Pertussis: a disease affecting all ages

Area of Science:

• Infectious Diseases
• Microbiology
• Public Health

Background:

• Bordetella pertussis causes highly contagious whooping cough, transmitted via airborne droplets.
• While childhood vaccination reduced cases, pertussis incidence has increased in adolescents and adults over the last 20 years.
• Pertussis requires clinical suspicion in all age groups presenting with cough, especially given low sensitivity of current diagnostic tests.

Purpose of the Study:

• To review the current understanding of pertussis (whooping cough) epidemiology, diagnosis, and treatment.
• To highlight the resurgence of pertussis in vaccinated populations and its implications.
• To discuss antimicrobial treatment options and the role of the Tdap vaccine in disease prevention.

Main Methods:

• Literature review of pertussis epidemiology, clinical presentation, diagnostic challenges, and treatment guidelines.
• Analysis of trends in pertussis incidence, particularly in adolescents and adults.
• Evaluation of antimicrobial efficacy and the impact of Tdap vaccination.

Main Results:

• Pertussis cases are increasing in adolescents and adults, including those previously immunized.
• Current FDA-approved diagnostic tests for pertussis exhibit low sensitivity.
• Shorter macrolide antibiotic courses (azithromycin, clarithromycin) may offer advantages over traditional erythromycin therapy.
• The Tdap vaccine for adolescents and adults is recommended to protect infants, who are most vulnerable to complications.

Conclusions:

• Pertussis should be suspected in patients of all ages with cough, irrespective of vaccination status or diagnostic test results.
• Prompt antimicrobial treatment is crucial for clinically suspected pertussis cases.
• The Tdap vaccine is essential for reducing pertussis transmission and protecting high-risk infants.