Current perspectives on pertussis outbreaks: Causes and consequences

Pertussis, or whooping cough, remains a significant global health concern despite widespread vaccination efforts. Caused by Bordetella pertussis and Bordetella parapertussis, its incidence dramatically declined after vaccine introduction in the 1940s but has resurged recently. Factors contributing to this resurgence include waning immunity, vaccine hesitancy, improved diagnostics, and molecular evolution of the pathogen. Infants bear the greatest disease burden, suffering severe complications such as pneumonia and respiratory failure. Adolescents and adults often act as reservoirs, posing risks to unvaccinated newborns. Diagnosing pertussis is challenging due to symptom overlap with other respiratory infections, particularly in infants. PCR and serology are key diagnostic tools. Macrolide antibiotics remain the mainstay of treatment and prophylaxis, though they do not significantly alter disease progression. Preventive measures emphasize vaccination, including booster doses and maternal immunization during pregnancy. Public health efforts must address vaccine hesitancy and ensure comprehensive immunization coverage to mitigate the persistent threat of pertussis. This review explores the pathophysiology, clinical features, diagnosis, treatment, and prevention strategies for pertussis, as well as factors contributing to its recent resurgence in the United States.