Pertussis in the adolescent and adult: a primary care concern.

Pertussis, a highly communicable, infectious respiratory disease, is considered a disease of childhood. The introduction of the standardized whole-cell pertussis vaccine in 1949 nearly eradicated pertussis. In 1976 in the United States, the lowest number of pertussis cases ever was reported. However, in recent years, there has been a resurgence in the number of pertussis cases among all age groups. This increase is especially noted among adolescents and adults. In 1996, the U.S. Centers for Disease Control and Prevention reported 7,796 cases of pertussis, with almost half among individuals aged 10 years or older. Although pertussis in adolescents and adults is generally more mild than in children, it is a major source of disease transmission to younger children, who may have more serious complications. Consequently, early recognition and treatment of pertussis in adolescents and adults is imperative in preventing potentially life-threatening illness in infants and young children. This article examines pertussis in the adolescent and adult population, describing the epidemiologic characteristics of the disease, its clinical manifestations, diagnosis, treatment, and the use of vaccinations.