Annette Regan, University of California, Los Angeles

Whooping cough, a bacterial infection that can be especially dangerous for babies and young children, is on the rise. Already in 2025 the U.S. has recorded 8,485 cases. That’s compared with 4,266 cases during the same period in 2024.

Like measles, which is also spreading at unprecedented levels, whooping cough, more formally known as pertussis, can be prevented by a safe
and effective vaccine. But with anti-vaccine sentiment increasing and cuts to immunization services, vaccination rates for whooping cough over the past two years have declined in children.

The Conversation asked epidemiologist Annette Regan to explain why pertussis has become so prevalent and how families can protect themselves from the disease.

What is pertussis and why is it dangerous?

Pertussis is a vaccine-preventable disease caused by the bacterium Bordetella pertussis. Researchers in France first identified the B. pertussis bacterium in 1906. The first recorded epidemic of pertussis is thought to have occurred in Paris in 1578.

Infection can cause an acute respiratory illness characterized by severe and spasmodic coughing spells. The classic symptom of pertussis is a “whoop” sound caused by someone trying to breath during a bad cough. Severe complications of pertussis include slowed or stopped breathing, pneumonia and seizures. The disease is most severe in young babies, although severe cases and deaths can also occur in older children and adults.

Some doctors call pertussis “the 100-day cough” because symptoms can linger for weeks or even months.

The World Health Organization estimates that 24.1 million pertussis cases and 160,700 deaths occur worldwide in children under 5 each year. Pertussis is highly contagious. Upon exposure, 80% of people who have not been previously exposed to the bacterium or vaccinated against the disease will develop an infection.

Fortunately, the disease is largely preventable with a safe and effective vaccine, which was first licensed in the U.S. in 1914.

How do cases last year and this year compare with past years?

During the COVID-19 pandemic between 2020 and 2022, pertussis cases were lower than usual. This may have been a result of limited social contact due to social distancing, masking, school closures and lockdown measures, which reduced the spread of disease overall.

In the past two years, however, pertussis cases have surpassed figures from before the pandemic. In 2024, local and state public health agencies reported 35,435 pertussis cases to the Centers for Disease Control and Prevention – a rate five times higher than the 7,063 cases reported in 2023 and nearly double the 18,617 cases reported in 2019 prior to the pandemic.

Between October 2024 and April 2025, at least four people in the U.S. have died of pertussis: two infants, one school-age child and one adult.

Why are pertussis cases rising?

Although vaccines have resulted in a dramatic decline in pertussis infections in the U.S., incidence of the disease has been rising since the 1990s, except for a brief dip during the COVID-19 pandemic.

Before the start of routine childhood vaccination for pertussis in 1947, its rates hovered between 100,000 and 200,000 cases per year. With vaccines, rates plunged under 50,000 annually by the late 1950s and under 10,000 per year in the late 1960s. They reached a low of 1,010 cases in 1976.

Starting in the 1980s and 1990s, however, the U.S. and several other countries have been seeing a steady resurgence of pertussis cases, which have exceeded 10,000 cases in the U.S. every year from 2003 to 2019. They dropped again during the pandemic until last year’s resurgence.

There is no single explanation for why cases have been rising recently, but several factors probably contribute. First, pertussis naturally occurs in cyclic epidemics, peaking every two to five years. It is possible that the U.S. is headed into one of these peaks after a period of low activity between 2020 and 2022. However, some scientists have noted that the increase in cases is larger than what would be expected during a usual peak.

Some scientists have noted that this apparent resurgence correlates with a change in the type of vaccine used in children. Until the 1990s, the pertussis vaccine contained whole, killed B. pertussis bacteria cells. Whole-cell vaccine can stimulate a long-lasting immune response, but it is also more likely to cause fever and other vaccine reactions in children.

In the 1990s, national vaccine programs began to transition to a vaccine that contains purified components of the bacterial cell but not the whole cell. Some scientists now believe that although this partial-cell vaccine is less likely to cause high fevers in children, it provides protection for a shorter time. Immunity after whole-cell vaccination is thought to last 10-12 years compared with three to five years after the partial-cell vaccine. This means people may become susceptible to infection more quickly after vaccination.

Vaccination rates are also not as high as they should be and have started falling in children since 2020. In the U.S., the percent of kindergartners who are up to date with recommended pertussis vaccines has declined from 95% during the 2019-20 school year to 92% in the 2023-24 school year. Even fewer adolescents receive a booster dose.

How can people protect themselves and their families?

Routine vaccination for children starting in infancy followed by booster doses in adolescents and adults can help keep immunity high.

Public health experts recommend that children receive five doses of the pertussis vaccine. According to the recommendations, they should receive the first three doses at 2, 4 and 6 months of age, then two additional doses at 15 months and 4 years of age, with the aim of providing protection through early adolescence.

