Whooping cough: Difference between revisions

Whooping cough
Whooping cough
Other names	Pertussis, 100-day cough
	A young boy coughing due to pertussis.
Specialty	Infectious disease
Symptoms	Runny nose, fever, cough
Complications	Vomiting, broken ribs, exhaustion
Duration	~ 3 months
Causes	Bordetella pertussis (spread through the air)
Diagnostic method	Nasopharyngeal swab
Prevention	Pertussis vaccine
Treatment	Antibiotics (if started early)
Frequency	16.3 million (2015)
Deaths	58,700 (2015)

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Whooping cough (/ˈhuːpɪŋ/), also known as pertussis or the 100-day cough, is a highly contagious, vaccine-preventable bacterial disease.^[1]^[10] Initial symptoms are usually similar to those of the common cold with a runny nose, fever, and mild cough, but these are followed by two or three months of severe coughing fits.^[1] Following a fit of coughing, a high-pitched whoop sound or gasp may occur as the person breathes in.^[1] The violent coughing may last for 10 or more weeks, hence the phrase "100-day cough".^[3] The cough may be so hard that it causes vomiting, rib fractures, and fatigue.^[1]^[2] Children less than one year old may have little or no cough and instead have periods when they cannot breathe.^[1] The incubation period is usually seven to ten days.^[11] Disease may occur in those who have been vaccinated, but symptoms are typically milder.^[1]

Pertussis is caused by the bacterium Bordetella pertussis, which is spread easily through the coughs and sneezes of an infected person.^[4]^[12] People are infectious from the start of symptoms until about three weeks into the coughing fits.^[7] Diagnosis is by collecting a sample from the back of the nose and throat.^[5] This sample can then be tested either by culture or by polymerase chain reaction.^[5]

Prevention is mainly by vaccination with the pertussis vaccine.^[6] Initial immunization is recommended between six and eight weeks of age, with four doses to be given in the first two years of life.^[13] Protection from pertussis decreases over time, so additional doses of vaccine are often recommended for older children and adults.^[14] Vaccination during pregnancy is highly effective at protecting the infant from pertussis during their vulnerable early months of life, and is recommended in many countries.^[15] Antibiotics may be used to prevent the disease in those who have been exposed and are at risk of severe disease.^[16] In those with the disease, antibiotics are useful if started within three weeks of the initial symptoms, but otherwise have little effect in most people.^[7] In pregnant women and children less than one year old, antibiotics are recommended within six weeks of symptom onset.^[7] Antibiotics used include erythromycin, azithromycin, clarithromycin, or trimethoprim/sulfamethoxazole.^[7] Evidence to support interventions for the cough, other than antibiotics, is poor.^[17] About 50% of infected children less than a year old require hospitalization and nearly 0.5% (1 in 200) die.^[1]^[2]

An estimated 16.3 million people worldwide were infected in 2015.^[8] Most cases occur in the developing world, and people of all ages may be affected.^[6]^[17] In 2015, pertussis resulted in 58,700 deaths – down from 138,000 deaths in 1990.^[9]^[18] Outbreaks of the disease were first described in the 16th century.^[11] The bacterium that causes the infection was discovered in 1906.^[11] The pertussis vaccine became available in the 1940s.^[11]

Signs and symptoms

A boy with pertussis

The classic symptoms of pertussis are a paroxysmal cough, inspiratory whoop, and fainting, or vomiting after coughing.^[19] The cough from pertussis has been documented to cause subconjunctival hemorrhages, rib fractures, urinary incontinence, hernias, and vertebral artery dissection.^[19] Violent coughing can cause the pleura to rupture, leading to a pneumothorax. Vomiting after a coughing spell or an inspiratory whooping sound on coughing almost doubles the likelihood that the illness is pertussis. The absence of a paroxysmal cough or posttussive emesis, though, makes it almost half as likely.^[19]

The illness usually starts with mild respiratory symptoms including mild coughing, sneezing, or a runny nose (known as the catarrhal stage). After one or two weeks, the coughing classically develops into uncontrollable fits, sometimes followed by a high-pitched "whoop" sound, as the person tries to inhale. About 50% of children and adults "whoop" at some point in diagnosed pertussis cases during the paroxysmal stage. This stage usually lasts up to 3 months, or sometimes longer.^[1] A gradual transition then occurs to the convalescent stage, which usually lasts one to four weeks. This stage is marked by a decrease in paroxysms of coughing, although paroxysms may occur with subsequent respiratory infection for many months after the onset of pertussis.^[20]

Symptoms of pertussis can be variable, especially between immunized and non-immunized people. Those that are immunized can present with a more mild infection; they may only have the paroxysmal cough for a couple of weeks, and it may lack the "whooping" characteristic.^[21] Although immunized people have a milder form of the infection, they can still spread the disease to others who are not immune.^[21]

Incubation period

The time between exposure and the development of symptoms is on average 7–14 days (ranging 6–20 days),^[22] and rarely as long as 42 days.^[23]

Cause

Pertussis is caused by the bacterium Bordetella pertussis. It is an airborne disease (through droplets) that spreads easily through the coughs and sneezes of an infected person.^[4]

Host species

Humans are the only host species of B. pertussis.^[24] Outbreaks of whooping cough have been observed among chimpanzees in a zoo, and among wild gorillas; in both cases it is considered likely that the infection was acquired as a result of close contact with humans.^[25]^[26] Several zoos have a long-standing custom of vaccinating their primates against whooping cough.^[27]

Mechanism

After the bacteria are inhaled, they initially adhere to the ciliated epithelium in the nasopharynx. Surface proteins of B. pertussis, including filamentous hemaglutinin and pertactin, mediate attachment to the epithelium. The bacteria then multiply.^[28]^[29] In infants, who experience more severe disease, the bacteria spread down to the lungs.^[29]

The bacteria secretes a number of toxins. Tracheal cytotoxin (TCT), a fragment of peptidoglycan, kills ciliated epithelial cells in the airway and thereby inhibits the mechanism which clears the airways of mucus and debris.^[30] TCT may contribute to the cough characteristic of pertussis.^[31] Pertussis toxin causes lymphocytosis by an unknown mechanism. The elevated number of white blood cells leads to pulmonary hypertension, a major cause of death by pertussis.^[30]^[29] In infants who develop encephalopathy, cerebral hemorrhage and cortical atrophy occur, likely due to hypoxia.^[29]

Diagnosis

Based on symptoms

A physician's overall impression is most effective in initially making the diagnosis.^[32] Single factors are much less useful.^[32] In adults with a cough of less than 8 weeks, vomiting after coughing or a "whoop" is supportive.^[33] If there are no bouts of coughing or there is a fever the diagnosis is unlikely.^[33] In children who have a cough of less than 4 weeks vomiting after coughing is somewhat supportive but not definitive.^[33]

Lab tests

Methods used in laboratory diagnosis include culturing of nasopharyngeal swabs on a nutrient medium (Bordet–Gengou medium), polymerase chain reaction (PCR), direct fluorescent antibody (DFA), and serological methods (e.g. complement fixation test).^[34] The bacteria can be recovered from the person only during the first three weeks of illness, rendering culturing and DFA useless after this period, although PCR may have some limited usefulness for an additional three weeks.

Serology may be used for adults and adolescents who have already been infected for several weeks to determine whether antibody against pertussis toxin or another virulence factor of B. pertussis is present at high levels in the blood of the person.^[35]

Differential diagnosis

A similar, milder disease is caused by B. parapertussis.^[36]

Prevention

The primary method of prevention for pertussis is vaccination.^[37] Evidence is insufficient to determine the effectiveness of antibiotics in those who have been exposed, but are without symptoms.^[38] Preventive antibiotics, however, are still frequently used in those who have been exposed and are at high risk of severe disease (such as infants).^[6]

Vaccine

Pertussis vaccines are effective at preventing illness^[39] and are recommended for routine use by the World Health Organization^[40] and the United States Centers for Disease Control and Prevention.^[41] The vaccine saved an estimated half a million lives in 2002.^[40]

The multicomponent acellular pertussis vaccine is 71–85% effective, with greater effectiveness against more severe strains.^[39] However, despite widespread vaccination, pertussis has persisted in vaccinated populations and is today "one of the most common vaccine-preventable diseases in Western countries".^[42] The 21st-century resurgences in pertussis infections is attributed to a combination of waning immunity and bacterial mutations that elude vaccines.^[42]^[43]

Immunization does not confer lifelong immunity; a 2011 CDC study indicated that protection may only last three to six years. This covers childhood, which is the time of greatest exposure and greatest risk of death from pertussis.^[19]^[44]

An effect of widespread immunization on society has been the shift of reported infections from children aged 1–9 years to infants, adolescents, and adults, with adolescents and adults acting as reservoirs for B. pertussis and infecting infants who have had fewer than three doses of vaccine.^[45]

Infection induces incomplete natural immunity that wanes over time.^[46] A 2005 study said estimates of the duration of infection-acquired immunity range from 7 to 20 years and the different results could be the result of differences in levels of circulating B. pertussis, surveillance systems, and case definitions used. The study said protective immunity after vaccination wanes after 4–12 years.^[47] One study suggested that the availability of vaccine exemptions increases the number of pertussis cases.^[48]

Some studies have suggested that while acellular pertussis vaccines are effective at preventing the disease, they have a limited impact on infection and transmission, meaning that vaccinated people could spread pertussis even though they may have only mild symptoms or none at all.^[49]^[50] Pertussis infection in these persons may be asymptomatic, or present as illness ranging from a mild cough to classic pertussis with persistent cough (i.e., lasting more than 7 days). Even though the disease may be milder in older persons, those who are infected may transmit the disease to other susceptible persons, including unimmunized or incompletely immunized infants. Older persons are often found to have the first case in a household with multiple pertussis cases, and are often the source of infection for children.^[20]

Treatment

The antibiotics erythromycin, clarithromycin, or azithromycin are typically the recommended treatment.^[38] Newer macrolides are frequently recommended due to lower rates of side effects.^[6] Trimethoprim-sulfamethoxazole (TMP/SMX) may be used in those with allergies to first-line agents or in infants who have a risk of pyloric stenosis from macrolides.^[6]

