5-Minute Clinical Consult
Pertussis
BASICS
- Highly contagious respiratory illness among close contacts
- Synonyms: whooping cough, “the cough of 100 days”
DESCRIPTION
- Host: humans
- Most common reservoir: adults
- Ages: all
- Distribution: worldwide
- Pattern: endemic or epidemic with outbreaks every 3 to 5 years
- Seasonality: peaks late summer–autumn; can occur year-round
- Transmission: person to person via aerosolized droplets
- Effective vaccine: available
- Immunity: neither 100% nor lifelong immunity with either infection or vaccine
- System(s) affected: respiratory
- Classic clinical manifestations include paroxysmal cough, inspiratory whoop, and posttussive emesis.
EPIDEMIOLOGY
- Caused by Bordetella pertussis
- Typical incubation period: 7 to 10 days
Incidence
- United States (2012 most recent peak year): 48,277 cases reported
- Worldwide: 24.1 million cases and about 160,700 deaths per year
ETIOLOGY AND PATHOPHYSIOLOGY
- Toxin mediated
- Infectious process with predilection for ciliated respiratory epithelium
- Common organisms:
- B. pertussis
- Bordetella parapertussis
Genetics
No known genetic predisposition
RISK FACTORS
- Exposure to a confirmed case
- Non- or underimmunized infants and children
- Premature birth
- Chronic lung disease
- Immunodeficiency (e.g., AIDS)
- Obesity and pre-existing asthma
- Age <6 months (accounts for ~90% pediatric pertussis hospitalizations) (1)
GENERAL PREVENTION
- Public health measures
- Surveillance
- Outbreak management
- Care of exposed individuals
- Prevention programs
- Immunizations
- Primary childhood immunization series against pertussis followed by boosters
- Maternal immunization during each pregnancy
- Adults, including health care providers in close contact with infants <1 year of age, should be immunized.
Pediatric Considerations
Strategies to reduce neonatal pertussis:
- Tdap with each pregnancy, ideally between 27 and 36 weeks’ gestation
- Cocooning
- Tdap recommended for all persons in close contact with infants <1 year of age
Geriatric Considerations
Older adults are at increased risk for pertussis complications due to (2):
- Age-related changes in immunity
- Comorbid medical conditions
COMMONLY ASSOCIATED CONDITIONS
- Apnea in infants
- Secondary bacterial pneumonia
- Sinusitis
- Seizures
- Encephalopathy
- Urinary incontinence
- Death
There's more to see -- the rest of this topic is available only to subscribers.
Citation
Domino, Frank J., et al., editors. "Pertussis." 5-Minute Clinical Consult, 34th ed., Wolters Kluwer, 2026. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116449/all/Pertussis.
Pertussis. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2026. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116449/all/Pertussis. Accessed November 4, 2025.
Pertussis. (2026). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (34th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116449/all/Pertussis
Pertussis [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2026. [cited 2025 November 04]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116449/all/Pertussis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Pertussis
ID - 116449
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116449/all/Pertussis
PB - Wolters Kluwer
ET - 34
DB - Medicine Central
DP - Unbound Medicine
ER -
