Pertussis : an old disease that is still with us

Our knowledge of pathogenesis, clinical presentation and prevention of pertussis has improved substantially over recent years. We now better understand the function of long-known virulence factors for Bordetella pertussis, and genome sequencing has identified a multitude of new proteins; their functions are yet to be elucidated. Furthermore, improved diagnostic tools have revealed the broad spectrum of disease, and new insights into the host's immune response have been gained. Finally, the development, evaluation, licensing and implementation of several new acellular pertussis vaccines with high acceptance have changed the epidemiology of pertussis in many countries (i.e. a shift towards an increasing burden of disease in adolescent persons and adults). These developments are likely to have great impact on the daily practice not only of paediatricians, but also of general practitioners, internists, gynaecologists and many other specialists in adolescent and adult medicine. The present review provides an update on recent progress.