A reasonable guideline is to treat people age >1 year within 3 weeks of cough onset and infants age <1 year and pregnant women within 6 weeks of cough onset. If the person is diagnosed late, antibiotics will not alter the course of the illness, and even without antibiotics, they should no longer be spreading pertussis.^[6] When used early, antibiotics decrease the duration of infectiousness, and thus prevent spread.^[6] Short-term antibiotics (azithromycin for 3–5 days) are as effective as long-term treatment (erythromycin 10–14 days) in eliminating B. pertussis with fewer and less severe side effects.^[38]

People with pertussis are most infectious during the first two weeks following the onset of symptoms.^[51]

Effective treatments of the cough associated with this condition have not been developed.^[52] The use of over the counter cough medications is discouraged and has not been found helpful.^[21]

Prognosis

While most healthy older children and adults fully recover, infection in newborns is particularly severe. Pertussis is fatal in an estimated 0.5% of US infants under one year of age.^[53] First-year infants are also more likely to develop complications, such as apneas (31%), pneumonia (12%), seizures (0.6%) and encephalopathy (0.15%).^[53] This may be due to the ability of the bacterium to suppress the immune system.^[54]

Epidemiology

Pertussis is endemic worldwide. More than 151,000 cases were reported globally during 2018.^[12] However not all cases are reported or correctly diagnosed, especially in developing countries. Pertussis is one of the leading causes of vaccine-preventable deaths worldwide.^[55] A study in 2017 estimated the global burden of the disease to be 24 million cases per year with 160,000 deaths among young children, with about 90% of all cases occurring in developing countries.^[56]^[55]

Epidemics of the disease occur cyclically, every three to 5 years, both in areas with vaccination programs and those without.^[57] Over time, immunity declines in those who have either been vaccinated or have recovered from infection.^[58] In addition, infants are born who are susceptible to infection. An epidemic can occur once herd immunity reduces below decreases below a certain level.^[59] It is also possible that the bacterium is evolving to evade vaccine-induced immunity.^[60]^[57]

Before vaccines, an average of 178,171 cases was reported in the U.S., with peaks reported every two to five years; more than 93% of reported cases occurred in children under 10 years of age. With the widespread introduction the DTP combined vaccine (diphtheria tetanus and pertussis) in the 1940s, pertussis incidence fell dramatically to approximately 1,000 by 1976, since when they have fluctuated between 1,000 and 30,000 annually.^[61]^[62]

Cases recorded outside of the U.S. were also recorded ^[when?] at high numbers comparable to their populations. Prior to the vaccine being discovered, Sweden averaged nearly 3,000 children deaths per year. With their population only being 1.8 million in the years 1749-64 this number was very high. The London population during the same time period recorded over 3,000 deaths. The rates in London continued to grow into the 18th century. These numbers show how the disease affected not only the U.S. but also those around the world.^[63]

According to the 2024^[update] CDC, reports that cases of whooping cough have reached their highest levels since 2014.^[64] This year, there have been over 16,000 cases, marking a fourfold increase compared to last year’s total of more than 3,700 cases.^[65] The CDC has also confirmed two deaths related to the illness.^{[citation needed]} The United States is seeing a return to pre-pandemic trends, where annual cases typically exceed 10,000.^[66]

History

Discovery

B. pertussis was discovered in 1906 by Jules Bordet and Octave Gengou (the bacterium is subsequently named Bordetella pertussis in honour of Jules Bordet). They were able to successfully culture B. pertussis and went on to develop the first inactivated whole-cell vaccine in 1912, followed by other researchers in 1913 and 1914. These early vaccines had limited effectiveness. In the 1920s, Louis W. Sauer developed a vaccine for whooping cough at Evanston Hospital. In 1925 Danish physician Thorvald Madsen was the first to test a whole-cell vaccine on a wide scale. Madsen used the vaccine to control outbreaks in the Faroe Islands in the North Sea, however two children died shortly after receiving the vaccine. ^[67]^[68]^[69]

Vaccine

In 1932, an outbreak of whooping cough hit Atlanta, Georgia, prompting pediatrician Leila Denmark to begin her study of the disease. Over the next six years, her work was published in the Journal of the American Medical Association, and in partnership with Emory University and Eli Lilly & Company, she developed the first safe and effective pertussis vaccine.^[70] In 1942, American scientists Grace Eldering, Loney Gordon, and Pearl Kendrick combined the whole-cell pertussis vaccine with diphtheria and tetanus toxoids to generate the first DTP combination vaccine.^[71] To minimize the frequent side effects caused by the pertussis component, Japanese scientist Yuji Sato developed an acellular vaccine consisting of purified haemagglutinins (HAs: filamentous strep throat and leukocytosis-promoting-factor HA), which are secreted by B. pertussis. Sato's acellular pertussis vaccine was used in Japan starting in 1981.^[72] Later versions of the acellular vaccine in other countries consisted of additional defined components of B. pertussis and were often part of the DTaP combination vaccine.

References

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^ ^a ^b "Pertussis in Other Countries". Centers for Disease Control and Prevention (CDC). Archived from the original on 12 May 2013. Retrieved 30 July 2024.
^ Yeung KH, Duclos P, Nelson EA, Hutubessy RC (September 2017). "An update of the global burden of pertussis in children younger than 5 years: a modelling study". The Lancet. Infectious Diseases. 17 (9): 974–980. doi:10.1016/S1473-3099(17)30390-0. ISSN 1474-4457. PMID 28623146.
^ ^a ^b Bouchez V, Guiso N (October 2015). Carbonetti N (ed.). "Bordetella pertussis , B. parapertussis , vaccines and cycles of whooping cough". Pathogens and Disease. 73 (7): ftv055. doi:10.1093/femspd/ftv055. ISSN 2049-632X. PMID 26242280.
^ Burdin N, Handy LK, Plotkin SA (December 2017). "What Is Wrong with Pertussis Vaccine Immunity? The Problem of Waning Effectiveness of Pertussis Vaccines". Cold Spring Harbor Perspectives in Biology. 9 (12): a029454. doi:10.1101/cshperspect.a029454. ISSN 1943-0264. PMC 5710106. PMID 28289064.
^ "Facts and figures - Whooping cough". NSW Health. 15 March 2017. Retrieved 26 March 2024.
^ "Pertussis (whooping cough) - Epidemic Control Toolkit". The International Federation of Red Cross. 14 June 2022. Retrieved 26 March 2024.
^ Kuchar E, Karlikowska-Skwarnik M, Han S, Nitsch-Osuch A (2016), Pokorski M (ed.), "Pertussis: History of the Disease and Current Prevention Failure", Pulmonary Dysfunction and Disease, vol. 934, Cham: Springer International Publishing, pp. 77–82, doi:10.1007/5584_2016_21, ISBN 978-3-319-42009-7, PMID 27256351, retrieved 30 September 2024
^ "Pertussis Cases by Year". Centers for Disease Control and Prevention. 23 July 2024. Retrieved 30 September 2024.
^ Weston R (October 2012). "Whooping Cough: A Brief History to the 19th Century". Canadian Bulletin of Medical History. 29 (2): 329–349. doi:10.3138/cbmh.29.2.329. ISSN 0823-2105. PMID 28155549.
^ America GM. "Whooping cough cases surge: CDC". Good Morning America. Retrieved 14 October 2024.
^ CDC (10 October 2024). "Pertussis Surveillance and Trends". Whooping Cough (Pertussis). Retrieved 14 October 2024.
^ Leake L. "Whooping cough cases up 342% since 2023 as U.S. outbreak continues. What to know about symptoms and spread". Fortune Well. Retrieved 14 October 2024.
^ Baker JP, Katz SL (February 2004). "Childhood vaccine development: an overview". Pediatric Research. 55 (2): 347–56. doi:10.1203/01.PDR.0000106317.36875.6A. PMID 14630981.
^ "Pertussis". Museum of Health Care. Retrieved 4 November 2024.
^ Vaccines Io, Howson CP, Howe CJ, Fineberg HV (1991), "Pertussis and Rubella Vaccines: A Brief Chronology", Adverse Effects of Pertussis and Rubella Vaccines: A Report of the Committee to Review the Adverse Consequences of Pertussis and Rubella Vaccines, National Academies Press (US), retrieved 4 November 2024
^ "Changing the Face of Medicine | Dr. Leila Alice Daughtry Denmark". www.nlm.nih.gov. Archived from the original on 21 March 2015. Retrieved 3 February 2016.
^ Bannink J. "Finding aid for the Michigan women and the whooping cough vaccine collection[s]" (PDF). Archived (PDF) from the original on 5 February 2015.
^ Sato Y, Kimura M, Fukumi H (January 1984). "Development of a pertussis component vaccine in Japan". Lancet. 1 (8369): 122–6. doi:10.1016/S0140-6736(84)90061-8. PMID 6140441. S2CID 23621152.

External links

Wikipedia's health care articles can be viewed offline with the Medical Wikipedia app.

Pertussis at Todar's Online Textbook of Bacteriology
PBS NOVA – Vaccines: Calling The Shots
"Whooping Cough". MedlinePlus. U.S. National Library of Medicine.

[CDC2014S-1] ^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j "Pertussis (Whooping Cough) Signs & Symptoms". Centers for Disease Control. 4 August 2022. Retrieved 26 March 2023.

[CDC2013Com-2] "Pertussis (Whooping Cough) Complications". Centers for Disease Control. 4 August 2022. Retrieved 26 March 2024.

[CDC2015Facts-3] "Pertussis (Whooping Cough) Fast Facts". cdc.gov. 13 February 2014. Archived from the original on 7 February 2015. Retrieved 12 February 2015.

