Epidemiology, reemergence of pertussis and vaccine development in Latin America: an overview

Pertussis or whooping cough is a highly contagious acute bacterial disease involving the respiratory tract, caused mainly by Bordetella pertussis and to a lesser extent by Bordetella parapertussis. Bordetella pertussis remains in fifth place in the list of deaths attributed to vaccine-preventable diseases in children under five years old around the world. It has been reported to cause significant morbidity and mortality in both developed and developing countries. The disease is most severe in young infants, but its prevalence has been observed worldwide occurring in all age groups, even after the development of whole-cells vaccines against pertussis in the 1940s. Since the last decade it has been reported a re-emergence of pertussis in many developed countries, including those that have shown high vaccination coverage for many years. Various factors might cause pertussis re-emergence, for instance, increased awareness, improved diagnostics through the PCR-technique implementation, decreased vaccination coverage, sub-optimal vaccines, waning vaccineinduced immunity and pathogen adaptation. This paper reviews the nowaday state of the epidemiology and re-emergence of the disease in Latin America, focusing the current Cuban situation, just for giving a panorama of the application of novel strategies for future vaccine development as well as general recommended means of treating the disease.