A newborn baby in Tamil Nadu suffered a severe case of whooping cough, prompting health experts to call for changes in vaccination policies. The infant, just 15 days old, was brought to a clinic in Karaikudi in early 2025 with a violent cough that turned his skin blue. Doctors initially prescribed cough suppressants, but the symptoms persisted. Over the following weeks, the parents sought help at multiple hospitals. The baby was 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 was correct.
Diagnosis and Recovery
Finally, the baby was referred to the Institute of Child Health in Chennai. Doctors collected swabs from his nose and throat, and the state public health laboratory confirmed the presence of Bordetella pertussis, the bacterium that causes whooping cough. The infant was treated with azithromycin and recovered. He was discharged with instructions for follow-up at the Vaccine Preventable Diseases clinic.
Case Documentation and Recommendations
The case, now documented by public health officers Krishnaveni A and Meenachi from the directorate of public health, appears in the latest edition of the Tamil Nadu Journal of Public Health and Medical Research. The authors emphasize the importance of maternal vaccination during pregnancy to provide passive immunity to newborns, protecting them in the vulnerable early weeks of life. In the United Kingdom and the United States, pregnant women routinely receive a pertussis booster (Tdap) in their third trimester, which allows antibodies to cross the placenta and shield newborns before their own vaccination begins. However, India's current schedule, followed by most government hospitals, only offers pregnant women the Td vaccine, which covers tetanus and diphtheria but not whooping cough.
Vaccination Gaps in India
Dr. Baranidharan B, who heads Tamil Nadu's state immunisation wing, explained the window of vulnerability. The first dose of pertussis vaccine for children is given at six weeks as part of the pentavalent vaccine. The second and third doses are given at 10 and 14 weeks, with booster doses of DPT at one-and-a-half years and again between five and six years. At 15 days, the baby had not reached any of these milestones. Tamil Nadu recorded six pertussis cases in 2025 and two so far this year. Dr. Baranidharan noted that older children often contract the disease due to inadequate vaccination.
Call for Awareness Among Healthcare Providers
The authors also recommend that pediatricians and frontline doctors consider pertussis in the differential diagnosis of neonates presenting with cough and respiratory distress. This ensures that whooping cough is never the last possibility considered when a newborn cannot stop coughing. The case highlights the need for updated maternal vaccination policies and heightened clinical awareness to prevent such severe infections in the most vulnerable patients.