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@@ Line 3: / Line 3: @@
 {{Use dmy dates|date=August 2020}}
 {{Infobox medical condition (new)
-| name          = Whooping cough
+| name = Whooping cough
-| synonyms      = Pertussis, 100-day cough
+| synonyms = Pertussis, 100-day cough
-| image         = Pertussis.jpg
+| image = Pertussis.jpg
-| image_size    = 250 px
+| image_size = 250 px
-| caption       = A young boy coughing due to pertussis.
+| caption = A young boy coughing due to pertussis.
-| field         = [[Infectious disease (medical specialty)|Infectious disease]]
+| field = [[Infectious disease (medical specialty)|Infectious disease]]
-| symptoms      = Runny nose, fever, cough<ref name=CDC2014S/>
+| symptoms = Runny nose, fever, cough<ref name=CDC2014S/>
 | complications = Vomiting, [[rib fracture|broken ribs]], [[fatigue (medicine)|exhaustion]]<ref name=CDC2014S/><ref name=CDC2013Com/>
-| onset         =
+| onset =
-| duration      = ~ 10 weeks<ref name=CDC2015Facts/>
+| duration = ~ 3 months<ref name=CDC2015Facts/>
-| causes        = ''[[Bordetella pertussis]]'' ([[airborne disease|spread through the air]])<ref name=CDC2014C/>
+| causes = ''[[Bordetella pertussis]]'' ([[airborne disease|spread through the air]])<ref name=CDC2014C/>
-| risks         =
+| risks =
-| diagnosis     = [[Nasopharyngeal swab]]<ref name=CDC2013Sam/>
+| diagnosis = [[Nasopharyngeal swab]]<ref name=CDC2013Sam/>
-| differential  =
+| differential =
-| prevention    = [[Pertussis vaccine]]<ref name=Update10/>
+| prevention = [[Pertussis vaccine]]<ref name=Update10/>
-| treatment     = [[Antibiotics]] (if started early)<ref name=CDC2013Tr/>
+| treatment = [[Antibiotics]] (if started early)<ref name=CDC2013Tr/>
-| medication    =
+| medication =
-| frequency     = 16.3&nbsp;million (2015)<!-- incidence table --><ref name=GBD2015Pre/>
+| frequency = 16.3&nbsp;million (2015)<!-- incidence table --><ref name=GBD2015Pre/>
-| deaths        = 58,700 (2015)<ref name=GBD2015De/>
+| deaths = 58,700 (2015)<ref name=GBD2015De/>
 }}
 <!-- Definition and symptoms -->
-'''Whooping cough''' ({{IPAc-en|'|h|uː|p|ɪ|ŋ}}), also known as '''pertussis''' or the '''100-day cough''', is a highly contagious, [[Vaccine-preventable diseases|vaccine-preventable]] [[Pathogenic bacteria|bacterial disease]].<ref name=CDC2014S/><ref>{{Cite web |date=2022-09-07 |title=Preventing Whooping Cough (Pertussis) {{!}} CDC |url=https://www.cdc.gov/pertussis/about/prevention/index.html |access-date=2023-05-21 |website=Centers for Disease Control |language=en-us}}</ref> Initial symptoms are usually similar to those of the [[common cold]] with a [[rhinorrhea|runny nose]], fever, and mild cough, but these are followed by two or three months of severe coughing fits.<ref name=CDC2014S/> Following a fit of coughing, a high-pitched whoop sound or gasp may occur as the person breathes in.<ref name=CDC2014S/> The violent coughing may last for 10 or more weeks, hence the phrase "100-day cough".<ref name=CDC2015Facts>{{cite web|title=Pertussis (Whooping Cough) Fast Facts|url=https://www.cdc.gov/pertussis/fast-facts.html|website=cdc.gov|access-date=12 February 2015|date=13 February 2014|url-status=live|archive-url=https://web.archive.org/web/20150207090550/http://www.cdc.gov/pertussis/fast-facts.html|archive-date=7 February 2015}}</ref> The cough may be so hard that it causes vomiting,  [[rib fracture]]s, and [[fatigue]].<ref name=CDC2014S/><ref name="CDC2013Com">{{cite web |date=4 August 2022 |title=Pertussis (Whooping Cough) Complications |url=https://www.cdc.gov/pertussis/about/complications.html |archive-url= |archive-date= |access-date=26 March 2024 |website=Centers for Disease Control}}</ref> Children less than one year old may have little or no cough and instead have [[apnea|periods where they cannot breathe]].<ref name="CDC2014S">{{cite web |date=August 4, 2022 |title=Pertussis (Whooping Cough) Signs & Symptoms |url=https://www.cdc.gov/pertussis/about/signs-symptoms.html |archive-url= |archive-date= |access-date=26 March 2023 |website=Centers for Disease Control}}</ref> The [[incubation period]] is usually seven to ten days.<ref name=CDC2012Pink/> Disease may occur in those who have been vaccinated, but symptoms are typically milder.<ref name=CDC2014S/>
+'''Whooping cough''' ({{IPAc-en|'|h|uː|p|ɪ|ŋ}}), also known as '''pertussis''' or the '''100-day cough''', is a highly contagious, [[Vaccine-preventable diseases|vaccine-preventable]] [[Pathogenic bacteria|bacterial disease]].<ref name=CDC2014S/><ref name=":2">{{Cite web |date=2022-09-07 |title=Preventing Whooping Cough (Pertussis) {{!}} CDC |url=https://www.cdc.gov/pertussis/about/prevention/index.html |access-date=2023-05-21 |website=Centers for Disease Control |language=en-us}}</ref> Initial symptoms are usually similar to those of the [[common cold]] with a [[rhinorrhea|runny nose]], fever, and mild cough, but these are followed by two or three months of severe coughing fits.<ref name=CDC2014S/> Following a fit of coughing, a high-pitched whoop sound or gasp may occur as the person breathes in.<ref name=CDC2014S/> The violent coughing may last for 10 or more weeks, hence the phrase "100-day cough".<ref name=CDC2015Facts>{{cite web|title=Pertussis (Whooping Cough) Fast Facts|url=https://www.cdc.gov/pertussis/fast-facts.html|website=cdc.gov|access-date=12 February 2015|date=13 February 2014|url-status=live|archive-url=https://web.archive.org/web/20150207090550/http://www.cdc.gov/pertussis/fast-facts.html|archive-date=7 February 2015}}</ref> The cough may be so hard that it causes vomiting,  [[rib fracture]]s, and [[fatigue]].<ref name=CDC2014S/><ref name="CDC2013Com">{{cite web |date=4 August 2022 |title=Pertussis (Whooping Cough) Complications |url=https://www.cdc.gov/pertussis/about/complications.html |archive-url= |archive-date= |access-date=26 March 2024 |website=Centers for Disease Control}}</ref> Children less than one year old may have little or no cough and instead have [[apnea|periods when they cannot breathe]].<ref name="CDC2014S">{{cite web |date=August 4, 2022 |title=Pertussis (Whooping Cough) Signs & Symptoms |url=https://www.cdc.gov/pertussis/about/signs-symptoms.html |archive-url= |archive-date= |access-date=26 March 2023 |website=Centers for Disease Control}}</ref> The [[incubation period]] is usually seven to ten days.<ref name=CDC2012Pink/> Disease may occur in those who have been vaccinated, but symptoms are typically milder.<ref name=CDC2014S/>
 <!-- Cause and diagnosis -->
-Pertussis is caused by the bacterium ''[[Bordetella pertussis]]'', which is spread easily through the coughs and sneezes of an infected person.<ref name="CDC2014C">{{cite web|title=Pertussis (Whooping Cough) Causes & Transmission|url=https://www.cdc.gov/pertussis/about/causes-transmission.html|website=cdc.gov|access-date=12 February 2015|date=4 September 2014|url-status=live|archive-url=https://web.archive.org/web/20150214040511/http://www.cdc.gov/pertussis/about/causes-transmission.html|archive-date=14 February 2015}}</ref><ref>{{Cite web |title=Pertussis |url=https://www.who.int/health-topics/pertussis |access-date=2024-03-26 |website=World Health Organization |language=en}}</ref> People are infectious from the start of symptoms until about three weeks into the coughing fits.<ref name="CDC2013Tr">{{cite web |date=28 August 2013 |title=Pertussis (Whooping Cough) Treatment |url=https://www.cdc.gov/pertussis/clinical/treatment.html |url-status=live |archive-url=https://web.archive.org/web/20150211094551/http://www.cdc.gov/pertussis/clinical/treatment.html |archive-date=11 February 2015 |access-date=13 February 2015 |website=cdc.gov}}</ref> Diagnosis is by collecting a [[nasopharyngeal swab|sample from the back of the nose and throat]].<ref name=CDC2013Sam/> This sample can then be tested either by [[Cell culture|culture]] or by [[polymerase chain reaction]].<ref name=CDC2013Sam>{{cite web|title=Pertussis (Whooping Cough) Specimen Collection|url=https://www.cdc.gov/pertussis/clinical/diagnostic-testing/specimen-collection.html|website=cdc.gov|access-date=13 February 2015|date=28 August 2013|url-status=live|archive-url=https://web.archive.org/web/20150208221312/http://www.cdc.gov/pertussis/clinical/diagnostic-testing/specimen-collection.html|archive-date=8 February 2015}}</ref>
+Pertussis is caused by the bacterium ''[[Bordetella pertussis]]'', which is spread easily through the coughs and sneezes of an infected person.<ref name="CDC2014C">{{cite web|title=Pertussis (Whooping Cough) Causes & Transmission|url=https://www.cdc.gov/pertussis/about/causes-transmission.html|website=cdc.gov|access-date=12 February 2015|date=4 September 2014|url-status=live|archive-url=https://web.archive.org/web/20150214040511/http://www.cdc.gov/pertussis/about/causes-transmission.html|archive-date=14 February 2015}}</ref><ref name="auto">{{Cite web |title=Pertussis |url=https://www.who.int/health-topics/pertussis |access-date=2024-03-26 |website=World Health Organization |language=en}}</ref> People are infectious from the start of symptoms until about three weeks into the coughing fits.<ref name="CDC2013Tr">{{cite web |date=28 August 2013 |title=Pertussis (Whooping Cough) Treatment |url=https://www.cdc.gov/pertussis/clinical/treatment.html |url-status=live |archive-url=https://web.archive.org/web/20150211094551/http://www.cdc.gov/pertussis/clinical/treatment.html |archive-date=11 February 2015 |access-date=13 February 2015 |website=cdc.gov}}</ref> Diagnosis is by collecting a [[nasopharyngeal swab|sample from the back of the nose and throat]].<ref name=CDC2013Sam/> This sample can then be tested either by [[Cell culture|culture]] or by [[polymerase chain reaction]].<ref name=CDC2013Sam>{{cite web|title=Pertussis (Whooping Cough) Specimen Collection|url=https://www.cdc.gov/pertussis/clinical/diagnostic-testing/specimen-collection.html|website=cdc.gov|access-date=13 February 2015|date=28 August 2013|url-status=live|archive-url=https://web.archive.org/web/20150208221312/http://www.cdc.gov/pertussis/clinical/diagnostic-testing/specimen-collection.html|archive-date=8 February 2015}}</ref>
