Overview of pertussis: focus on epidemiology, sources of infection, and long term protection after infant vaccination.
BACKGROUND
Pertussis, or whooping cough, is a bacterial disease characterized by paroxysmal cough often accompanied by inspiratory whoop and posttussive emesis. Although the introduction of whole-cell pertussis vaccine in the 1940s led to a significant decline in the incidence of pertussis, there has been a gradual increase in reported pertussis cases since 1980. Some of these cases are in infants too young to have received routine pertussis vaccination, and many are in adolescents immunized previously as young children.


METHODS
Based on a literature review, an overview of pertussis is provided, focusing on epidemiology, sources of infection, and trends in incidence patterns, particularly among adolescents. Issues surrounding long-term protection after infant vaccination are also discussed.


RESULTS
The most dramatic increase in pertussis incidence has been among adolescents and young adults. Waning vaccine-induced immunity and refinements in the diagnosis of pertussis have contributed to the rise in the occurrence of pertussis in older age groups. Disease rates in infants have also increased. Determining the source of infection in infants can be challenging, but studies have demonstrated that many infant cases are attributable to infections in adolescent or adult family members.


CONCLUSIONS
Pertussis is on the rise, particularly in adolescents. Booster vaccination of adolescents with less-reactogenic acellular pertussis vaccines appears to be the most logical approach to disease prevention in adolescents and reduced transmission to young infants.
Edwards
Kathryn M
KM
Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232-2573, USA. Kathryn.Edwards@vanderbilt.edu
D000293:Adolescent; D000328:Adult; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D015994:Incidence; D007223:Infant; D010567:Pertussis Vaccine; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014917:Whooping Cough / Q000453:epidemiology* / Q000266:history / Q000517:prevention & control / Q000635:transmission
D010567:Pertussis Vaccine