Re-Emergence of Childhood Respiratory Infections in Adults (RSV&Pertussis)

Pertussis (whooping cough) remains an uncontrolled infectious disease despite the institution of universal vaccination in children since the early 1940s. In fact in many developed countries in North America and Europe pertussis has been increasing since 1980. In the United States the number of annually reported cases has increased sixfold since 1980, with 11,647 cases reported in 2003, despite vaccination compliance of more than 80% of young children.¹ Pertussis whole-cell vaccine was introduced in Canada in 1943, and the incidence of whooping cough declined by 90% over the subsequent 40 years.² However, it has increased again in the early 1990s and has remained high since then. The incidence of whooping cough has also increased in recent years in Norway, especially in older children and adults, and in 2004 it was 168 cases per 100,000 of the population.³ The reported incidence rates probably underestimate the true burden of the disease because of incomplete reporting and lack of recognition of the illness.^4,5

Young children with pertussis are more easily diagnosed because of presentations with whooping cough, paroxysmal cough episodes followed by an audible inspiratory whoop and sometimes vomiting. Although most children have a persistent but benign illness, serious sequale may occur in infants such as pneumonia, seizures, encephalopathy, and death. Infants can also present with cough and apneic episodes. Immunized infants, older children, adolescents, and adults do not exhibit whooping cough but may have prolonged cough for several weeks.