 <!-- Prevention and treatment -->
-Prevention is mainly by [[vaccination]] with the [[pertussis vaccine]].<ref name=Update10>{{cite journal | vauthors = Heininger U | title = Update on pertussis in children | journal = Expert Review of Anti-Infective Therapy | volume = 8 | issue = 2 | pages = 163–73 | date = February 2010 | pmid = 20109046 | doi = 10.1586/eri.09.124 | s2cid = 207217558 }}</ref> Initial immunization is recommended between six and eight weeks of age, with four doses to be given in the first two years of life.<ref>{{cite journal | title = Revised guidance on the choice of pertussis vaccines: July 2014 | journal = Relevé Épidémiologique Hebdomadaire | volume = 89 | issue = 30 | pages = 337–40 | date = July 2014 | pmid = 25072068 | url =https://www.who.int/wer/2013/wer8930.pdf?ua=1 | archive-url = https://web.archive.org/web/20150213144751/http://www.who.int/wer/2013/wer8930.pdf?ua=1 | url-status = live | archive-date = 13 February 2015 }}</ref> Protection from pertussis decreases over time, so additional doses of vaccine are often recommended for older children and adults.<ref>{{cite journal | title = Pertussis vaccines: WHO position paper | journal = Relevé Épidémiologique Hebdomadaire | volume = 85 | issue = 40 | pages = 385–400 | date = October 2010 | pmid = 20939150 }}</ref> Vaccination during pregnancy is highly effective at protecting the infant from pertussis during their vulnerable early months of life, and is recommended in many countries.<ref name="pmid32054444">{{cite journal | vauthors = Vygen-Bonnet S, Hellenbrand W, Garbe E, von Kries R, Bogdan C, Heininger U, Röbl-Mathieu M, Harder T | title = Safety and effectiveness of acellular pertussis vaccination during pregnancy: a systematic review | journal = BMC Infect Dis | volume = 20 | issue = 1 | pages = 136 | date = February 2020 | pmid = 32054444 | pmc = 7020352 | doi = 10.1186/s12879-020-4824-3 | doi-access = free }}</ref> Antibiotics may be used to prevent the disease in those who have been exposed and are at risk of severe disease.<ref>{{cite web|title=Pertussis (Whooping Cough) Prevention|url=https://www.cdc.gov/pertussis/clinical/prevention.html|website=cdc.gov|access-date=13 February 2015|date=10 October 2014|url-status=live|archive-url=https://web.archive.org/web/20150208221327/http://www.cdc.gov/pertussis/clinical/prevention.html|archive-date=8 February 2015}}</ref> In those with the disease, antibiotics are useful if started within three weeks of the initial symptoms, but otherwise have little effect in most people.<ref name=CDC2013Tr/> In pregnant women and children less than one year old, antibiotics are recommended within six weeks of symptom onset.<ref name=CDC2013Tr/> Antibiotics used include [[erythromycin]], [[azithromycin]], [[clarithromycin]], or [[trimethoprim/sulfamethoxazole]].<ref name=CDC2013Tr/> Evidence to support interventions for the cough, other than antibiotics, is poor.<ref name=Wang2014>{{cite journal | vauthors = Wang K, Bettiol S, Thompson MJ, Roberts NW, Perera R, Heneghan CJ, Harnden A | title = Symptomatic treatment of the cough in whooping cough | journal = The Cochrane Database of Systematic Reviews | volume = 9 | issue = 9 | pages = CD003257 | date = September 2014 | pmid = 25243777 | doi = 10.1002/14651858.CD003257.pub5 | url = https://ora.ox.ac.uk/objects/uuid:66161792-3b06-4f30-bdbf-3f2000828ade/datastreams/ATTACHMENT01 | pmc = 7154224 }}</ref> About 50% of infected children less than a year old require hospitalization and nearly 0.5% (1 in 200) die.<ref name=CDC2014S/><ref name=CDC2013Com/>
+Prevention is mainly by [[vaccination]] with the [[pertussis vaccine]].<ref name=Update10>{{cite journal | vauthors = Heininger U | title = Update on pertussis in children | journal = Expert Review of Anti-Infective Therapy | volume = 8 | issue = 2 | pages = 163–73 | date = February 2010 | pmid = 20109046 | doi = 10.1586/eri.09.124 | s2cid = 207217558 }}</ref> Initial immunization is recommended between six and eight weeks of age, with four doses to be given in the first two years of life.<ref>{{cite journal | title = Revised guidance on the choice of pertussis vaccines: July 2014 | journal = Relevé Épidémiologique Hebdomadaire | volume = 89 | issue = 30 | pages = 337–40 | date = July 2014 | pmid = 25072068 | url =https://www.who.int/wer/2013/wer8930.pdf?ua=1 | archive-url = https://web.archive.org/web/20150213144751/http://www.who.int/wer/2013/wer8930.pdf?ua=1 | url-status = live | archive-date = 13 February 2015 }}</ref> Protection from pertussis decreases over time, so additional doses of vaccine are often recommended for older children and adults.<ref>{{cite journal | title = Pertussis vaccines: WHO position paper | journal = Relevé Épidémiologique Hebdomadaire | volume = 85 | issue = 40 | pages = 385–400 | date = October 2010 | pmid = 20939150 }}</ref> Vaccination during pregnancy is highly effective at protecting the infant from pertussis during their vulnerable early months of life, and is recommended in many countries.<ref name="pmid32054444">{{cite journal | vauthors = Vygen-Bonnet S, Hellenbrand W, Garbe E, von Kries R, Bogdan C, Heininger U, Röbl-Mathieu M, Harder T | title = Safety and effectiveness of acellular pertussis vaccination during pregnancy: a systematic review | journal = BMC Infect Dis | volume = 20 | issue = 1 | pages = 136 | date = February 2020 | pmid = 32054444 | pmc = 7020352 | doi = 10.1186/s12879-020-4824-3 | doi-access = free }}</ref> Antibiotics may be used to prevent the disease in those who have been exposed and are at risk of severe disease.<ref>{{cite web|title=Pertussis (Whooping Cough) Prevention|url=https://www.cdc.gov/pertussis/clinical/prevention.html|website=cdc.gov|access-date=13 February 2015|date=10 October 2014|url-status=live|archive-url=https://web.archive.org/web/20150208221327/http://www.cdc.gov/pertussis/clinical/prevention.html|archive-date=8 February 2015}}</ref> In those with the disease, antibiotics are useful if started within three weeks of the initial symptoms, but otherwise have little effect in most people.<ref name=CDC2013Tr/> In pregnant women and children less than one year old, antibiotics are recommended within six weeks of symptom onset.<ref name=CDC2013Tr/> Antibiotics used include [[erythromycin]], [[azithromycin]], [[clarithromycin]], or [[trimethoprim/sulfamethoxazole]].<ref name=CDC2013Tr/> Evidence to support interventions for the cough, other than antibiotics, is poor.<ref name=Wang2014>{{cite journal | vauthors = Wang K, Bettiol S, Thompson MJ, Roberts NW, Perera R, Heneghan CJ, Harnden A | title = Symptomatic treatment of the cough in whooping cough | journal = The Cochrane Database of Systematic Reviews | volume = 2014 | issue = 9 | pages = CD003257 | date = September 2014 | pmid = 25243777 | doi = 10.1002/14651858.CD003257.pub5 | url = https://ora.ox.ac.uk/objects/uuid:66161792-3b06-4f30-bdbf-3f2000828ade/datastreams/ATTACHMENT01 | pmc = 7154224 }}</ref> About 50% of infected children less than a year old require hospitalization and nearly 0.5% (1 in 200) die.<ref name=CDC2014S/><ref name=CDC2013Com/>
 <!-- Epidemiology and history -->
 An estimated 16.3&nbsp;million people worldwide were infected in 2015.<ref name=GBD2015Pre>{{cite journal | title = Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015 | journal = Lancet | volume = 388 | issue = 10053 | pages = 1545–1602 | date = October 2016 | pmid = 27733282 | pmc = 5055577 | doi = 10.1016/S0140-6736(16)31678-6 | last1 = Vos | first1 = Theo | last2 = Allen | first2 = Christine | last3 = Arora | first3 = Megha | last4 = Barber | first4 = Ryan M. | last5 = Bhutta | first5 = Zulfiqar A. | last6 = Brown | first6 = Alexandria | last7 = Carter | first7 = Austin | last8 = Casey | first8 = Daniel C. | last9 = Charlson | first9 = Fiona J. | last10 = Chen | first10 = Alan Z. | last11 = Coggeshall | first11 = Megan | last12 = Cornaby | first12 = Leslie | last13 = Dandona | first13 = Lalit | last14 = Dicker | first14 = Daniel J. | last15 = Dilegge | first15 = Tina | last16 = Erskine | first16 = Holly E. | last17 = Ferrari | first17 = Alize J. | last18 = Fitzmaurice | first18 = Christina | last19 = Fleming | first19 = Tom | last20 = Forouzanfar | first20 = Mohammad H. | last21 = Fullman | first21 = Nancy | last22 = Gething | first22 = Peter W. | last23 = Goldberg | first23 = Ellen M. | last24 = Graetz | first24 = Nicholas | last25 = Haagsma | first25 = Juanita A. | last26 = Hay | first26 = Simon I. | last27 = Johnson | first27 = Catherine O. | last28 = Kassebaum | first28 = Nicholas J. | last29 = Kawashima | first29 = Toana | last30 = Kemmer | first30 = Laura }}</ref> Most cases occur in the [[developing world]], and people of all ages may be affected.<ref name=Update10/><ref name=Wang2014/> In 2015, pertussis resulted in 58,700 deaths – down from 138,000 deaths in 1990.