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Pertussis

Last edited: 4/14/2026

Overview

Pertussis, commonly known as whooping cough, is a highly contagious respiratory infection caused by Bordetella pertussis. It predominantly affects infants who are too young to be fully vaccinated, leading to significant morbidity and mortality in this age group 11011.

Diagnosis

  • Clinical Presentation: Characteristic paroxysmal cough, inspiratory whoop, and post-tussive vomiting 9.
  • Laboratory Tests: Nasopharyngeal culture or PCR for B. pertussis 9.
  • Serology: Antibody levels can support diagnosis, especially in adults 7.
  • Epidemiological Factors: History of exposure, unvaccinated or partially vaccinated status 2.

    • Management

  • Antibiotics: Azithromycin, erythromycin, or clarithromycin for treatment; duration typically 5-7 days 9.
  • Supportive Care: Hydration, oxygen support for severe cases, and monitoring for complications like encephalopathy 9.
  • Prophylactic Antibiotics: Administered to close contacts, especially infants, to prevent infection 10.

    • Special Populations

  • Pregnancy: Tdap vaccination recommended between 27-36 weeks of gestation to provide passive immunity to newborns 381011.
  • Pediatrics: Early initiation of the DTaP vaccine series at 2, 4, and 6 months, with booster doses 1011.
  • Elderly: Not specifically addressed in abstracts; routine vaccination recommendations may apply based on general guidelines 10.

    • Key Recommendations

  • Pregnant Women Vaccination: Administer Tdap vaccine between 27-36 weeks of gestation to protect newborns 381011 (Evidence: Strong).
  • Infant Protection: Ensure infants receive the DTaP vaccine series starting at 2 months of age 1011 (Evidence: Strong).
  • Contact Prophylaxis: Provide prophylactic antibiotics to exposed infants and close contacts to prevent transmission 10 (Evidence: Moderate).
  • Healthcare Worker Immunization: Encourage pertussis vaccination among healthcare workers in pediatric settings to reduce nosocomial transmission 56 (Evidence: Moderate).
  • School Exclusion Policies: Implement policies excluding unvaccinated students during outbreaks to control spread 4 (Evidence: Moderate).

