Whooping cough – still a challenge

Globally, whooping cough (pertussis) is still an important cause of death in infancy and continues to be a public health concern even in countries with high vaccination coverage.In 2008, over 80% of all infants worldwide received three doses of pertussis vaccines. 1Despite this, 15 million pertussis cases occurred worldwide, 95% of them in developing countries, and about 200,000 children died from the disease. 1 The causative agent of whooping cough, Bordetella pertussis, was isolated about one-hundred years ago.Before the development of the killed whole-cell vaccine and the implementation of mass immunizations in the 1950's, pertussis was the main cause of infant mortality. 2Thereafter, the incidence of whooping cough in vaccinated infants and young children has dropped dramatically.Vaccinations were implemented in most countries and the programs were successful, but increasing publicity was focused on the adverse reactions. 3ue to increasing risk of adverse reactions by age and by vaccination times using the whole-cell vaccine, and less severity of whooping cough in older children, vaccinations were in most programs not given after the age of 24 months.Therefore, previously vaccinated children became again susceptible to pertussis at school age, and the incidence of pertussis increased particularly in school children.