increasing number of cases of pertussis have been reported to the CDC since the 1980s. The increases are greatest among adolescents (aged 10-19 years), but an increase is also seen among infants younger than 5 months old. The reported increases may reflect greater awareness of pertussis to some degree. Even with the increase in reports among adolescents and very young infants, the number of reported cases is more than 97 % lower than in the pre-vaccine era.

Infants under the age of 12 months have more serious illness from pertussis and they are more likely to have complications and be hospitalized than persons in other age groups. In the 1990s, about two thirds of infants reported with pertussis were hospitalized. Infants are more likely to have pneumonia or convulsions. Infants also are at greatest risk of fatal pertussis. In recent years, 15 to 21 infant deaths from pertussis are reported to CDC annually.

The case-reports of pertussis among infants younger than 5 months have been increasing since the 1980s. This age group is too young to be well protected by DTaP (diphtheria and tetanus toxoids and acellular pertussis) vaccine. For example, the number of case-reports among infants younger than 5 months was about 600 per year in the early 1980s, and about 1,700 per year at the end of the 1990s.

In the U.S., we have the vaccine called DTaP (diphtheria and tetanus toxoids and acellular pertussis vaccine). DTaP is safe and effective, and prevents severe pertussis and death among infants and young children. The best way to protect infants from pertussis is to give DTaP vaccine starting on time at 2 months of age. Parents should vaccinate their infant on-time (at 2, 4, and 6 months of age) and complete all the recommended doses of DTaP vaccine to best protect their infant.

There is a good chance that we will see a pertussis vaccine licensed for persons beyond childhood somewhere in the future. The hard questions to answer are: Who will get it? When will they get it? and How often will they get it? Currently there is no adult pertussis-containing vaccine licensed for this use in this country, but there is in Canada. We will have to see how the clinical trials go and how FDA and ACIP recommend its use.

Pertussis, also known as whooping cough, is extremely contagious. Before widespread immunization, virtually all children contracted whooping cough. Small children get the sickest while adults appear only to have a bad cold. In recent years 4,200 cases of pertussis have been officially reported. Pertussis is the common cause for undiagnosed chronic cough in adults and older children.

average of more than 160,000 cases and more than 5,000 deaths were reported every year in the 1920s-30s. At its peak during this period, the annual number of case-reports was more than 250,000 with up to 9,000 deaths. In the 1940s, whole-cell pertussis vaccine combined with diphtheria and tetanus toxoids (DTP) was introduced, and case-reports of pertussis decreased more than 99% by 1976, when the number of reported cases reached a record-low of 1,010 cases.

DTaP (diphtheria and tetanus toxoids and acellular pertussis) vaccine is recommended for all infants at 2, 4 and 6 months of age. An additional dose of DTaP vaccine is recommended at 15-18 months of age and at 4-6 years of age. It is important that young infants start their DTaP vaccination without delay at 2 months of age.

Pertussis is a bacterial respiratory illness characterized by severe spasms of coughing that can last for several weeks or even for months. Pertussis is usually spread from person-to-person through close contact with respiratory droplets released when a person coughs or sneezes. Before the introduction of vaccination in the 1940s, pertussis was a major cause of serious illness and death among infants and young children in the United States.

There is no pertussis-containing vaccine licensed by the FDA for use in persons 7 years of age or older. The conclusion was basically that pertussis was not a problem in older children and adults. Now we know that is not true. We have no vaccine that is properly built for older children and adults. The current vaccine has a pediatric dose of diphtheria, which we would not want to give to older children and adults because it is more reactogenic than in children.

encephalopathy within 7 days of DTPa, defined as severe acute neurological illness with prolonged seizures and/or unconsciousness and/or focal signs, not due to another identified cause. Note that encephalopathy is much less likely to occur now that the acellular pertussis vaccine (DTPa) is routinely used, rather than whole-cell pertussis vaccine (DTPw). immediate severe allergic or anaphylactic reaction to vaccination with DTPa. In these cases CDT should be used for further vaccination.

acellular pertussis vaccine (combined with tetanus and diphtheria antigens) is now available for adolescents and adults (dTpa, or Boostrix). This vaccine should not be given as a primary vaccination series against pertussis; further, no recommendations about additional booster doses using adult/adolescent formulation dTpa can be made at this time.