    • References

    1 Roberts L. A shot at survival. Science (New York, N.Y.) 2025. link 2 Roush K. Whooping Cough Cases Are on the Rise in the United States. The American journal of nursing 2025. link 3 Abu-Raya B, Maertens K, Munoz FM, Zimmermann P, Curtis N, Halperin SA et al.. The Effect of Tetanus-Diphtheria-Acellular-Pertussis Immunization During Pregnancy on Infant Antibody Responses: Individual-Participant Data Meta-Analysis. Frontiers in immunology 2021. link 4 Liko J, Cieslak PR. School Exclusions During Selected Pertussis Outbreaks, Oregon, 2017-2018. Journal of the Pediatric Infectious Diseases Society 2021. link 5 RICCò M, Vezzosi L, Gualerzi G, Bragazzi NL, Balzarini F. Pertussis immunization in healthcare workers working in pediatric settings: Knowledge, Attitudes and Practices (KAP) of Occupational Physicians. Preliminary results from a web-based survey (2017). Journal of preventive medicine and hygiene 2020. link 6 Pellissier G, Lolom I, Cairati N, Cherifi C, Amiel-Taieb C, Farbos S et al.. Maternity staff immunization coverage against pertussis and maternal vaccination practices: Results of a 2017 cross-sectional survey in five public maternity hospitals. Medecine et maladies infectieuses 2020. link 7 Winter K, Klein NP, Ackley S, Cherry JD. Comment on "The impact of past vaccination coverage and immunity on pertussis resurgence". Science translational medicine 2018. link 8 Koerner J, Forinash AB, Yancey AM, Brinkmeyer J, Dingman S, Miller C et al.. Administration Rates of the Tdap Vaccine in Obstetric Patients. The Annals of pharmacotherapy 2018. link 9 Tian SF, Wang HM, Deng JK. Fatal malignant pertussis with hyperleukocytosis in a Chinese infant: A case report and literature review. Medicine 2018. link 10 . Committee Opinion No. 718: Update on Immunization and Pregnancy: Tetanus, Diphtheria, and Pertussis Vaccination. Obstetrics and gynecology 2017. link 11 . Committee Opinion No. 718 Summary: Update on Immunization and Pregnancy: Tetanus, Diphtheria, and Pertussis Vaccination. Obstetrics and gynecology 2017. link 12 Regan AK, Tracey LE, Blyth CC, Richmond PC, Effler PV. A prospective cohort study assessing the reactogenicity of pertussis and influenza vaccines administered during pregnancy. Vaccine 2016. link 13 Klar S, Harris T, Wong K, Fediurek J, Deeks SL. Vaccine safety implications of Ontario, Canada's switch from DTaP-IPV to Tdap-IPV for the pre-school booster. Vaccine 2014. link 14 Bass JB, Turpin-Saunders SR. Coughing up answers: a community's response to pertussis. North Carolina medical journal 2013. link 15 Kemmeren JM, Timmer SS, van der Maas NA, de Melker HE. Comparison of the tolerability of an acellular pertussis-containing vaccine given as the fifth booster dose in differently primed children. Vaccine 2011. link 16 Wilson K, Potter B, Manuel D, Keelan J, Chakraborty P. Revisiting the possibility of serious adverse events from the whole cell pertussis vaccine: were metabolically vulnerable children at risk?. Medical hypotheses 2010. link 17 Zieliński A, Rosińska M. Comparison of adverse effects following immunization with vaccine containing whole-cell vs. acellular pertussis components. Przeglad epidemiologiczny 2008. link 18 Sokol TM, Mehta M, Hall S, Ratard RC. Pertussis in Louisiana. The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society 2004. link 19 Gold MS, Noonan S, Osbourn M, Precepa S, Kempe AE. Local reactions after the fourth dose of acellular pertussis vaccine in South Australia. The Medical journal of Australia 2003. link 20 Le Saux N, Barrowman NJ, Moore DL, Whiting S, Scheifele D, Halperin S. Decrease in hospital admissions for febrile seizures and reports of hypotonic-hyporesponsive episodes presenting to hospital emergency departments since switching to acellular pertussis vaccine in Canada: a report from IMPACT. Pediatrics 2003. link 21 Gold MS. Hypotonic-hyporesponsive episodes following pertussis vaccination: a cause for concern?. Drug safety 2002. link 22 Rohani P, Earn DJ, Grenfell BT. Impact of immunisation on pertussis transmission in England and Wales. Lancet (London, England) 2000. link04482-7) 23 Braun MM, Mootrey GT, Salive ME, Chen RT, Ellenberg SS. Infant immunization with acellular pertussis vaccines in the United States: assessment of the first two years' data from the Vaccine Adverse Event Reporting System (VAERS). Pediatrics 2000. link 24 Gust I. Standardisation and licensing of combination vaccines based on DTP. Developments in biological standardization 1999. link 25 Braun MM, Terracciano G, Salive ME, Blumberg DA, Vermeer-de Bondt PE, Heijbel H et al.. Report of a US public health service workshop on hypotonic-hyporesponsive episode (HHE) after pertussis immunization. Pediatrics 1998. link 26 Mahon BP, Sheahan BJ, Griffin F, Murphy G, Mills KH. Atypical disease after Bordetella pertussis respiratory infection of mice with targeted disruptions of interferon-gamma receptor or immunoglobulin mu chain genes. The Journal of experimental medicine 1997. link 27 Morishita R, Kato K, Asano T. Major pertussis-toxin-sensitive GTP-binding protein of bovine lung. Purification, characterization and production of specific antibodies. European journal of biochemistry 1988. link 28 Toutant M, Aunis D, Bockaert J, Homburger V, Rouot B. Presence of three pertussis toxin substrates and Go alpha immunoreactivity in both plasma and granule membranes of chromaffin cells. FEBS letters 1987. link80174-6) 29 Beare TH. Pertussis (whooping cough). The specialist view. Australian family physician 1982. link