Infants younger than 6 weeks are not old enough to get a pertussis vaccine but are at the greatest risk of severe illness from pertussis. Vaccination during pregnancy can offer protection from birth due to antibodies that pass from the mother to the developing fetus. Many countries, including the U.S., now recommend that women receive one dose of pertussis vaccine between the 27th and 36th week of every pregnancy to protect their babies.

To maintain protection against pertussis after childhood, a booster dose of pertussis vaccine is recommended for adolescents at 11 to 12 years of age. The CDC recommends that all adults receive at least one booster dose.

Because immunity declines over time, people who are in contact with infants and other high-risk groups, such as caregivers, parents and grandparents, may benefit from additional booster doses. When feasible, the CDC also recommends a booster dose for adults 65 years and older.

Vaccine safety studies over the past 80 years have proven the pertussis vaccine to be safe. Around 20% to 40% of vaccinated infants experience local reactions, such as pain, redness and swelling at the vaccination site, and 3% to 5% of vaccinated infants experience a low-grade fever. More severe reactions are much less common and occur in fewer than 1% of vaccinated infants.

The vaccine is also highly effective: For the first year after receiving all five doses of the pertussis vaccine, 98% of children are protected from pertussis. Five years after the fifth dose, 65% of vaccinated children remain protected.

Booster vaccination during adolescence protects 74% of teens against pertussis, and booster vaccination during pregnancy protects 91% to 94% of immunized babies against hospitalization due to pertussis.

Families can talk to their regular health care providers about whether a pertussis vaccine is needed for their child, themselves or other family members.

Annette Regan, Adjunct Associate Professor of Epidemiology, University of California, Los Angeles

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Joe Smith, University of Tennessee

A perentie lizard in Dallas, an African penguin in Boston and an Oberhasli goat in Chicago are just a few recent examples of animals at zoos and aquariums benefiting recently from acupuncture therapy. As acupuncture has gained wide use in human medicine in the U.S., it also has become increasingly common in veterinary practice, especially for pain management.

The Conversation U.S. interviewed University of Tennessee Assistant Professor of Veterinary Medicine Joe Smith, a specialist in farm animal medicine and veterinary clinical pharmacology, about this trend. He describes acupuncture’s current uses for treating many species, from household dogs and cats to large animals like horses, cows and llamas:

Is veterinary acupuncture modeled on the traditional Chinese version?

There are two schools of thought about veterinary acupuncture. The original form of acupuncture, which has been practiced for thousands of years, follows principles of traditional Chinese medicine. It views the patient through a lens of five elements: wood, fire, earth, metal and water.

Each element is associated with a different type of energy. Practitioners work to maintain balance between those energies, which they believe is essential for a healthy body to function.

Another approach focuses on anatomical effects on the body. Practitioners place needles to achieve specific effects by stimulating muscles or nerves.

Both versions of acupuncture can help veterinary patients. They use very small, flexible needles, about two-tenths of a millimeter wide – less than one-hundredth of an inch. The needles are placed at various parts of the body to elicit specific responses from connective tissues, muscles and nerves.

The needles can be used by themselves, or with low levels of electrical current – a process called electroacupuncture. Both approaches are effective, but research suggests that benefits from electroacupunture last longer.

What does research show about using acupuncture on animals?

Acupuncture and electroacupuncture both increase the body’s levels of compounds called endogenous opioids. These are pain-relieving substances that the body produces naturally. They work similarly to pharmaceutical opioids, such as fentanyl and morphine.

Acupuncture increases these compounds so dramatically that the effect can be reversed with opioid antidotes, such as Narcan.

Studies in small animal medicine show that using acupuncture can speed up healing from nerve injuries, such as spinal cord damage from herniated disks. This is a condition in which material from the disks in between the vertebra of the spinal cord is damaged, and puts pressure on the spinal cord and other parts of the nervous system.

Herniated disks can be very painful for animals. A 2023 study found that when dogs with this condition were treated with acupuncture, nearly 80% recovered, compared with 60% of animals whose cases were managed conservatively without acupuncture. Acupuncture can also make other techniques, such as epidural nerve blocks, more effective when both methods are used together.

Many vets are using acupuncture creatively for other purposes, such as increasing sick animals’ appetites, improving their digestion and accelerating healing from injuries.

How does your veterinary medicine group use acupuncture?

Our practice at the University of Tennessee has used acupuncture most extensively to help rehabilitate animals recovering from conditions like radial nerve paralysis and femoral nerve injury. We can use acupuncture to stimulate muscles or to provide pain relief, either by itself or combined with other therapies.

In our Farm Animal Hospital, we regularly use acupuncture for recumbent or “down” animals. That’s a veterinary term for animals that have been unable to stand for extended periods of time.

