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Pertussis infection: Epidemiology, microbiology, and pathogenesis

Paul Cornia, MD
Benjamin A Lipsky, MD, FACP, FIDSA, FRCP (London), FRCPS (Glasg)
Section Editors
Stephen B Calderwood, MD
Sheldon L Kaplan, MD
Deputy Editor
Elinor L Baron, MD, DTMH


Pertussis, also known as "whooping cough," is a highly contagious acute respiratory illness caused by Bordetella pertussis. A Chinese reference to "the cough of 100 days" by Chao Yuanfang in the early 7th century may have referred to pertussis [1]. In 1679, Sydenham named the illness pertussis, from the Latin term meaning "intense cough." These names describe the key clinical features of pertussis infection. However, the classic clinical manifestations of pertussis infection (paroxysmal cough, inspiratory whoop, and posttussive emesis) are frequently absent in adolescents and adults.

The microbiology, epidemiology, and pathogenesis of pertussis are reviewed here. The clinical manifestations, diagnosis, management, and prevention of pertussis are discussed separately. (See "Pertussis infection in adolescents and adults: Clinical manifestations and diagnosis" and "Pertussis infection in infants and children: Treatment and prevention" and "Pertussis infection in infants and children: Clinical features and diagnosis".)


Pertussis is caused by the gram-negative coccobacillus B. pertussis, a strict human pathogen with no known animal or environmental reservoir [2]. The organism is fastidious, surviving only a few hours in respiratory secretions and thus requiring special media for culture.

Eight additional Bordetella species have been described: B. parapertussishu, B. parapertussisov (ovine-adapted parapertussis), B. bronchiseptica, B. avium, B. hinzii, B. holmesii, B. trematum, and B. petrii [3]. Three of these species (B. parapertussis, B. bronchiseptica, and B. holmesii) can cause respiratory illness in humans. B. parapertussis may cause a spectrum of disease ranging from a nonspecific upper respiratory tract illness to classic pertussis (ie, clinically indistinguishable from that of B. pertussis) [4,5]. B. bronchiseptica causes respiratory infections in a variety of mammals; human infection most often occurs in immunocompromised hosts with animal exposure [6]. Unlike B. pertussis, B. holmesii may also cause bacteremia; asplenia is the most common risk factor, but other immunocompromising conditions have been reported [7-11].


Pertussis is a highly contagious respiratory illness. In adolescents and adults, infection may result in a protracted cough and is occasionally associated with substantial morbidity. In children and particularly infants, morbidity is more often substantial, and the disease may be fatal.

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Literature review current through: Oct 2017. | This topic last updated: Aug 25, 2017.
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