    Original source

    1. [1]
      A shot at survival. — Roberts L Science (New York, N.Y.) (2025)
    2. [2]
      Whooping Cough Cases Are on the Rise in the United States. — Roush K The American journal of nursing (2025)
    3. [3]
      The Effect of Tetanus-Diphtheria-Acellular-Pertussis Immunization During Pregnancy on Infant Antibody Responses: Individual-Participant Data Meta-Analysis. — Abu-Raya B, Maertens K, Munoz FM, Zimmermann P, Curtis N, Halperin SA et al. Frontiers in immunology (2021)
    4. [4]
      School Exclusions During Selected Pertussis Outbreaks, Oregon, 2017-2018. — Liko J, Cieslak PR Journal of the Pediatric Infectious Diseases Society (2021)
    5. [5]
      Pertussis immunization in healthcare workers working in pediatric settings: Knowledge, Attitudes and Practices (KAP) of Occupational Physicians. Preliminary results from a web-based survey (2017). — RICCò M, Vezzosi L, Gualerzi G, Bragazzi NL, Balzarini F Journal of preventive medicine and hygiene (2020)
    6. [6]
      Maternity staff immunization coverage against pertussis and maternal vaccination practices: Results of a 2017 cross-sectional survey in five public maternity hospitals. — Pellissier G, Lolom I, Cairati N, Cherifi C, Amiel-Taieb C, Farbos S et al. Medecine et maladies infectieuses (2020)
    7. [7]
      Comment on "The impact of past vaccination coverage and immunity on pertussis resurgence". — Winter K, Klein NP, Ackley S, Cherry JD Science translational medicine (2018)
    8. [8]
      Administration Rates of the Tdap Vaccine in Obstetric Patients. — Koerner J, Forinash AB, Yancey AM, Brinkmeyer J, Dingman S, Miller C et al. The Annals of pharmacotherapy (2018)
    9. [9]
      Fatal malignant pertussis with hyperleukocytosis in a Chinese infant: A case report and literature review. — Tian SF, Wang HM, Deng JK Medicine (2018)
    10. [10]
      Committee Opinion No. 718: Update on Immunization and Pregnancy: Tetanus, Diphtheria, and Pertussis Vaccination. Obstetrics and gynecology (2017)
    11. [11]
      Committee Opinion No. 718 Summary: Update on Immunization and Pregnancy: Tetanus, Diphtheria, and Pertussis Vaccination. Obstetrics and gynecology (2017)
    12. [12]
      A prospective cohort study assessing the reactogenicity of pertussis and influenza vaccines administered during pregnancy. — Regan AK, Tracey LE, Blyth CC, Richmond PC, Effler PV Vaccine (2016)
    13. [13]
      Vaccine safety implications of Ontario, Canada's switch from DTaP-IPV to Tdap-IPV for the pre-school booster. — Klar S, Harris T, Wong K, Fediurek J, Deeks SL Vaccine (2014)
    14. [14]
      Coughing up answers: a community's response to pertussis. — Bass JB, Turpin-Saunders SR North Carolina medical journal (2013)
    15. [15]
      Comparison of the tolerability of an acellular pertussis-containing vaccine given as the fifth booster dose in differently primed children. — Kemmeren JM, Timmer SS, van der Maas NA, de Melker HE Vaccine (2011)
    16. [16]
      Revisiting the possibility of serious adverse events from the whole cell pertussis vaccine: were metabolically vulnerable children at risk? — Wilson K, Potter B, Manuel D, Keelan J, Chakraborty P Medical hypotheses (2010)
    17. [17]
      Comparison of adverse effects following immunization with vaccine containing whole-cell vs. acellular pertussis components. — Zieliński A, Rosińska M Przeglad epidemiologiczny (2008)
    18. [18]
      Pertussis in Louisiana. — Sokol TM, Mehta M, Hall S, Ratard RC The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society (2004)
    19. [19]
      Local reactions after the fourth dose of acellular pertussis vaccine in South Australia. — Gold MS, Noonan S, Osbourn M, Precepa S, Kempe AE The Medical journal of Australia (2003)
    20. [20]
      Decrease in hospital admissions for febrile seizures and reports of hypotonic-hyporesponsive episodes presenting to hospital emergency departments since switching to acellular pertussis vaccine in Canada: a report from IMPACT. — Le Saux N, Barrowman NJ, Moore DL, Whiting S, Scheifele D, Halperin S Pediatrics (2003)
    21. [21]
      Hypotonic-hyporesponsive episodes following pertussis vaccination: a cause for concern? — Gold MS Drug safety (2002)
    22. [22]
      Impact of immunisation on pertussis transmission in England and Wales. — Rohani P, Earn DJ, Grenfell BT Lancet (London, England) (2000)
    23. [23]
      Infant immunization with acellular pertussis vaccines in the United States: assessment of the first two years' data from the Vaccine Adverse Event Reporting System (VAERS). — Braun MM, Mootrey GT, Salive ME, Chen RT, Ellenberg SS Pediatrics (2000)
    24. [24]
      Standardisation and licensing of combination vaccines based on DTP. — Gust I Developments in biological standardization (1999)
    25. [25]
      Report of a US public health service workshop on hypotonic-hyporesponsive episode (HHE) after pertussis immunization. — Braun MM, Terracciano G, Salive ME, Blumberg DA, Vermeer-de Bondt PE, Heijbel H et al. Pediatrics (1998)
    26. [26]
      Atypical disease after Bordetella pertussis respiratory infection of mice with targeted disruptions of interferon-gamma receptor or immunoglobulin mu chain genes. — Mahon BP, Sheahan BJ, Griffin F, Murphy G, Mills KH The Journal of experimental medicine (1997)
    27. [27]
      Major pertussis-toxin-sensitive GTP-binding protein of bovine lung. Purification, characterization and production of specific antibodies. — Morishita R, Kato K, Asano T European journal of biochemistry (1988)
    28. [28]
      Presence of three pertussis toxin substrates and Go alpha immunoreactivity in both plasma and granule membranes of chromaffin cells. — Toutant M, Aunis D, Bockaert J, Homburger V, Rouot B FEBS letters (1987)
    29. [29]
      Pertussis (whooping cough). The specialist view. — Beare TH Australian family physician (1982)
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