20.12 Pertussis (Whooping Cough)

The causative agent is Bordetella pertussis. It is a gram-negative bacillus and releases a toxin that binds to the cilia in the respiratory tract (6). It was discovered in 1906. There is a vaccine available that is typically given in the first year of life. The characteristic “whooping cough” is typically present only in the very young and may often go overlooked in an adult population. There is a booster available, which is recommended for those in their mid-20s and again in the elderly population (6). Without a booster, a susceptible adult may develop the disease and easily pass it along to an unvaccinated or under vaccinated child. In uninfected populations, transmission is almost 100%. Before the development of the vaccine in the 1940s, approximately 200,000 people were affected annually. This fell to less than 1000 annually in the 1970s in the United States with a mortality of almost 1% (9).