While the flu is tracking higher than usual, doctors are specifically warning families about a sharp rise in Pertussis (Whooping Cough). Known as the “100-Day Cough” because of its exhausting longevity, the infection is surging in communities where vaccination rates have dipped.
According to the North Carolina Department of Health and Human Services (NCDHHS), the number of confirmed cases in January 2026 is outpacing the five-year average, with significant clusters appearing in the state’s most populated regions.
The Hotspots: Where is it Spreading?
The outbreak is currently tracking highest in three specific areas. Residents here should be on high alert:
- The Triangle (Wake & Durham Counties): Pediatric urgent care centers in Cary, Apex, and Chapel Hill are seeing a spike in school-aged children testing positive for Pertussis.
- Mecklenburg County: Health officials in Charlotte have flagged a rise in cases, noting that the “Subclade K” flu strain is also complicating diagnoses.
- Western NC (Buncombe County): Following a surge in late 2025, Asheville is seeing a “second wave” of cases, particularly among adults who have not received a booster shot in over a decade.
Is it a Cold, the Flu, or the ‘100-Day Cough’?
The danger of the “100-Day Cough” is that it mimics a harmless cold for the first week. By the time the violent coughing starts, you have already exposed your family.
Here is how to distinguish Pertussis from the “Subclade K” flu circulating in NC right now:
- The Cough Type: Pertussis causes violent, rapid coughing fits that may end with a “whoop” noise or vomiting. The flu typically causes a dry, hacking cough.
- Duration: The flu usually lasts 5 to 7 days. Pertussis can last for 2 to 12 weeks.
- Fever: Pertussis usually presents with a mild fever or no fever. The flu brings a high fever (100°F+) that hits suddenly.
- How You Feel: With Pertussis, you often feel fine between coughing fits. With the flu, you feel exhausted and achy all the time.
Warning for Parents: In infants, the tell-tale “whoop” noise is often missing. Instead, watch for “apnea”—where the baby pauses breathing or turns blue. This is a medical emergency.
Why is This Happening Now?
NC health experts point to “waning immunity” as the primary driver.
- Fading Protection: The Tdap vaccine loses effectiveness after about 10 years. Most adults in North Carolina haven’t had a booster since high school.
- The “Winter Gathering” Effect: The cold snap in January has pushed families indoors, creating the perfect environment for the bacteria to spread in schools and workplaces.
The Action Plan: What to Do Today
- Check Your ‘Tdap’ Status: If it has been more than 10 years since your last tetanus shot, you are likely unprotected. Pharmacies like CVS, Walgreens, and Harris Teeter have confirmed stock of the vaccine.
- The “Vomit” Test: If you or your child coughs so hard that it causes gagging or vomiting, do not send them to school. Ask your doctor specifically for a Pertussis PCR test.
- Cocoon the Vulnerable: If you are visiting a newborn or an immunocompromised relative, ensure you are boosted. “Cocooning” infants from the virus is critical right now.
Stay safe, North Carolina. Share this alert with neighbors in the Triangle and Charlotte areas to help stop the spread.
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