Pertussis Immunisation in Adolescents and Adults

Pertussis, or “whooping cough,” is an acute bacterial infection of the respiratory tract which is caused by Bordetella pertussis and, less frequently, by B. parapertussis (Cherry and Heininger 2004) and that occurs worldwide. It is a widely held belief that pertussis is an exclusive childhood disease while in reality it affects all age groups. However, it is most frequently recognised in children. Wide-spread immunisation in children has controlled the disease successfully since its introduction in the early 1940s for several decades. Yet, the incidence of reported pertussis has increased continuously in many countries over the last approximate 30 years in all age groups, but especially among young infants, adolescents, and adults (Mortimer 1990; Cromer et al. 1993; Mink et al. 1994; Aoyama et al. 1995; Baron et al. 1998; Cherry 1999; Güris et al. 1999; De Serres et al. 2000; de Melker et al. 2000; Yih et al. 2000; Senzilet et al. 2001; Tanaka et al. 2003; Gzyl et al. 2004). Moreover, pertussis has been re- discovered as a frequent cause of prolonged cough in adolescents and adults in the recent past but the diagnosis still is often missed unless specific diagnostic tests are applied (Mink et al. 1992; Deville et al. 1995; Postels-Multani et al. 1995; Schmitt-Grohé et al. 1995; Nennig et al. 1996; Birkebaek et al. 1999; Gilberg et al. 2002; Lee et al. 2004). Pertussis can be effectively prevented by immunisation with wholecell and, more recently, with acellular component vaccines. The introduction of combined reduced antigen diphtheria- tetanus-acellular pertussis component vaccines offers the option to expand pertussis immunisation efforts beyond childhood into adolescence and adulthood. This will be necessary to better control the increase of pertussis and its associated outbreaks.