<ref name=GBD2015De>{{cite journal | title = Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015 | journal = Lancet | volume = 388 | issue = 10053 | pages = 1459–1544 | date = October 2016 | pmid = 27733281 | pmc = 5388903 | doi = 10.1016/s0140-6736(16)31012-1 | last1 = Wang | first1 = Haidong | last2 = Naghavi | first2 = Mohsen | last3 = Allen | first3 = Christine | last4 = Barber | first4 = Ryan M. | last5 = Bhutta | first5 = Zulfiqar A. | last6 = Carter | first6 = Austin | last7 = Casey | first7 = Daniel C. | last8 = Charlson | first8 = Fiona J. | last9 = Chen | first9 = Alan Zian | last10 = Coates | first10 = Matthew M. | last11 = Coggeshall | first11 = Megan | last12 = Dandona | first12 = Lalit | last13 = Dicker | first13 = Daniel J. | last14 = Erskine | first14 = Holly E. | last15 = Ferrari | first15 = Alize J. | last16 = Fitzmaurice | first16 = Christina | last17 = Foreman | first17 = Kyle | last18 = Forouzanfar | first18 = Mohammad H. | last19 = Fraser | first19 = Maya S. | last20 = Fullman | first20 = Nancy | last21 = Gething | first21 = Peter W. | last22 = Goldberg | first22 = Ellen M. | last23 = Graetz | first23 = Nicholas | last24 = Haagsma | first24 = Juanita A. | last25 = Hay | first25 = Simon I. | last26 = Huynh | first26 = Chantal | last27 = Johnson | first27 = Catherine O. | last28 = Kassebaum | first28 = Nicholas J. | last29 = Kinfu | first29 = Yohannes | last30 = Kulikoff | first30 = Xie Rachel }}</ref><ref name=GBD204>{{cite journal | title = Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 | journal = Lancet | volume = 385 | issue = 9963 | pages = 117–71 | date = January 2015 | pmid = 25530442 | pmc = 4340604 | doi = 10.1016/S0140-6736(14)61682-2 | vauthors = ((GBD 2013 Mortality Causes of Death Collaborators)) }}</ref> Outbreaks of the disease were first described in the 16th century.<ref name=CDC2012Pink/> The bacterium that causes the infection was discovered in 1906.<ref name=CDC2012Pink/> The pertussis vaccine became available in the 1940s.<ref name=CDC2012Pink>{{cite book|last1=Atkinson|first1=William |title=Pertussis Epidemiology and Prevention of Vaccine-Preventable Diseases|date=May 2012|publisher=Public Health Foundation|isbn=978-0-9832631-3-5|pages=215–230|edition=12th|url=https://www.cdc.gov/vaccines/pubs/pinkbook/pert.html|url-status=live|archive-url=https://web.archive.org/web/20170729141728/https://www.cdc.gov/vaccines/pubs/pinkbook/pert.html|archive-date=29 July 2017}}</ref>
 ==Signs and symptoms==
@@ Line 39: / Line 39: @@
 The classic symptoms of pertussis are a [[paroxysmal]] cough, inspiratory whoop, and [[fainting]], or vomiting after coughing.<ref name=JAMA2010>{{cite journal | vauthors = Cornia PB, Hersh AL, Lipsky BA, Newman TB, Gonzales R | title = Does this coughing adolescent or adult patient have pertussis? | journal = JAMA | volume = 304 | issue = 8 | pages = 890–6 | date = August 2010 | pmid = 20736473 | doi = 10.1001/jama.2010.1181 | s2cid = 14430946 }}</ref> The cough from pertussis has been documented to cause [[subconjunctival hemorrhage]]s, [[rib fracture]]s, [[urinary incontinence]], [[hernias]], and [[vertebral artery dissection]].<ref name=JAMA2010/> Violent coughing can cause the [[pleura]] to rupture, leading to a [[pneumothorax]]. Vomiting after a coughing spell or an inspiratory whooping sound on coughing almost doubles the likelihood that the illness is pertussis. The absence of a paroxysmal cough or posttussive [[emesis]], though, makes it almost half as likely.<ref name="JAMA2010"/>
-The illness usually starts with mild respiratory symptoms include mild coughing, sneezing, or a [[Rhinorrhea|runny nose]] (known as the [[catarrhal]] stage). After one or two weeks, the coughing classically develops into uncontrollable fits, sometimes followed by a high-pitched "whoop" sound, as the person tries to inhale. About 50% of children and adults "whoop" at some point in diagnosed pertussis cases during the [[Paroxysmal attack|paroxysmal]] stage.
+The illness usually starts with mild respiratory symptoms including mild coughing, sneezing, or a [[Rhinorrhea|runny nose]] (known as the [[catarrhal]] stage). After one or two weeks, the coughing classically develops into uncontrollable fits, sometimes followed by a high-pitched "whoop" sound, as the person tries to inhale. About 50% of children and adults "whoop" at some point in diagnosed pertussis cases during the [[Paroxysmal attack|paroxysmal]] stage. This stage usually lasts up to 3 months, or sometimes longer.<ref name="CDC2014S" /> A gradual transition then occurs to the [[Convalescence|convalescent]] stage, which usually lasts one to four weeks. This stage is marked by a decrease in paroxysms of coughing, although paroxysms may occur with subsequent respiratory infection for many months after the onset of pertussis.<ref name=":1">{{Cite web | url=https://www.cdc.gov/vaccines/pubs/pinkbook/pert.html |title = Pink book &#124; Pertussis &#124; Epidemiology of Vaccine-Preventable Diseases &#124; CDC|date = 2 March 2019}}</ref>
+Symptoms of pertussis can be variable, especially between immunized and non-immunized people. Those that are immunized can present with a more mild infection; they may only have the paroxysmal cough for a couple of weeks, and it may lack the "whooping" characteristic.<ref name=":3">{{Cite journal|last1=Nguyen|first1=Van Tuong Ngoc|last2=Simon|first2=Lauren|date=1 September 2018|title=Pertussis: The Whooping Cough|journal=Primary Care: Clinics in Office Practice|series=Infectious Disease|volume=45|issue=3|pages=423–431|doi=10.1016/j.pop.2018.05.003|pmid=30115332|s2cid=240275364 |issn=0095-4543}}</ref> Although immunized people have a milder form of the infection, they can still spread the disease to others who are not immune.<ref name=":3" />
-This stage usually lasts two to eight weeks, or sometimes longer. A gradual transition then occurs to the convalescent stage, which usually lasts one to four weeks. This stage is marked by a decrease in paroxysms of coughing, although paroxysms may occur with subsequent respiratory infection for many months after the onset of pertussis.<ref name=":1">{{Cite web | url=https://www.cdc.gov/vaccines/pubs/pinkbook/pert.html |title = Pink book &#124; Pertussis &#124; Epidemiology of Vaccine-Preventable Diseases &#124; CDC|date = 2 March 2019}}</ref>
-Symptoms of pertussis can be variable, especially between immunized and non-immunized people. Those that are immunized can present with a more mild infection; they may only have the paroxysmal cough for a couple of weeks, and it may lack the "whooping" characteristic.<ref name=":3">{{Cite journal|last1=Nguyen|first1=Van Tuong Ngoc|last2=Simon|first2=Lauren|date=1 September 2018|title=Pertussis: The Whooping Cough|journal=Primary Care: Clinics in Office Practice|series=Infectious Disease|volume=45|issue=3|pages=423–431|doi=10.1016/j.pop.2018.05.003|pmid=30115332|s2cid=240275364 |issn=0095-4543}}</ref> Although immunized people have a milder form of the infection, they can spread the disease to others who are not immune.<ref name=":3" />
 ===Incubation period===
-The [[incubation period|time between exposure and the development of symptoms]] is on average 7–14 days (range 6–20 days),<ref>Heymann, David L. (ed): Pertussis; in Control of Communicable Diseases Manual. p. 457. American Public Health Association, Washington DC, 2008, {{ISBN|978-0-87553-189-2}}</ref> rarely as long as 42 days.<ref>{{cite web |title=Pertussis (whooping cough) |url=http://www.health.ny.gov/diseases/communicable/pertussis/fact_sheet.htm |publisher=New York State Department of Health |access-date=8 June 2013 |url-status=live |archive-url=https://web.archive.org/web/20130722133222/http://www.health.ny.gov/diseases/communicable/pertussis/fact_sheet.htm |archive-date=22 July 2013 }}</ref>
+The [[incubation period|time between exposure and the development of symptoms]] is on average 7–14 days (ranging 6–20 days),<ref>Heymann, David L. (ed): Pertussis; in Control of Communicable Diseases Manual. p. 457. American Public Health Association, Washington DC, 2008, {{ISBN|978-0-87553-189-2}}</ref> and rarely as long as 42 days.<ref>{{cite web |title=Pertussis (whooping cough) |url=http://www.health.ny.gov/diseases/communicable/pertussis/fact_sheet.htm |publisher=New York State Department of Health |access-date=8 June 2013 |url-status=live |archive-url=https://web.archive.org/web/20130722133222/http://www.health.ny.gov/diseases/communicable/pertussis/fact_sheet.htm |archive-date=22 July 2013 }}</ref>
 ==Cause==
@@ Line 52: / Line 50: @@
 ===Host species===
-Humans are the only host species of B. pertussis.<ref>{{Cite web |date=2018-06-29 |title=15.3E: Whooping Cough |url=https://bio.libretexts.org/Bookshelves/Microbiology/Microbiology_(Boundless)/15%3A_Diseases/15.03%3A_Bacterial_Diseases_of_the_Respiratory_System/15.3E%3A_Whooping_Cough |access-date=2024-03-29 |website=Biology LibreTexts |language=en}}</ref> Outbreaks of whooping cough have been observed among chimpanzees in a zoo, and among wild gorillas; in both cases it is considered likely that the infection  was acquired as a result of close contact with humans.<ref>{{cite journal | vauthors = Gustavsson OE, Röken BO, Serrander R | title = An epizootic of whooping cough among chimpanzees in a zoo | journal = Folia Primatologica; International Journal of Primatology | volume = 55 | issue = 1 | pages = 45–50 | year = 1990 | pmid = 2394416 | doi = 10.1159/000156498 }}</ref><ref>{{Cite journal |last1=Palacios |first1=Gustavo |last2=Lowenstine |first2=Linda J. |last3=Cranfield |first3=Michael R. |last4=Gilardi |first4=Kirsten V. K. |last5=Spelman |first5=Lucy |last6=Lukasik-Braum |first6=Magda |last7=Kinani |first7=Jean-Felix |last8=Mudakikwa |first8=Antoine |last9=Nyirakaragire |first9=Elisabeth |last10=Bussetti |first10=Ana Valeria |last11=Savji |first11=Nazir |last12=Hutchison |first12=Stephen |last13=Egholm |first13=Michael |last14=Lipkin |first14=W. Ian |date=April 2011 |title=Human Metapneumovirus Infection in Wild Mountain Gorillas, Rwanda |url=https://wwwnc.cdc.gov/eid/article/17/4/10-0883_article |journal=Emerging Infectious Diseases |language=en-us |volume=17 |issue=4 |pages=711–713 |doi=10.3201/eid1704.100883 |pmc=3377396 |pmid=21470468}}</ref> Several [[zoo]]s have a long-standing custom of vaccinating their primates against whooping cough.<ref>{{cite book | vauthors = Loomis MR |chapter=Immunoprofylaxis in infant great apes | veditors = Graham CE, Bowen JA |series=Monographs in Primatology |volume=5 |title=Clinical Management of Infant Great Apes |pages=107–112 |publisher=Liss |location=New York |year=1985}}</ref>
