Abstract
Despite high coverage with pertussis-containing vaccines, pertussis remains endemic to the United States. There have been increases in reported cases in recent years, punctuated by striking epidemics and shifting epidemiology, both of which raise questions about current policies regarding its prevention and control. Limited data on pertussis reported through the National Notifiable Disease Surveillance System have proved insufficient to answer these questions. To address shortcomings of national pertussis data, the Emerging Infections Program at the US Centers for Disease Control and Prevention launched Enhanced Pertussis Surveillance (EPS), which is characterized by systematic case ascertainment, augmented data collection, and collection of Bordetella pertussis isolates. Data collected through EPS have been instrumental in understanding the rapidly evolving epidemiology and molecular epidemiology of pertussis and have contributed essential information regarding pertussis vaccines. EPS also serves as a platform for conducting critical and timely evaluations of pertussis prevention and control strategies, including targeting of vaccinations and antimicrobial prophylaxis.
Highlights
Despite high coverage with pertussis-containing vaccines, pertussis remains endemic to the United States
Annual numbers of reported cases decreased >99% in the United States after introduction of whole-cell pertussis vaccines in the 1940s, this highly contagious respiratory illness has refused to go the way of other vaccine-preventable diseases of childhood, such as polio, Haemophilus influenzae type b infection, and diphtheria
Pertussis remains endemic to the United States, and the number of reported cases has been increasing steadily since the late 1980s, with notable epidemic peaks in recent years (Figure 1)
Summary
Despite high coverage with pertussis-containing vaccines, pertussis remains endemic to the United States. Because case investigation requires the effort and resources of disparate local and state public health agencies, the quantity and quality of pertussis case reports vary, and data elements fundamental to the understanding of pertussis, including case demographics, clinical symptoms and pertussis vaccination history, are often incomplete.
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