Pertussis in the Preantibiotic and Prevaccine Era, with Emphasis on Adult

Pertussis was first recognized as an epidemic disease in the 16th century. The classic illness is a three-stage illness (catarrhal, spasmodic, and convalescent), with a distinctive cough, and its characteristics today are similar to those in the prevaccine era. In the prevaccine era, the calculated attack rate was 872/100,000 population, and the majority of cases occurred in children 5 years of age. On average, there were 7,300 deaths/year; the death rate began to decline before antimicrobial therapy and vaccination. Reported pertussis in adults was rare, but numerous investigators noted that atypical cases of pertussis were common in adults. Pertussis (whooping cough) is an infectious illness of the sis perennis, tussis epidemica infantum, tussis puerorum con-vulsiva, tussis quinta, and tussis quintana [4].respiratory tract, caused by Bordetella pertussis and less com-monly by Bordetella parapertussis [1]. From 1922 through In 1679, Sydenham described the illness clearly and gave it the name pertussis (meaning a violent cough) [5]. In 1900,1931 in the preantibiotic, prevaccine era, there were 1.7 mil-lion reported cases and 73,000 deaths due to pertussis in the Bordet and Gengou observed the causative organism micro-scopically in the sputum of a patient with pertussis [4], and inUnited States [2]. In comparison, during a recent 10-year period (1983–1992), there were 34,325 reported pertussis cases and 1906 they reported the isolation of the organism [6]. Thirty years later, B. parapertussis was recognized by Eldering and56 deaths [3]