Following a period of reduced pertussis activity during 2020–2021, South Africa experienced a marked resurgence in 2022 and 2023. Case numbers declined through 2024 but have shown a gradual increase during 2025.
From January to October 2025, a total of 483 confirmed pertussis cases were reported nationally through the Notifiable Medical Conditions (NMC) surveillance system. Over half the cases (273/483, 56%) occurred in children under five years of age, with approximately one in four (128/483, 26%) cases being infants six months or younger.
Most cases were reported from Gauteng and the Western Cape provinces, which account for 111 (23%) and 162 (34%) of all reported cases, respectively.
Clinicians are therefore encouraged to consider pertussis (whooping cough) in the differential diagnosis of respiratory illness, particularly among infants and unvaccinated individuals, as surveillance continues to monitor these trends.
Whooping cough: Why are the rates on the rise again?
Pertussis, caused by Bordetella pertussis, is a vaccine-preventable respiratory infection and a notifiable medical condition. In South Africa, pertussis vaccination is included in the Expanded Programme on Immunisation (EPI), with doses administered during infancy and booster doses given at six and twelve years.
In addition, maternal vaccination against pertussis was introduced in 2024 to protect newborns in the first months of life. Immunity following vaccination is thought to last for 5–6 years, and periodic increases in pertussis cases occur in vaccinated populations every 3–5 years.