Adults are whooping, but are internists listening?

Although studies have shown that pertussis is responsible for approximately 20% to 30% of cases of cough lasting more than 2 weeks in adults and adolescents, physicians have generally considered pertussis a disease that affects only children. Epidemiologic trends demonstrate that the incidence of pertussis has been rising, especially in adolescents and adults. Consequently, pertussis is not a "zebra" diagnosis but deserves a place among the community-acquired list of adult pathogens. Increased awareness among physicians about pertussis is important because adults may transmit the infection to infants, in whom the disease often leads to hospitalization and may result in death. Reporting this disease to the local health department is critical to its control because both case-patients and their close contacts should receive antimicrobial prophylaxis. A booster vaccine for adolescents and adults is likely to become available in the near future, so this is an important time to ensure that all physicians, not just pediatricians, are knowledgeable about the diagnosis, treatment, and reporting requirements for pertussis.