What’s Old Is New Again: Pertussis

Despite the availability of a vaccine, pertussis is a particularly difficult disease to control. Improvements in molecular diagnosis, changes in vaccine components, and missed opportunities for vaccination have resulted in rising pertussis disease incidence. Young infants are at the highest risk of severe complications and mortality, but immunization of mothers during pregnancy can provide protection. The presentation of infant pertussis differs somewhat from the traditional catarrhal, paroxysmal, and convalescent stages seen in adults. By understanding the clinical presentation of pertussis in all age groups, providers can more quickly prescribe appropriate antibiotic therapy and postexposure prophylaxis. Providers are also an essential source of evidence-based vaccination counseling for pregnant women and families, and understanding the complications of this disease is an important part of these sometimes difficult but critical conversations.