Pertussis

PERTUSSIS

Pertussis (whooping cough) is a highly communicable infectious disease caused by the bacterium Bordetella pertussis. Pertussis is characterized by spasms (paroxysms) of severe coughing. The cough spasms are often followed by vomiting and by a characteristic inspiratory "whoop." The incubation period is about 7 to 20 days. Pertussis starts with symptoms similar to those of a minor upper respiratory infection and is followed by several weeks of episodes of paroxysmal coughing. Pertussis can occur among persons of any age, regardless of vaccination status, and may be relatively common among adolescents and adults in the United States, although infants less than one year old have the highest rates of reported disease. Infants with pertussis commonly require hospitalization and may die.

Between 1940 and 1945 in the United States, an average of 175,000 cases and 2,700 deaths occurred from pertussis each year. A vaccination program has been in place in the United States since 1948; in the 1990s, an average of 6,000 pertussis cases and 12 deaths are reported each year.

The U.S. vaccination schedule is five doses of diphtheria and tetanus toxoids and acellular pertussis vaccine (DtaP) for children under 7 years of age: three doses at ages 2, 4, and 6 months, a fourth dose at 15 to 18 months of age, and the fifth dose at 4 to 6 years. No pertussis vaccine is currently licensed for use in persons 7 years old or older.

Early diagnosis and antimicrobial treatment of case-patients may lessen the severity of symptoms and limit the period of communicability; treatment of close contacts can provide protection from developing pertussis.

KRISTINE M. BISGARD

(SEE ALSO: Communicable Disease Control)

BIBLIOGRAPHY

American Public Health Association (2000). "Pertussis." In Control of Communicable Diseases Manual, 17th edition, ed. A. S. Benenson. Washington, DC: Author.

Edwards, K. M.; Decker, M. D.; and Mortimer, E. A., Jr. (1999). "Pertussis Vaccine." In Vaccines, 3rd edition, eds. S. A. Plotkin and W. A. Orenstein. Philadelphia, PA: W. B. Saunders.

Guris, D.; Strebel, P. M.; Bardenheier, B. et al. (1999). "Changing Epidemiology of Pertussis in the United States: Increasing Reported Incidence among Adolescents and Adults, 1990–1996." Clinical Infectious Disease 28:1230–1237.