Pertussis, a disease whose time has come: what can be done to control the problem?

Area of Science:

• Public Health
• Epidemiology
• Immunology

Background:

• Pertussis (whooping cough) outbreaks are a significant public health concern in the U.S.
• Adolescents and adults are primary pertussis transmitters, with infants bearing the brunt of severe complications and mortality.
• Current vaccination strategies require optimization to reduce disease burden and transmission.

Discussion:

• The cocoon strategy, focusing on immunizing infants' close contacts, is vital for controlling pertussis.
• Pregnant women's immunization is a critical component of vaccine optimization.
• Studies indicate over 50% of infant pertussis cases stem from transmission by adolescent and adult close contacts, particularly new mothers.

Key Insights:

• Vaccinating pregnant women during each pregnancy (27-36 weeks gestation) is strongly recommended.
• This strategy protects vulnerable infants from pertussis.
• The tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) booster vaccine is recommended.

Outlook:

• Continued emphasis on maternal immunization is essential for pertussis control.
• Further research may refine optimal vaccination schedules and strategies.
• Reducing pertussis transmission to infants will lower hospitalization rates and prevent mortality.