Abstract
This review summarises the epidemiology and control of pertussis in England and Wales since the introduction of routine immunisation and considers the implications for future control. Routine infant immunisation with a whole-cell pertussis (wP) vaccine was introduced in 1957 and had a marked impact on the overall disease burden. Following a fall in vaccine coverage during the 1970s and 80s linked to a safety scare with wP vaccine, there was an extended period of high coverage and pertussis incidence fell dramatically. Incidence continued to decrease with the introduction of an acellular pertussis vaccine in the pre-school booster in November 2001 and in the primary United Kingdom (UK) schedule in September 2004 but has increased since July 2011. In response to a high rate of pertussis in infants, a temporary vaccination programme for pregnant women was introduced in October 2012. The key aim of the programme is to protect vulnerable infants from birth in the first months of life, before they can be fully protected by routine infant immunisation. A review of the UK adolescent immunisation programme is currently ongoing and the inclusion of a pertussis booster is being considered.
Highlights
IntroductionPertussis (whooping cough) is an acute bacterial respiratory infection caused by Bordetella pertussis
Pertussis is an acute bacterial respiratory infection caused by Bordetella pertussis
Following a fall in vaccine coverage during the 1970s and 80s linked to a safety scare with whole-cell pertussis (wP) vaccine, there was an extended period of high coverage and pertussis incidence fell dramatically
Summary
Pertussis (whooping cough) is an acute bacterial respiratory infection caused by Bordetella pertussis. It is characterised by a protracted coughing illness that can last for several weeks. England and Wales have experienced an extended period of high vaccine coverage and disease incidence has fallen dramatically, pertussis remains the most common vaccine-preventable cause of hospitalisation and death in infants [3]. There was concern that early waning of immunity following an accelerated primary course could lead to inadequate immunity in the pre-school years and increase transmission to unimmunised young infants from older siblings [51]. A Swedish multicentre trial of threeand five-component acellular vaccines and the wholecell vaccine in use in the UK confirmed that the latter was highly effective against mild and severe disease [56]
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