Pertussis in Adults

History has a way of creating ironies, and the invitation to write this editorial on pertussis in adults is a case in point. Ten years ago, I was the moderator of an interdepartmental conference at the University of California, Los Angeles (UCLA), entitled, “The Past, Present, and Future of Pertussis. The Role of Adults in Epidemiology and Future Control” [1]. Conferences in this UCLA series were usually published in Annals. To my surprise (and that of the other two authors), our edited summary of the conference was rejected by the then-editor of the journal, with the following explanation: “Although the conference certainly has some relevance to some interests in internal medicine, its main audience appears to us to be more in among persons in public health and in pediatrics.”

Pertussis, an endemic and epidemic disease with a characteristic paroxysmal cough, is most often caused by Bordetella pertussis[2] but is sometimes caused by B. parapertussis. Historical dogma and epidemic patterns of recognized pertussis had, until recently, led to the beliefs that pertussis is an epidemic disease of children; adult pertussis is rare; and vaccine-induced immunity is relatively short-lived, whereas immunity following infection is life-long. Studies done during the past decade indicate that B. pertussis infections and illnesses are common and endemic in adults and that these infections are the reservoir for pertussis in susceptible children. In addition, it is clear that immunity after infection is not lifelong, and it seems that this type of immunity is inferior to that induced by immunization.

The importance of adult pertussis was …