases of pertussis in England: 2011 to 2024 [note 1]

Note 1: Data for 2024 and 2025 is provisional.

Note 2: Culture-confirmed cases may additionally have tested positive by any other method; PCR-confirmed cases may have additionally tested positive by serology or oral fluid; and serology-confirmed cases may also have been confirmed by oral fluid. Cases are only represented once in the table.

Note 3: 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.  ↩

3. A new point of care app developed by NHSE to record vaccination events was introduced in September 2024. The Record a Vaccination service (RAVs) has improved dataflows into general practice, which may partially account for the increase in coverage reported in recent months. ↩