+Humans are the only host species of ''B. pertussis.''<ref>{{Cite web |date=2018-06-29 |title=15.3E: Whooping Cough |url=https://bio.libretexts.org/Bookshelves/Microbiology/Microbiology_(Boundless)/15%3A_Diseases/15.03%3A_Bacterial_Diseases_of_the_Respiratory_System/15.3E%3A_Whooping_Cough |access-date=2024-03-29 |website=Biology LibreTexts |language=en}}</ref> Outbreaks of whooping cough have been observed among chimpanzees in a zoo, and among wild gorillas; in both cases it is considered likely that the infection  was acquired as a result of close contact with humans.<ref>{{cite journal | vauthors = Gustavsson OE, Röken BO, Serrander R | title = An epizootic of whooping cough among chimpanzees in a zoo | journal = Folia Primatologica; International Journal of Primatology | volume = 55 | issue = 1 | pages = 45–50 | year = 1990 | pmid = 2394416 | doi = 10.1159/000156498 }}</ref><ref>{{Cite journal |last1=Palacios |first1=Gustavo |last2=Lowenstine |first2=Linda J. |last3=Cranfield |first3=Michael R. |last4=Gilardi |first4=Kirsten V. K. |last5=Spelman |first5=Lucy |last6=Lukasik-Braum |first6=Magda |last7=Kinani |first7=Jean-Felix |last8=Mudakikwa |first8=Antoine |last9=Nyirakaragire |first9=Elisabeth |last10=Bussetti |first10=Ana Valeria |last11=Savji |first11=Nazir |last12=Hutchison |first12=Stephen |last13=Egholm |first13=Michael |last14=Lipkin |first14=W. Ian |date=April 2011 |title=Human Metapneumovirus Infection in Wild Mountain Gorillas, Rwanda |url=https://wwwnc.cdc.gov/eid/article/17/4/10-0883_article |journal=Emerging Infectious Diseases |language=en-us |volume=17 |issue=4 |pages=711–713 |doi=10.3201/eid1704.100883 |pmc=3377396 |pmid=21470468}}</ref> Several [[zoo]]s have a long-standing custom of vaccinating their primates against whooping cough.<ref>{{cite book | vauthors = Loomis MR |chapter=Immunoprofylaxis in infant great apes | veditors = Graham CE, Bowen JA |series=Monographs in Primatology |volume=5 |title=Clinical Management of Infant Great Apes |pages=107–112 |publisher=Liss |location=New York |year=1985}}</ref>
 ==Mechanism==
@@ Line 74: / Line 72: @@
 ==Prevention==
-The primary method of prevention for pertussis is [[vaccination]].<ref>{{cite web|title=Pertussis {{!}} Whooping Cough {{!}} Vaccination {{!}} CDC|url=https://www.cdc.gov/pertussis/vaccines.html|website=www.cdc.gov|access-date=27 May 2017|url-status=live|archive-url=https://web.archive.org/web/20170526025248/https://www.cdc.gov/pertussis/vaccines.html|archive-date=26 May 2017}}</ref> Evidence is insufficient to determine the effectiveness of antibiotics in those who have been exposed, but are without symptoms.<ref name=Cochrane07>{{cite journal | vauthors = Altunaiji S, Kukuruzovic R, Curtis N, Massie J | title = Antibiotics for whooping cough (pertussis) | journal = The Cochrane Database of Systematic Reviews | issue = 3 | pages = CD004404 | date = July 2007 | pmid = 17636756 | doi = 10.1002/14651858.CD004404.pub3 }}</ref> Preventive antibiotics, however, are still frequently used in those who have been exposed and are at high risk of severe disease (such as infants).<ref name=Update10/>
+The primary method of prevention for pertussis is [[vaccination]].<ref>{{cite web|title=Pertussis {{!}} Whooping Cough {{!}} Vaccination {{!}} CDC|url=https://www.cdc.gov/pertussis/vaccines.html|website=www.cdc.gov|access-date=27 May 2017|url-status=live|archive-url=https://web.archive.org/web/20170526025248/https://www.cdc.gov/pertussis/vaccines.html|archive-date=26 May 2017}}</ref> Evidence is insufficient to determine the effectiveness of antibiotics in those who have been exposed, but are without symptoms.<ref name=Cochrane07>{{cite journal | vauthors = Altunaiji S, Kukuruzovic R, Curtis N, Massie J | title = Antibiotics for whooping cough (pertussis) | journal = The Cochrane Database of Systematic Reviews | issue = 3 | pages = CD004404 | date = July 2007 | volume = 2013 | pmid = 17636756 | doi = 10.1002/14651858.CD004404.pub3 | pmc = 11322855 }}</ref> Preventive antibiotics, however, are still frequently used in those who have been exposed and are at high risk of severe disease (such as infants).<ref name=Update10/>
 === Vaccine ===
@@ Line 98: / Line 96: @@
 <!-- Cough -->
-Effective treatments of the cough associated with this condition have not been developed.<ref>{{cite journal | vauthors = Wang K, Bettiol S, Thompson MJ, Roberts NW, Perera R, Heneghan CJ, Harnden A | title = Symptomatic treatment of the cough in whooping cough | journal = The Cochrane Database of Systematic Reviews | volume = 9 | issue = 9 | pages = CD003257 | date = September 2014 | pmid = 25243777 | doi = 10.1002/14651858.CD003257.pub5 | pmc = 7154224 }}</ref> The use of over the counter cough medications is discouraged and has not been found helpful.<ref name=":3" />
+Effective treatments of the cough associated with this condition have not been developed.<ref>{{cite journal | vauthors = Wang K, Bettiol S, Thompson MJ, Roberts NW, Perera R, Heneghan CJ, Harnden A | title = Symptomatic treatment of the cough in whooping cough | journal = The Cochrane Database of Systematic Reviews | volume = 2014 | issue = 9 | pages = CD003257 | date = September 2014 | pmid = 25243777 | doi = 10.1002/14651858.CD003257.pub5 | pmc = 7154224 }}</ref> The use of over the counter cough medications is discouraged and has not been found helpful.<ref name=":3" />
 == Prognosis ==
@@ Line 117: / Line 115: @@
 {{div col end}}]]
-While most healthy older children and adults fully recover, infection in newborns is particularly severe. Pertussis is fatal in an estimated 0.5% of US infants under one year of age.<ref name="complications">{{cite web |title=Pertussis: Complications |url=https://www.cdc.gov/pertussis/about/complications.html |publisher=[[Centers for Disease Control and Prevention]] |access-date=24 August 2012 |url-status=live |archive-url=https://web.archive.org/web/20120814112442/http://www.cdc.gov/pertussis/about/complications.html |archive-date=14 August 2012 }}</ref> First-year infants are also more likely to develop complications, such as: [[apnea]]s (31%), pneumonia (12%), seizures (0.6%) and [[encephalopathy]] (0.15%).<ref name="complications"/> This may be due to the ability of the bacterium to suppress the [[immune system]].<ref>{{cite journal | vauthors = Carbonetti NH | title = Pertussis toxin and adenylate cyclase toxin: key virulence factors of Bordetella pertussis and cell biology tools | journal = Future Microbiology | volume = 5 | issue = 3 | pages = 455–69 | date = March 2010 | pmid = 20210554 | pmc = 2851156 | doi = 10.2217/fmb.09.133 }}</ref>
+While most healthy older children and adults fully recover, infection in newborns is particularly severe. Pertussis is fatal in an estimated 0.5% of US infants under one year of age.<ref name="complications">{{cite web |title=Pertussis: Complications |url=https://www.cdc.gov/pertussis/about/complications.html |publisher=[[Centers for Disease Control and Prevention]] |access-date=24 August 2012 |url-status=live |archive-url=https://web.archive.org/web/20120814112442/http://www.cdc.gov/pertussis/about/complications.html |archive-date=14 August 2012 }}</ref> First-year infants are also more likely to develop complications, such as [[apnea]]s (31%), pneumonia (12%), seizures (0.6%) and [[encephalopathy]] (0.15%).<ref name="complications"/> This may be due to the ability of the bacterium to suppress the [[immune system]].<ref>{{cite journal | vauthors = Carbonetti NH | title = Pertussis toxin and adenylate cyclase toxin: key virulence factors of Bordetella pertussis and cell biology tools | journal = Future Microbiology | volume = 5 | issue = 3 | pages = 455–69 | date = March 2010 | pmid = 20210554 | pmc = 2851156 | doi = 10.2217/fmb.09.133 }}</ref>
 ==Epidemiology==
@@ Line 132: / Line 130: @@
 {{legend|#600202|100+}}
 {{div col end}}]]
-Pertussis is [[Endemic (epidemiology)|endemic]] worldwide. More than 151,000 cases were reported globally during 2018.<ref>{{Cite web |title=Pertussis |url=https://www.who.int/health-topics/pertussis |access-date=2024-03-26 |website=World Health Organization |language=en}}</ref> However not all cases are reported or correctly diagnosed, especially in [[Developing country|developing countries]]. Pertussis is one of the leading causes of vaccine-preventable deaths worldwide.<ref name="cdcothercountries">{{cite web |title=Pertussis in Other Countries |url=https://www.cdc.gov/pertussis/countries.html |url-status=live |archive-url=https://web.archive.org/web/20130512041451/http://www.cdc.gov/pertussis/countries.html |archive-date=12 May 2013 |access-date=27 May 2013 |publisher=Centers for Disease Control and Prevention (CDC)}}</ref> A study in 2017 estimated the global burden of the disease to be 24 million cases per year with 160,000 deaths among young children, with about 90% of all cases occurring in developing countries.<ref>{{Cite journal |last1=Yeung |first1=Karene Hoi Ting |last2=Duclos |first2=Philippe |last3=Nelson |first3=E. Anthony S. |last4=Hutubessy |first4=Raymond Christiaan W. |date=September 2017 |title=An update of the global burden of pertussis in children younger than 5 years: a modelling study |url=https://pubmed.ncbi.nlm.nih.gov/28623146/ |journal=The Lancet. Infectious Diseases |volume=17 |issue=9 |pages=974–980 |doi=10.1016/S1473-3099(17)30390-0 |issn=1474-4457 |pmid=28623146}}</ref><ref name=cdcothercountries/>
