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Pertussis: a disease affecting all ages.

David S Gregory1

  • 1Lynchburg Family Medicine Residency, Virginia, USA. david.gregory@centrahealth.com

American Family Physician
|August 18, 2006
PubMed
Summary

Bordetella pertussis (whooping cough) is rising in vaccinated adults and adolescents. Early antimicrobial treatment and Tdap vaccination are key to controlling this contagious respiratory illness.

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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.

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