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Abstract:

Pertussis is a highly contagious acute respiratory illness classically known as “whooping cough” because of its characteristic cough. The majority of cases are caused by , with some caused by ( ). Pertussis is a vaccine-preventable disease that was a major cause of childhood morbidity and mortality during the first half of the 20th century. Following worldwide implementation of pertussis vaccination, cases declined significantly ( ) ( Fig. 1 ). However, it was never fully eliminated, and epidemic peaks continued on a cycle of every 2 or 3 to 5 years. In the past several years, even countries with generally high immunization rates in early childhood have experienced a rise in pertussis cases. In 2014, the World Health Organization (WHO) reported 139,786 cases of pertussis in spite of an estimated global 86% diphtheria-tetanus-pertussis (DTP) vaccine coverage with three doses ( ). In 2013 and 2014, there were 28,639 and 32,791, respectively yearly reported cases of pertussis in the United States, which makes pertussis the most prominent emerging vaccine-preventable disease in this country. Of those cases involving patients 6 months to 6 years of age, 42% had a DTaP vaccination history of 3 or more doses, 6% had 1 or 2 doses, 8% had none, and 44% had an unknown vaccination status ( ). In 2014, there were more than 10,000 reported cases of pertussis in California alone. The greatest morbidity and mortality associated with pertussis infection occur in young infants, particularly those under 3 months of age, often requiring hospitalization in an intensive care setting ( ). With this upsurge in pertussis, much more has been learned about the organism, the vaccines available, and the variability of illness presentation. This complex disease has promoted many public health actions aimed at reducing the spread of , specifically to the fragile neonate, at risk of much worse disease than older age groups and of high mortality.

Citation: Nieves D, Heininger U. 2016. , p 311-339. In Scheld W, Hughes J, Whitley R (ed), Emerging infections 10. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.EI10-0008-2015
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Figure 1

Reported pertussis cases from the National Notifiable Disease Surveillance System, United States, 1922 to 2014. The inset show cases from 1990 to 2014. Data for 1950 to 2013 were obtained from the Centers for Disease Control and Prevention National Notifiable Diseases Surveillance System. Data for 1922 to 1949 were obtained from passive reports to the U.S. Public Health Service. DTP, diphtheria and tetanus toxoids combined with whole-cell pertussis vaccine; DTaP, diphtheria and tetanus toxoids and acellular pertussis vaccine; Tdap, reduced-dose acellular pertussis vaccine combined with tetanus and diphtheria toxoids. Figure adapted with permission from reference .

Citation: Nieves D, Heininger U. 2016. , p 311-339. In Scheld W, Hughes J, Whitley R (ed), Emerging infections 10. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.EI10-0008-2015
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