Research and analysis

Laboratory confirmed cases of pertussis in England: July to September 2025

Updated 26 February 2026

Applies to England

Introduction

This report summarises data on laboratory-confirmed cases of pertussis reported in England between July and September 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 for January to June 2025, has 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 of pertussis by quarter in England: 2011 to September 2025 (Q3) [note 1]

Note 1: data for 2024 and 2025 is provisional.

The number of cases continued to decrease between April and June 2025 and remained very low between July and September 2025 (Figure 2).

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

Note 1: data for 2024 and 2025 is provisional.

Laboratory confirmed cases and incidence

In England, there were 101 laboratory confirmed cases of pertussis – culture, PCR, serology or oral fluid (OF) – reported to the UKHSA pertussis enhanced surveillance programme in the third quarter of 2025, from July to September (Table 1).

Table 1. Laboratory confirmed cases of pertussis by laboratory test method in England: July to September 2025 [note 1][note 2][note 3]

Age group	Culture	PCR	Serology	OF	Not reported	Total
Under 3 months	0	2	0	0	0	2
3 to 5 months	0	1	0	0	0	1
6 to 11 months	0	7	0	0	0	7
1 to 4 years	0	5	0	3	0	8
5 to 9 years	0	2	0	2	0	4
10 to 14 years	0	1	1	3	0	5
15 years and over	1	9	63	0	1	74
Total	1	27	64	8	1	101

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: details of test method were not reported.

The total number of cases in this quarter was 66% lower than the 168 cases reported in the second quarter of 2025 and substantially lower than the 3,451 cases reported in the third quarter of 2024 ^{[footnote 1]} (Figure 1 and Table 2).

Table 2. Laboratory-confirmed cases of pertussis, by age and year, in England: July to September, 2018 to 2025 [note 1][note 4]

Age group	2018	2019	2020	2021	2022	2023	2024	2025
Under 3 months	16	29	1	0	0	16	94	2
3 to 5 months	11	12	1	0	2	4	47	1
6 to 11 months	7	6	0	0	0	10	68	7
1 to 4 years	40	72	1	1	1	26	249	8
5 to 9 years	41	72	0	1	2	25	348	4
10 to 14 years	73	125	3	0	1	61	386	5
15 years and over	720	856	29	7	13	125	2259	74
Total	908	1174	35	9	19	267	3451	101

Note 1: data for 2024 and 2025 is provisional.
Note 4: 2019 total excludes 2 cases where the age was not known.

Of the 101 cases confirmed between July and September 2025, 73.3% (74 cases) were in those aged 15 years or older with 5.0% in children aged between 10 and 14 years (5 cases), 4.0% (4 cases) in children aged 5 to 9 years, 7.9% (8 cases) aged 1 to 4 years and 9.9% (10 cases) under one year of age (Table 1). Only 3 cases were confirmed in infants aged under 3 months between January and March 2025, 5 cases between April and June 2025 and 2 cases between July and September 2025.

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).

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.

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 September 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. Sadly this includes one infant death reported between January and September 2025 ^{[footnote 2]}. Of the 33 infants that died, 27 had mothers who were not vaccinated in pregnancy.

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 increased from April 2024 reaching 72.9% in September 2025. Coverage for 2025 quarter 3 (July to September) was 71.9%, which was 7.5 percentage points higher than the coverage for the same quarter in 2024. Whilst monthly coverage has been steadily increasing in recent months, 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 July and September 2025 for DTaP/IPV/Hib/HepB immunisation across England, was 90.4% for 3 doses at 12 months of age, 0.7 percentage point decrease from the previous quarter. Coverage estimates for DTaP/IPV (pre-school booster) by fifth birthday increased by 0.5 percentage point to 81.8%.

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.

1. The numbers 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.  ↩