+<!-- Global perspective -->
-Before vaccines, an average of 178,171 cases was reported in the U.S., with peaks reported every two to five years; more than 93% of reported cases occurred in children under 10 years of age. The actual [[Incidence (epidemiology)|incidence]] was likely much higher. After vaccinations were introduced in the 1940s, pertussis incidence fell dramatically to approximately 1,000 by 1976. Incidence rates have increased since 1980. In 2015, 20,762 people were reported to have been infected in the United States.<ref>{{cite web|title=Pertussis {{!}} Whooping Cough {{!}} Surveillance {{!}} Cases by Year {{!}} CDC|url=https://www.cdc.gov/pertussis/surv-reporting/cases-by-year.html|website=www.cdc.gov|access-date=10 April 2017|url-status=live|archive-url=https://web.archive.org/web/20170410214238/https://www.cdc.gov/pertussis/surv-reporting/cases-by-year.html|archive-date=10 April 2017}}</ref>  Pertussis is the only vaccine-preventable disease that is associated with increasing deaths in the U.S. The number of deaths increased from four in 1996 to 17 in 2001, almost all of which were infants under one year.<ref>{{cite journal | vauthors = Gregory DS | title = Pertussis: a disease affecting all ages | journal = American Family Physician | volume = 74 | issue = 3 | pages = 420–6 | date = August 2006 | pmid = 16913160 | url = http://www.aafp.org/afp/20060801/420.html | archive-url = https://web.archive.org/web/20080516080021/http://www.aafp.org/afp/20060801/420.html | url-status = live | archive-date = 16 May 2008 }}</ref> In the U.S. pertussis in adults has increased significantly since about 2004.<ref>{{cite news| url = https://www.nytimes.com/2005/02/22/health/22cough.html| title = Enduring and Painful, Pertussis Leaps Back| author = Kate Murphy| work = [[The New York Times]]| date = 22 February 2005| url-status = live| archive-url = https://web.archive.org/web/20130524191616/http://www.nytimes.com/2005/02/22/health/22cough.html| archive-date = 24 May 2013}}</ref>
+Pertussis is [[Endemic (epidemiology)|endemic]] worldwide. More than 151,000 cases were reported globally during 2018.<ref name="auto"/> However not all cases are reported or correctly diagnosed, especially in [[Developing country|developing countries]]. Pertussis is one of the leading causes of vaccine-preventable deaths worldwide.<ref name="cdcothercountries">{{cite web |title=Pertussis in Other Countries |url=https://www.cdc.gov/pertussis/php/global/?CDC_AAref_Val=https://www.cdc.gov/pertussis/countries.html |url-status=live |archive-url=https://web.archive.org/web/20130512041451/http://www.cdc.gov/pertussis/countries.html |archive-date=12 May 2013 |access-date=30 July 2024 |publisher=Centers for Disease Control and Prevention (CDC)}}</ref> A study in 2017 estimated the global burden of the disease to be 24 million cases per year with 160,000 deaths among young children, with about 90% of all cases occurring in developing countries.<ref>{{Cite journal |last1=Yeung |first1=Karene Hoi Ting |last2=Duclos |first2=Philippe |last3=Nelson |first3=E. Anthony S. |last4=Hutubessy |first4=Raymond Christiaan W. |date=September 2017 |title=An update of the global burden of pertussis in children younger than 5 years: a modelling study |url=https://pubmed.ncbi.nlm.nih.gov/28623146/ |journal=The Lancet. Infectious Diseases |volume=17 |issue=9 |pages=974–980 |doi=10.1016/S1473-3099(17)30390-0 |issn=1474-4457 |pmid=28623146}}</ref><ref name=cdcothercountries/>
-Epidemics of the disease occur cyclically, every three to 5 years, both in areas with vaccination programs and those without.<ref name=":12">{{Cite journal |last1=Bouchez |first1=Valérie |last2=Guiso |first2=Nicole |date=October 2015 |editor-last=Carbonetti |editor-first=Nicholas |title=Bordetella pertussis , B. parapertussis , vaccines and cycles of whooping cough |url=https://academic.oup.com/femspd/article/580714/Bordetella-pertussis-B-parapertussis-vaccines-and |journal=Pathogens and Disease |language=en |volume=73 |issue=7 |pages=ftv055 |doi=10.1093/femspd/ftv055 |pmid=26242280 |issn=2049-632X}}</ref> Over time, immunity declines in those who have either been vaccinated or have recovered from infection.<ref>{{Cite journal |last1=Burdin |first1=Nicolas |last2=Handy |first2=Lori Kestenbaum |last3=Plotkin |first3=Stanley A. |date=December 2017 |title=What Is Wrong with Pertussis Vaccine Immunity? The Problem of Waning Effectiveness of Pertussis Vaccines |url=http://cshperspectives.cshlp.org/content/9/12/a029454 |journal=Cold Spring Harbor Perspectives in Biology |language=en |volume=9 |issue=12 |pages=a029454 |doi=10.1101/cshperspect.a029454 |issn=1943-0264 |pmc=5710106 |pmid=28289064}}</ref> In addition, infants are born who are susceptible to infection. An epidemic can occur once [[herd immunity]] reduces below decreases below a certain level.<ref name=":02">{{Cite web |date=15 March 2017 |title=Facts and figures - Whooping cough |url=https://www.health.nsw.gov.au/Infectious/whoopingcough/Pages/facts-and-figures.aspx |access-date=2024-03-26 |website=NSW Health |language=en}}</ref> It is also possible that the bacterium is evolving to evade vaccine-induced immunity.<ref>{{Cite web |date=2022-06-14 |title=Pertussis (whooping cough) - Epidemic Control Toolkit |url=https://epidemics.ifrc.org/pdf/223 |access-date=26 March 2024 |website=The International Federation of Red Cross}}</ref><ref name=":12" />[[File:Whooping Cough (8744519854).jpg|left|thumb|An epidemiologist tests blood samples for pertussis during a 2010 outbreak.]]
+Epidemics of the disease occur cyclically, every three to 5 years, both in areas with vaccination programs and those without.<ref name=":12">{{Cite journal |last1=Bouchez |first1=Valérie |last2=Guiso |first2=Nicole |date=October 2015 |editor-last=Carbonetti |editor-first=Nicholas |title=Bordetella pertussis , B. parapertussis , vaccines and cycles of whooping cough |url=https://academic.oup.com/femspd/article/580714/Bordetella-pertussis-B-parapertussis-vaccines-and |journal=Pathogens and Disease |language=en |volume=73 |issue=7 |pages=ftv055 |doi=10.1093/femspd/ftv055 |pmid=26242280 |issn=2049-632X}}</ref> Over time, immunity declines in those who have either been vaccinated or have recovered from infection.<ref>{{Cite journal |last1=Burdin |first1=Nicolas |last2=Handy |first2=Lori Kestenbaum |last3=Plotkin |first3=Stanley A. |date=December 2017 |title=What Is Wrong with Pertussis Vaccine Immunity? The Problem of Waning Effectiveness of Pertussis Vaccines |url=http://cshperspectives.cshlp.org/content/9/12/a029454 |journal=Cold Spring Harbor Perspectives in Biology |language=en |volume=9 |issue=12 |pages=a029454 |doi=10.1101/cshperspect.a029454 |issn=1943-0264 |pmc=5710106 |pmid=28289064}}</ref> In addition, infants are born who are susceptible to infection. An epidemic can occur once [[herd immunity]] reduces below decreases below a certain level.<ref name=":02">{{Cite web |date=15 March 2017 |title=Facts and figures - Whooping cough |url=https://www.health.nsw.gov.au/Infectious/whoopingcough/Pages/facts-and-figures.aspx |access-date=2024-03-26 |website=NSW Health |language=en}}</ref> It is also possible that the bacterium is evolving to evade vaccine-induced immunity.<ref>{{Cite web |date=2022-06-14 |title=Pertussis (whooping cough) - Epidemic Control Toolkit |url=https://epidemics.ifrc.org/pdf/223 |access-date=26 March 2024 |website=The International Federation of Red Cross}}</ref><ref name=":12" />
+<!-- US specific perspective -->
+Before vaccines, an average of 178,171 cases was reported in the U.S., with peaks reported every two to five years; more than 93% of reported cases occurred in children under 10 years of age. With the widespread introduction the DTP combined vaccine (diphtheria tetanus and pertussis) in the 1940s, pertussis incidence fell dramatically to approximately 1,000 by 1976, since when they have fluctuated between 1,000 and 30,000 annually.<ref>{{Citation |last1=Kuchar |first1=E. |title=Pertussis: History of the Disease and Current Prevention Failure |date=2016 |work=Pulmonary Dysfunction and Disease |volume=934 |pages=77–82 |editor-last=Pokorski |editor-first=Mieczyslaw |url=http://link.springer.com/10.1007/5584_2016_21 |access-date=2024-09-30 |place=Cham |publisher=Springer International Publishing |language=en |doi=10.1007/5584_2016_21 |isbn=978-3-319-42009-7 |last2=Karlikowska-Skwarnik |first2=M. |last3=Han |first3=S. |last4=Nitsch-Osuch |first4=A.|pmid=27256351 }}</ref><ref>{{cite web |date=23 July 2024 |title=Pertussis Cases by Year |url=https://www.cdc.gov/pertussis/php/surveillance/pertussis-cases-by-year.html |archive-url= |archive-date= |access-date=30 September 2024 |website=Centers for Disease Control and Prevention}}</ref>
