Whooping Cough (Pertussis): Severity, Mortality, and Vaccination Impact

Pertussis is not a mild childhood illness—it can be fatal, especially in infants.

Infant Vulnerability

• Highest risk: <6 months, particularly newborns.
• Complications: Pneumonia (most common cause of death), apnea, seizures, encephalopathy, malnutrition from feeding difficulty.
• Mortality: ~1% of hospitalized infants; 0.5% overall in unvaccinated populations.

Historical and Global Burden

• Pre-vaccine (1940s US): ~200,000 cases, 9,000 deaths annually.
• Post-vaccine: >90% reduction, but resurgences in undervaccinated communities.
• WHO estimate: ~160,000 deaths globally/year, mostly in low-vaccination regions.

Vaccination Strategy

• DTaP (pediatric): 2, 4, 6, 15–18 months, 4–6 years.
• Tdap (adolescent/adult): Booster at 11–12; every pregnancy (27–36 weeks) to protect newborns via transplacental antibodies.
• Cocooning: Vaccinate household contacts of infants.

Adults and Older Children

Typically milder (prolonged paroxysmal cough), but can transmit to vulnerable infants. Waning immunity necessitates boosters.