With acupuncture, and occasionally electroacupuncture, we can stimulate muscles and nerves that aren’t functioning normally. This help to prevent atrophy, or wasting and thinning of muscle mass.

For every day that a large animal is down, its muscles atrophy and fluid builds up around injured limbs or joints. These effects can prolong their recovery, or even make it less likely that they will recover.

By using acupuncture to stimulate atrophied muscles, veterinarians can start to reverse this process. We have used acupuncture extensively on large animals, including cattle, horses, llamas, alpacas, sheep, goats, pigs and even camels.

One example is goats that have spinal cord injuries caused by parasite migration – a condition called cerebrospinal nematodiasis, or “meningeal worm.” Worm larvae that normally are parasites of white tail deer infect goats through the animals’ digestive tracts, then migrate to the spinal cord and nervous system. They get lost and die there, causing inflammation that can do significant damage.

We use acupuncture and electroacupuncture to stimulate the goats’ large and accessory spinal nerves and the muscles in the animals’ legs and backs. This gives the goats more muscle function when the inflammation clears, and we believe it helps reduce their pain.

We’ve also had good results with acupuncture treatment for llamas and alpacas, which are widely used in Tennessee’s Smokey Mountains to carry tourists’ gear up- and downhill. As large animals like these age, they can develop osteoarthritis, a degenerative joint disease that’s incredibly painful and debilitating for them. Acupuncture and electroacupuncture can help keep them moving.

Our equine services mainly use acupuncture for rehabilitation, helping horses recover from injuries.

One advantage of acupuncture and electroacupuncture in large animals is that they don’t have many adverse effects. Drugs can have side effects such as nausea and diarrhea, and may cause potentially serious complications. An acupuncture needle placed by a trained veterinarian has few to no adverse effects when it’s done correctly.

Can pet owners be confident if their vet recommends acupuncture?

If there is a nerve or muscle involved, there is probably a veterinary treatment option using acupuncture or electroacupuncture. New studies regularly add to our understanding of the neurology and biochemistry that underlie these therapies.

Although we’re still learning, if your vet recommends acupuncture for an aging dog or cat – especially for chronic pain – you can be confident that it’s not a fringe treatment. As long as the person treating your pet is a licensed veterinarian, and is certified by a professional organization like Curacore, Chi University or the American Academy of Veterinary Acupuncture, acupuncture should make your pet more comfortable and improve its quality of life.

Joe Smith, Assistant Professor of Veterinary Medicine, University of Tennessee

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Jeffrey MacKeigan, Michigan State University

Cancer research in the U.S. doesn’t rely on a single institution or funding stream − it’s a complex ecosystem made up of interdependent parts: academia, pharmaceutical companies, biotechnology startups, federal agencies and private foundations. As a cancer biologist who has worked in each of these sectors over the past three decades, I’ve seen firsthand how each piece supports the others.

When one falters, the whole system becomes vulnerable.

The United States has long led the world in cancer research. It has spent more on cancer research than any other country, including more than US$7.2 billion annually through the National Cancer Institute alone. Since the 1971 National Cancer Act, this sustained public investment has helped drive dramatic declines in cancer mortality, with death rates falling by 34% since 1991. In the past five years, the Food and Drug Administration has approved over 100 new cancer drugs, and the U.S. has brought more cancer drugs to the global market than any other nation.

But that legacy is under threat. Funding delays, political shifts and instability across sectors have created an environment where basic research into the fundamentals of cancer biology is struggling to keep traction and the drug development pipeline is showing signs of stress.

These disruptions go far beyond uncertainty and have real consequences. Early-career scientists faced with unstable funding and limited job prospects may leave academia altogether. Mid-career researchers often spend more time chasing scarce funding than conducting research. Interrupted research budgets and shifting policy priorities can unravel multiyear collaborations. I, along with many other researchers, believe these setbacks will slow progress, break training pipelines and drain expertise from critical areas of cancer research – delays that ultimately hurt patients waiting for new treatments.

A 50-year foundation of federal investment

The modern era of U.S. cancer research began with the signing of the National Cancer Act in 1971. That law dramatically expanded the National Cancer Institute, an agency within the National Institutes of Health focusing on cancer research and education. The NCI laid the groundwork for a robust national infrastructure for cancer science, funding everything from early research in the lab to large-scale clinical trials and supporting the training of a generation of cancer researchers.

This federal support has driven advances leading to higher survival rates and the transformation of some cancers into a manageable chronic or curable condition. Progress in screening, diagnostics and targeted therapies – and the patients who have benefited from them – owe much to decades of NIH support.

But federal funding has always been vulnerable to political headwinds. During the first Trump administration, deep cuts to biomedical science budgets threatened to stall the progress made under initiatives such as the 2016 Cancer Moonshot. The rationale given for these cuts was to slash overall spending, despite facing strong bipartisan opposition in Congress. Lawmakers ultimately rejected the administration’s proposal and instead increased NIH funding. In 2022, the Biden administration worked to relaunch the Cancer Moonshot.

