Delayed introduction and susceptible variation drive spatial asynchrony in pertussis epidemics

Infectious disease outbreaks typically exhibit a large-scale, spatial synchrony, reflecting coupling through shared environmental forcing and human mobility. During South Korea’s unprecedented large pertussis outbreak in 2024—2025, however, asynchronous epidemic patterns were observed throughout the country: some regions experienced two epidemic waves, while others regions experienced only the first or second wave. Using high-resolution surveillance data from 252 municipalities and a simple transmission model, we show that heterogeneity in introduction timing and local susceptibility can drive such fine-scale asynchrony even when transmission is spatially homogeneous. These results redefine epidemic synchrony as a condition contingent not only on shared transmission dynamics, but also on variation in initial epidemic conditions.