Published online May 2, 2005
PEDIATRICS Vol. 115 No. 5 May 2005, pp. 1422-1427 (doi:10.1542/peds.2004-2648)

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EXPERIENCE AND REASON

The Epidemiology of Pertussis: A Comparison of the Epidemiology of the Disease Pertussis With the Epidemiology of Bordetella pertussis Infection

James D. Cherry, MD, MSc

From the Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California

In the prevaccine era pertussis epidemics followed a cyclic pattern, with peaks every 2 to 5 years. With the marked reduction of pertussis by vaccination, the same cyclic pattern still occurs. Studies relating to reported pertussis and Bordetella pertussis infection have been reviewed and analyzed. The increase in reported pertussis over the last 2 decades is mainly due to a greater awareness of pertussis and perhaps to the use of several less efficacious vaccines.

Studies of prolonged cough illnesses in adolescents and adults reveal that 13% to 20% are a result of B pertussis infection. Serologic studies suggest that the rate of B pertussis infection in adolescents and adults is 2.0% per year. The rate of cough illnesses (pertussis) caused by B pertussis infection in adolescents and adults is between 370 and 1500 per 100 000 population. These data suggest that there are between 800 000 and 3.3 million cases per year in the United States.

The coming availability of adolescent- and adult-formulated diphtheria and tetanus toxoids and acellular pertussis vaccines for adolescents and adults and their widespread use should reduce the reservoir of B pertussis disease. It is suggested that a universal program of adolescent and adult boosters would decrease the circulation of B pertussis in these age groups and possibly could lead to the elimination of the organism from the population.

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Key Words: pertussis • Bordetella pertussis • adult pertussis • adolescent pertussis • pertussis • epidemiology

Abbreviations: DTaP, adolescent- and adult-formulated diphtheria and tetanus toxoids and acellular pertussis • ELISA, enzyme-linked immunosorbent assay • PCR, polymerase chain reaction • PT, pertussis toxin • FHA, filamentous hemagglutinin • PRN, pertactin • FIM, fimbriae • DTP, diphtheria and tetanus toxoids and pertussis • APERT, adult acellular pertussis vaccine efficacy trial

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Accepted Feb 7, 2005.

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