Pertussis

Pertussis (whooping cough) is an acute infectious disease caused by Bordetella pertussis. Toxins and other factors produced by the bacteria are responsible for clinical manifestations.

With the resurgence of pertussis in highly vaccinated populations, the disease continues to be a public health and medical concern.

Pertussis classically progresses through three identifiable stages: catarrhal, paroxysmal, and convalescent. Initial symptoms suggesting a mild upper respiratory tract infection are followed by episodes of severe coughing, often accompanied by an inspiratory whoop and post-tussive emesis. Cough may persist for weeks. Fever is absent or low-grade.

Previously vaccinated or infected individuals often have milder disease. Illness in infants may be atypical and is associated with high rates of hospitalisation and death. Pneumonia and hospitalisations for pertussis are also more common in older adults and people with pre-existing pulmonary disease.

The diagnosis is confirmed by identification of B pertussis by culture or nucleic acid amplification from nasopharyngeal specimens, or by serology.

Macrolide antibiotics are the preferred first-line agent for treatment and prophylaxis.

Universal childhood immunisation with the acellular pertussis vaccine is advised; however, immunity following immunisation is not durable. Booster vaccination is recommended for pregnant women. In the US, booster vaccinations are also recommended for non-pregnant adults.

Pertussis (whooping cough) is a respiratory tract infection, usually caused by a fastidious pleomorphic gram-negative coccobacillus, Bordetella pertussis, and characterised by a severe and protracted cough. In China, pertussis is known as the '100-day cough'.​[1]Havers FP, Moro PL, Hariri S, et al. Pertussis. In: Hall E, Wodi AP, Hamborsky J, et al, eds. Centers for Disease Control and Prevention. Epidemiology and prevention of vaccine-preventable diseases (the Pink Book). 14th ed. Washington, DC: Public Health Foundation; 2021. Updated Apr 2024. https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-16-pertussis.html [2]Kilgore PE, Salim AM, Zervos MJ, et al. Pertussis: microbiology, disease, treatment, and prevention. Clin Microbiol Rev. 2016 Jul;29(3):449-86. https://journals.asm.org/doi/10.1128/CMR.00083-15 http://www.ncbi.nlm.nih.gov/pubmed/27029594?tool=bestpractice.com [3]Centers for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. Section 5: travel-associated infections & diseases - pertussis/whooping cough. May 2023 [internet publication]. https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/pertussis-whooping-cough