This uncertainty has worsened in 2025 as the second Trump administration has cut or canceled many NIH grants. Labs that relied on these awards are suddenly facing funding cliffs, forcing them to lay off staff, pause experiments or shutter entirely. Deliberate delays in communication from the Department of Health and Human Services have stalled new NIH grant reviews and funding decisions, putting many promising research proposals already in the pipeline at risk.

Philanthropy’s support is powerful – but limited

While federal agencies remain the backbone of cancer research funding, philanthropic organizations provide the critical support for breakthroughs – especially for new ideas and riskier projects.

Groups such as the American Cancer Society, Stand Up To Cancer and major hospital foundations have filled important gaps in support, often funding pilot studies or supporting early-career investigators before they secure federal grants. By supporting bold ideas and providing seed funding, they help launch innovative research that may later attract large-scale support from the NIH.

Without the bureaucratic constraints of federal agencies, philanthropy is more nimble and flexible. It can move faster to support work in emerging areas, such as immunotherapy and precision oncology. For example, the American Cancer Society grant review process typically takes about four months from submission, while the NIH grant review process takes an average of eight months.

But philanthropic funds are smaller in scale and often disease-specific. Many foundations are created around a specific cause, such as advancing cures for pancreatic, breast or pediatric cancers. Their urgency to make an impact allows them to fund bold approaches that federal funders may see as too preliminary or speculative. Their giving also fluctuates. For instance, the American Cancer Society awarded nearly $60 million less in research grants in 2020 compared with 2019.

While private foundations are vital partners for cancer research, they cannot replace the scale and consistency of federal funding. Total U.S. philanthropic funding for cancer research is estimated at a few billion dollars per year, spread across hundreds of organizations. In comparison, the federal government has typically contributed roughly five to eight times more than philanthropy to cancer research each year.

Industry innovation − and its priorities

Private-sector innovation is essential for translating discoveries into treatments. In 2021, nearly 80% of the roughly $57 billion the U.S. spent on cancer drugs came from pharmaceutical and biotech companies. Many of the treatments used in oncology today, including immunotherapies and targeted therapies, emerged from collaborations between academic labs and industry partners.

But commercial priorities don’t always align with public health needs. Companies naturally focus on areas with strong financial returns: common cancers, projects that qualify for fast-track regulatory approval, and high-priced drugs. Rare cancers, pediatric cancers and basic science often receive less attention.

Industry is also saddled with uncertainty. Rising R&D costs, tough regulatory requirements and investor wariness have created a challenging environment to bring new drugs to market. Several biotech startups have folded or downsized in the past year, leaving promising new drugs stranded in limbo in the lab before they can reach clinical trials.

Without federal or philanthropic entities to pick up the slack, these discoveries may never reach the patients who need them.

A system under strain

Cancer is not going away. As the U.S. population ages, the burden of cancer on society will only grow. Disparities in treatment access and outcomes persist across race, income and geography. And factors such as environmental exposures and infectious diseases continue to intersect with cancer risk in new and complex ways.

Addressing these challenges requires a strong, stable and well-coordinated research system. But that system is under strain. National Cancer Institute grant paylines, or funding cutoffs, remain highly competitive. Early-career researchers face precarious job prospects. Labs are losing technicians and postdoctoral researchers to higher-paying roles in industry or to burnout. And patients, especially those hoping to enroll in clinical trials, face delays, disruptions and dwindling options.

This is not just a funding issue. It’s a coordination issue between the federal government, academia and industry. There are currently no long-term policy solutions that ensure sustained federal investment, foster collaboration between academia and industry, or make room for philanthropy to drive innovation instead of just filling gaps.

I believe that for the U.S. to remain a global leader in cancer research, it will need to recommit to the model that made success possible: a balanced ecosystem of public funding, private investment and nonprofit support. Up until recently, that meant fully funding the NIH and NCI with predictable, long-term budgets that allow labs to plan for the future; incentivizing partnerships that move discoveries from bench to bedside without compromising academic freedom; supporting career pathways for young scientists so talent doesn’t leave the field; and creating mechanisms for equity to ensure that research includes and benefits all communities.

Cancer research and science has come a long way, saving about 4.5 million lives in the U.S. from cancer from 1991 to 2022. Today, patients are living longer and better because of decades of hard-won discoveries made by thousands of researchers. But science doesn’t run on good intentions alone. It needs universities. It needs philanthropy. It needs industry. It needs vision. And it requires continued support from the federal government.

Jeffrey MacKeigan, Professor of Pediatrics and Human Development, Michigan State University

This article is republished from The Conversation under a Creative Commons license. Read the original article.