Sewage monitoring may provide earlier warning of pertussis outbreaks

Add as a preferred source Wastewater testing could help detect rising whooping cough infections weeks before they are picked up through routine health surveillance, a study by Japanese researchers has found.

The approach could provide an earlier warning of pertussis outbreaks, particularly among infants who are not yet fully vaccinated and are at greater risk of severe illness.

Researchers from the University of Osaka and the Osaka Institute of Public Health monitored wastewater across Osaka Prefecture for more than two years and found that increases in pertussis-related DNA occurred before rises in reported cases.

Between April 2023 and July 2025, the researchers collected wastewater weekly from four treatment plants and tested it for genetic markers linked to Bordetella pertussis, the bacterium that causes whooping cough, as well as Bordetella parapertussis.