Chandigarh, October 31, 2025 – A groundbreaking study from the Postgraduate Institute of Medical Education and Research (PGIMER) here has uncovered a troubling shift in respiratory illnesses across northern India: a lesser-known bacterium, Bordetella holmesii, is now the primary culprit behind nearly 37% of pertussis-like chest infections, outpacing the traditional whooping cough pathogen and threatening to escalate healthcare burdens amid rising case numbers. Published in the prestigious *Emerging Infectious Diseases* journal by the U.S. Centers for Disease Control and Prevention, the research—spanning 2019 to 2023—analyzes 935 suspected cases and signals an urgent need for revamped diagnostics and surveillance to curb what could become a public health crisis.
Pertussis, or whooping cough, has long haunted childhood health, once claiming up to 10% of infected infants in the early 20th century before vaccines tamed its toll. Yet in Asia's densely populated hotspots like India and China, the disease persists as a formidable foe, disproportionately striking young children and infants. The COVID-19 era offered a fleeting reprieve, with lockdowns slashing transmission, but cases have roared back: India alone tallied 13.6 million infections recently, while China's incidence spiked from 0.13 to 2.15 per 100,000 between 2013 and 2019, surpassing 58,990 reports by early 2024. Now, PGIMER's findings reveal a stealthy newcomer eclipsing the old guard.
The Study: Unmasking an Emerging Threat
Led by Dr. Vikas Gautam's laboratory at PGIMER in collaboration with Dr. Prabhu Patil from CSIR-IMTECH, the probe drew from the institute's ongoing surveillance since 2015. By scrutinizing respiratory samples from suspected pertussis patients, researchers pinpointed a dramatic pivot: infections from Bordetella pertussis—the classic whooping cough bacterium—plummeted from 15-20% to a mere 2-5% over the study period. In their place surged B. holmesii, accounting for 37% of cases by 2023, with the sharpest uptick hitting children aged 5-10 years in states like Punjab, Haryana, and Himachal Pradesh.
The bacterium mimics pertussis symptoms with eerie precision: severe coughing fits, wheezing, chest congestion, and the hallmark "whoop" on inhalation, often escalating to pneumonia in vulnerable kids. Unlike B. pertussis, however, B. holmesii evades standard vaccine protections and diagnostic tests calibrated for its more famous kin, leading to frequent misdiagnoses and delayed interventions. "These findings indicate an evolving trend in the causes of pertussis-like illness in India," Dr. Gautam told reporters. "Continuous monitoring is essential to understand the epidemiology and prevent misdiagnosis."
This isn't PGIMER's first brush with microbial surprises; the team previously identified Stenotrophomonas sepilia, a novel sepsis-causing bug, underscoring the institute's frontline role in pathogen detection.
Healthcare Ripple Effects: Costs and Calls for Action
The implications ripple far beyond labs into hospitals and budgets. With B. holmesii's rise—most acute in 2023—northern India's pediatric wards are bracing for overflow, as prolonged illnesses demand extended antibiotics, ventilatory support, and follow-up care. Experts warn of strained resources in underfunded public facilities, where treatment costs could balloon by 20-30% per case due to specialized testing and resistance patterns in this elusive germ. In a region already grappling with air pollution-fueled respiratory woes, this could exacerbate winter spikes, hitting low-income families hardest.
The study hammers home the gaps in current protocols: routine PCR tests often miss B. holmesii, and vaccines like DTP (diphtheria-tetanus-pertussis) offer no shield. Health officials are urging multiplex diagnostics and clinician training, while advocating for expanded genomic surveillance akin to COVID tracking. "This is a wake-up call for India's immunization strategy," said Dr. Gautam. "We must adapt to these shifts or risk a resurgence of preventable deaths."
As Diwali lights flicker across the north, the shadow of this bacterial insurgency looms, prompting policymakers to fast-track funding for respiratory sentinel sites. For now, parents are advised to watch for persistent coughs in school-age children and seek prompt medical aid—lest a forgotten foe upends hard-won gains against childhood killers.
This report is based on the PGIMER study and expert insights as of October 31, 2025.
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