Historical Perspective on Pertussis and Use of Vaccines To Prevent It

U nlike many other severe epidemic infectious diseases, pertussis lacks an ancient history. Perhaps the earliest mention of pertussis, or whooping cough, is of a 1414 outbreak in Paris in Moulton’s The Mirror of Health, published in 1640. A contemporary observer, Guillaume de Baillou, described a 1578 epidemic of pertussis in Paris and, by the middle of the 18th century, pertussis was well recognized throughout Europe. Carl Burger at University of Bonn, Germany, apparently recognized Bordetella pertussis in stained films of sputum by 1883, based on his drawings of elliptical rods. Other observations of bacilli in respiratory mucus followed, including Jules Bordet and Octave Gengou who in 1900 described finding a new “ovoid bacillus” in the sputum of a 6-month-old infant with whooping cough. They were also the first to cultivate the causative agent at the Pasteur Institute in Brussels in 1906. Before pertussis vaccines became available, this disease caused a staggering amount of morbidity and mortality. U.S. use of vaccines to protect against pertussis from the 1940s to 1984 reduced the incidence of reported disease by more than 157-fold. Nonetheless, B. pertussis continues to circulate, with adolescents and adults serving as a reservoir for this pathogen. In general, the older, whole-cell-based pertussis vaccines have greater efficacy than do the newer acellular vaccines, but the former are also more reactogenic. An important advantage of the acellular vaccines is that because of their lessened reactogenicity they can be given to adolescents and adults, which will lead to the better control of pertussis.