Chennai: When a baby boy was brought to a clinic in Karaikudi in early 2025, he was coughing so hard his skin turned blue. He was 15 days old.Doctors gave him cough suppressants. When that failed, his parents took him to another hospital, then another. He was then admitted to a medical college in Madurai for 10 days, where doctors suspected acid reflux or a structural airway defect called tracheoesophageal fistula. Neither diagnosis held.Finally, he was referred to the Chennai-based Institute of Child Health, where doctors drew two swabs from his nose and throat. The state public health laboratory, which ran tests confirmed doctor’s suspicion: Bordetella pertussis, which causes ‘whooping cough’. He recovered after treatment with azithromycin and was discharged with instructions for follow-up at the Vaccine Preventable Diseases clinic.More than a year later now, the case has now been documented by public health officers Krishnaveni A and Meenachi from the directorate of public health in the latest edition of Tamil Nadu Journal of Public Health and Medical Research. “Maternal vaccination during pregnancy can provide passive immunity to neonates, offering protection during the vulnerable early weeks of life,” the authors write.In the United Kingdom and the United States, pregnant women routinely receive a pertussis booster — Tdap — in their third trimester. Antibodies cross the placenta, shielding newborns before their own vaccine schedule begins. India’s schedule, which most govt hospitals follow, offers pregnant women only Td, which covers tetanus and diphtheria but not whooping cough.Dr Baranidharan B, who heads Tamil Nadu’s state immunisation wing, explained the window of vulnerability. “The first dose of vaccine against pertussis for children is given in the sixth week as the pentavalent vaccine. The second and third doses are given at 10 and 14 weeks. Two booster doses of DPT are given at one-and-a-half years and again between five and six years,” he said. At 15 days, this baby had reached none of those milestones. Tamil Nadu had six pertussis cases in 2025 and has logged two this year. “Older children get it because of a lack of adequate vaccination,” Dr Baranidharan said.The authors also make a second recommendation for paediatricians and frontline doctors. “Healthcare providers,” they write, must consider pertussis “in the differential diagnosis of neonates presenting with cough and respiratory distress” — a call to ensure that whooping cough is never again the last possibility considered when a newborn cannot stop coughing.