+Cases recorded outside of the U.S. were also recorded {{When|date=October 2024}} at high numbers comparable to their populations. Prior to the vaccine being discovered, Sweden averaged nearly 3,000 children deaths per year. With their population only being 1.8 million in the years 1749-64 this number was very high. The London population during the same time period recorded over 3,000 deaths. The rates in London continued to grow into the 18th century. These numbers show how the disease affected not only the U.S. but also those around the world.<ref>{{Cite journal |last=Weston |first=Robert |date=October 2012 |title=Whooping Cough: A Brief History to the 19th Century |url=https://utpjournals.press/doi/10.3138/cbmh.29.2.329 |journal=Canadian Bulletin of Medical History |language=en |volume=29 |issue=2 |pages=329–349 |doi=10.3138/cbmh.29.2.329 |pmid=28155549 |issn=0823-2105}}</ref>
+According to the {{As of|2024|bare=yes}} CDC, reports that cases of whooping cough have reached their highest levels since 2014.<ref>{{Cite web |last=America |first=Good Morning |title=Whooping cough cases surge: CDC |url=https://www.goodmorningamerica.com/wellness/video/whooping-cough-cases-surge-cdc-114757172 |access-date=2024-10-14 |website=Good Morning America |language=en}}</ref> This year, there have been over 16,000 cases, marking a fourfold increase compared to last year’s total of more than 3,700 cases.<ref>{{Cite web |last=CDC |date=2024-10-10 |title=Pertussis Surveillance and Trends |url=https://www.cdc.gov/pertussis/php/surveillance/index.html |access-date=2024-10-14 |website=Whooping Cough (Pertussis) |language=en-us}}</ref> The CDC has also confirmed two deaths related to the illness.{{Cn|date=October 2024}} The United States is seeing a return to pre-pandemic trends, where annual cases typically exceed 10,000.<ref>{{Cite web |last=Leake |first=Lindsey |title=Whooping cough cases up 342% since 2023 as U.S. outbreak continues. What to know about symptoms and spread |url=https://fortune.com/well/article/whooping-cough-pertussis-symptoms-spread-2024/ |access-date=2024-10-14 |website=Fortune Well |language=en}}</ref>[[File:Whooping Cough (8744519854).jpg|left|thumb|An epidemiologist tests blood samples for pertussis during a 2010 outbreak.]]
 ==History==
 === Discovery ===
-''B. pertussis'' was discovered in 1906 by [[Jules Bordet]] and [[Octave Gengou]], who also developed the first serology and vaccine. Efforts to develop an inactivated [[whole-cell vaccine]] began soon after ''B. pertussis'' was cultured that year. In the 1920s, [[Louis W. Sauer]] developed a weak vaccine for whooping cough at [[NorthShore University HealthSystem#Evanston Hospital|Evanston Hospital]] (Evanston, IL). In 1925 Danish physician Thorvald Madsen was the first to test a whole-cell vaccine on a wide scale.<ref name="Baker_2004">{{cite journal | vauthors = Baker JP, Katz SL | title = Childhood vaccine development: an overview | journal = Pediatric Research | volume = 55 | issue = 2 | pages = 347–56 | date = February 2004 | pmid = 14630981 | doi = 10.1203/01.PDR.0000106317.36875.6A | doi-access = free }}</ref> Madsen used the vaccine to control outbreaks in the [[Faroe Islands]] in the North Sea.
+''B. pertussis'' was discovered in 1906 by [[Jules Bordet]] and [[Octave Gengou]] (the bacterium is subsequently named ''Bordetella pertussis'' in honour of Jules Bordet).  They were able to successfully culture ''B. pertussis'' and went on to develop the first inactivated [[whole-cell vaccine]] in 1912, followed by other researchers in 1913 and 1914. These early vaccines had limited effectiveness. In the 1920s, [[Louis W. Sauer]] developed a vaccine for whooping cough at [[NorthShore University HealthSystem#Evanston Hospital|Evanston Hospital]]. In 1925 Danish physician Thorvald Madsen was the first to test a whole-cell vaccine on a wide scale. Madsen used the vaccine to control outbreaks in the [[Faroe Islands]] in the North Sea, however two children died shortly after receiving the vaccine. <ref name="Baker_2004">{{cite journal | vauthors = Baker JP, Katz SL | title = Childhood vaccine development: an overview | journal = Pediatric Research | volume = 55 | issue = 2 | pages = 347–56 | date = February 2004 | pmid = 14630981 | doi = 10.1203/01.PDR.0000106317.36875.6A | doi-access = free }}</ref><ref>{{Cite web |title=Pertussis |url=https://www.museumofhealthcare.ca/explore/exhibits/vaccinations/pertussis.html |access-date=2024-11-04 |website=Museum of Health Care}}</ref><ref>{{Citation |last=Vaccines |first=Institute of Medicine (US) Committee to Review the Adverse Consequences of Pertussis and Rubella |title=Pertussis and Rubella Vaccines: A Brief Chronology |date=1991 |work=Adverse Effects of Pertussis and Rubella Vaccines: A Report of the Committee to Review the Adverse Consequences of Pertussis and Rubella Vaccines |url=https://www.ncbi.nlm.nih.gov/books/NBK234365/ |access-date=2024-11-04 |publisher=National Academies Press (US) |language=en |last2=Howson |first2=Christopher P. |last3=Howe |first3=Cynthia J. |last4=Fineberg |first4=Harvey V.}}</ref>
 === Vaccine ===
-In 1932, an outbreak of whooping cough hit [[Atlanta]], Georgia, prompting pediatrician [[Leila Denmark]] to begin her study of the disease. Over the next six years, her work was published in the ''[[JAMA (journal)|Journal of the American Medical Association]]'', and in partnership with [[Emory University]] and [[Eli Lilly and Company|Eli Lilly & Company]], she developed the first pertussis vaccine.<ref>{{Cite web|title = Changing the Face of Medicine {{!}} Dr. Leila Alice Daughtry Denmark|url = https://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_78.html|website = www.nlm.nih.gov|access-date = 3 February 2016|url-status = live|archive-url = https://web.archive.org/web/20150321042123/http://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_78.html|archive-date = 21 March 2015}}</ref> In 1942, American scientists [[Grace Eldering]], [[Loney Gordon]], and [[Pearl Kendrick]] combined the whole-cell pertussis vaccine with [[diphtheria]] and [[tetanus]] toxoids to generate the first DTP combination vaccine.<ref name="Bannink_2013">{{cite web | last = Bannink | first = Jill | title = Finding aid for the Michigan women and the whooping cough vaccine collection[s] | url = http://grplpedia.grpl.org/wiki/images/6/65/328.pdf | url-status = live | archive-url = https://web.archive.org/web/20150205095413/http://grplpedia.grpl.org/wiki/images/6/65/328.pdf | archive-date = 5 February 2015 }}</ref> To minimize the frequent side effects caused by the pertussis component, Japanese scientist Yuji Sato developed an acellular vaccine consisting of purified haemagglutinins (HAs: filamentous [[strep throat]] and [[leukocytosis]]-promoting-factor HA), which are secreted by ''B. pertussis''. Sato's acellular pertussis vaccine was used in Japan starting in 1981.<ref name="Sato_1984">{{cite journal | vauthors = Sato Y, Kimura M, Fukumi H | title = Development of a pertussis component vaccine in Japan | journal = Lancet | volume = 1 | issue = 8369 | pages = 122–6 | date = January 1984 | pmid = 6140441 | doi = 10.1016/S0140-6736(84)90061-8 | s2cid = 23621152 }}</ref> Later versions of the acellular vaccine in other countries consisted of additional defined components of ''B. pertussis'' and were often part of the [[DTaP]] combination vaccine.
+In 1932, an outbreak of whooping cough hit [[Atlanta]], Georgia, prompting pediatrician [[Leila Denmark]] to begin her study of the disease. Over the next six years, her work was published in the ''[[JAMA (journal)|Journal of the American Medical Association]]'', and in partnership with [[Emory University]] and [[Eli Lilly and Company|Eli Lilly & Company]], she developed the first safe and effective pertussis vaccine.<ref>{{Cite web|title = Changing the Face of Medicine {{!}} Dr. Leila Alice Daughtry Denmark|url = https://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_78.html|website = www.nlm.nih.gov|access-date = 3 February 2016|url-status = live|archive-url = https://web.archive.org/web/20150321042123/http://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_78.html|archive-date = 21 March 2015}}</ref> In 1942, American scientists [[Grace Eldering]], [[Loney Gordon]], and [[Pearl Kendrick]] combined the whole-cell pertussis vaccine with [[diphtheria]] and [[tetanus]] toxoids to generate the first DTP combination vaccine.<ref name="Bannink_2013">{{cite web | last = Bannink | first = Jill | title = Finding aid for the Michigan women and the whooping cough vaccine collection[s] | url = http://grplpedia.grpl.org/wiki/images/6/65/328.pdf | url-status = live | archive-url = https://web.archive.org/web/20150205095413/http://grplpedia.grpl.org/wiki/images/6/65/328.pdf | archive-date = 5 February 2015 }}</ref> To minimize the frequent side effects caused by the pertussis component, Japanese scientist Yuji Sato developed an acellular vaccine consisting of purified haemagglutinins (HAs: filamentous [[strep throat]] and [[leukocytosis]]-promoting-factor HA), which are secreted by ''B. pertussis''. Sato's acellular pertussis vaccine was used in Japan starting in 1981.<ref name="Sato_1984">{{cite journal | vauthors = Sato Y, Kimura M, Fukumi H | title = Development of a pertussis component vaccine in Japan | journal = Lancet | volume = 1 | issue = 8369 | pages = 122–6 | date = January 1984 | pmid = 6140441 | doi = 10.1016/S0140-6736(84)90061-8 | s2cid = 23621152 }}</ref> Later versions of the acellular vaccine in other countries consisted of additional defined components of ''B. pertussis'' and were often part of the [[DTaP]] combination vaccine.
 == References ==
@@ Line 151: / Line 157: @@
 {{Medical condition classification and resources
 | DiseasesDB = 1523
+| ICD11 = {{ICD11|1C12}}
 | ICD10 = {{ICD10|A|37||a|30}}
 | ICD9 = {{ICD9|033}}

Classification	D ICD-11: 1C12 ICD-10: A37 ICD-9-CM: 033 MeSH: D014917 DiseasesDB: 1523
External resources	MedlinePlus: 001561 eMedicine: emerg/394 ped/1778 Patient UK: Whooping cough Orphanet: 1489