Pertussis epidemiology and demographics

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

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Petsussis infection according to incidence within each State.

Overview

Pertussis results in high morbidity and mortality in many countries every year. Pertussis causes 20-40 million deaths worldwide, the majority of which occur in Africa and Southeast Asia.

Epidemiology and Demographics

Incidence

• In the United States, 5000-7000 cases are reported each year.
• Incidence of pertussis has increased steadily since the 1980s.
• The incidence in 2002 was 3.01/100,000 when 8,296 cases of pertussis were reported.
• The Center for Disease Control and prevention (CDC) reported the incidence of pertussis in 2005 to be 25,616, which is triple the incidence reported in 2001.

• There are several hypothesized reasons for the increase in incidence:
  • Decreased use of the vaccination.
  • Decrease in the level of vaccine induced immunity over the years.
  • Increased circulation of the pathogen itself.

• The following have been enacted to decrease incidence of pertussis and increase efficacy of treatment:
  • Heightened awareness of whooping cough among health care providers.
  • An increased amount of public health reporting.
  • The increased sensitivity of PCR testing to diagnose pertussis.

Susceptible Populations

• Outbreaks of pertussis occur in under-vaccinated or un-vaccinated populations of individuals, such as those in particular religious communities.
• Outbreaks have also occurred in settings such as sports facilities, schools and health care facilities, where an infected individual has not been diagnosed and the infection has spread.
• In adults and adolescents, pertussis may simply present as a prolonged cough and poses a great risk of exposure to young and immunocompromised contacts.
• The highest incidence of infection occurs in infants and young children.

Age

• The number of reported cases has increased in all age groups, but the increase is greatest among persons aged greater than or equal to 5 years.
• Nevertheless, infants and young children continue to have the highest risk for pertussis and its complications, with 84% of the deaths due to pertussis occurring in infants less than 6 months of age.

Pertussis infection incidence according to different age groups.

• Children below the age of 1 year are mostly affected.
• Incidence decreases with increasing age.

Gender

• Gender is not associated with an increased risk of pertussis.