Resurgence of Pertussis in the Gyeongnam Region of South Korea in 2023 and 2024

<b>Background/Objectives</b>: Pertussis continues to pose a substantial global health challenge despite widespread vaccination programs. This study aimed to analyze the epidemiological characteristics of recent pertussis cases in the Gyeongnam region of South Korea. <b>Methods</b>: We analyzed 419 pertussis cases in the Gyeongnam region of South Korea between October 2023 and April 2024, using data collected from epidemiological investigation reports, medical records, and interviews with health officials and school staff. <b>Results</b>: Our analysis revealed a distinct age distribution pattern with minimal cases in infants (0.2% under 1 year) and young children (7.9% in ages 1-6 years), while school-aged children showed the highest incidence (31.8% in ages 7-9 years, 36.0% in ages 10-12 years). The outbreak pattern demonstrated a progressive shift from preschool and elementary school students to middle and high school students. The time from symptoms onset to diagnosis varied significantly across age groups, with a median of 3.0 days (1.0-6.0) overall; notably, this was longer in high school students at 5.0 days (2.3-8.0) (<i>p</i> = 0.023). While 92.4% (365/395) of cases were fully vaccinated, substantial delays were observed in third and fourth dose administration (18.2% and 25.8%, respectively), with considerable timing variability for the fifth and sixth doses. <b>Conclusions</b>: Our findings highlight the changing epidemiology of pertussis in South Korea, characterized by an age shift toward older children. These results emphasize the need for enhanced surveillance focusing on school-aged populations and the reassessment of vaccination strategies, particularly regarding booster dose timings and adherence.