What is the History of Pertussis in America and Other Countries?
What Is the Incidence of Pertussis in the US?
In 1922, there were 107,473 pertussis cases reported in the U.S. with 5,099 deaths.1 In the United States, deaths from pertussis infections dropped by more than 75% between 1922 and 1948, the year before the DPT vaccine was licensed. In 1948, the mortality rate was less than 1 pertussis death per 100,000 persons and would never be higher than that again.2 3 Mortality associated with pertussis declined dramatically in the 1940’s as living conditions improved, including sanitation and hygiene and access to health care.4 During the past quarter century, reports of whooping cough cases have increased among babies less than six months old and among teenagers and adults but mortality has remained low.5 In 2013, there were about 29,000 reported pertussis cases and 13 pertussis-related deaths in America, with nine of those deaths in infants under age one.6
According to the CDC, in 2017, out of a U.S. population of 326 million people, there were 15,808 reported cases of pertussis including 13 deaths, with 4 deaths occurring in infants under age one year.7 Out of 3,663 cases occurring in children from six months of age through six years of age, 44 percent of cases occurred in children who had completed the primary DTaP series.8
However, many cases of whooping cough are never diagnosed or reported. Every three to five years, there are reported increases in whooping cough disease in the U.S. and other countries, no matter how high the vaccination rate.9
What Is the Incidence of Pertussis in Other Countries?
In underdeveloped countries with poor sanitation, nutrition and limited access to health care, whooping cough disease still causes significant complications and death, especially in infants and small children.10 The World Health Organization estimates that globally 85 percent of children have gotten three pertussis shots. However each year, approximately 160,000 children under age five die from pertussis complications such as pneumonia, with over 60 percent of these children live in Africa.11 12 Mortality rates from infectious diseases are always higher where people live in poverty, with crowding and poor sanitation, industrial pollution, substandard nutrition, and lack of access to health care facilities.13 In 2015, the World Health Organization reported 142,512 cases of pertussis globally.14
In the U.S., Canada, Australia, Europe and other developed countries, whooping cough disease is much more manageable due to:
- raised standards of living and availability of antibiotics to control secondary infections like pneumonia;
- the use of suction to clear mucous from the throats and airways of babies and resuscitate those, who choke on mucus and stop breathing;
- rehydration techniques to control the loss of body fluids from high fever, vomiting, or diarrhea.
IMPORTANT NOTE: NVIC encourages you to become fully informed about Pertussis and the Pertussis vaccine by reading all sections in the Table of Contents , which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.
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1 CDC Achievements in Public Health, 1900-1999 Impact of Vaccines Universally Recommended for Children -- United States, 1990-1998. MMWR. Apr. 02, 1999 48(12);243-248
2 National Center for Health Statistics. U.S. Vital Statistics Mortality Data 1940-1949. Table 2 – Death Rates for Selected Causes, Whooping Cough (All Races, Both Sexes) 1948 . Pg. 38.
3 Grove RD, Hetzel AM. Vital Statistics Rates in the United States 1940-1960. General Mortality (1921-1929), Section C, Table 65: Whooping Cough . Pg. 577. U.S. Public Health Service National Center for Health Statistics 1968.
4 Chow MYK, Khandaker G, McIntyre P. Global Childhood Deaths From Pertussis: A Historical Review. Clin Infect Dis. 2016 Dec 1; 63(Suppl 4): S134–S141.
5 Brooks DA, Clover R. Pertussis Infection in the United States: Role for Vaccination of Adolescents and Adults. J Am Board Fam Med November-December 2006 vol. 19 no. 6
6 CDC. 2013 Final Pertussis Surveillance Report. Aug. 15, 2014.
7 CDC 2017 Provisional Pertussis Surveillance Report. Jan 5, 2018 66(52)
8 CDC 2017 Provisional Pertussis Surveillance Report. Jan 5, 2018 66(52)
9 CDC Pertussis Frequently Asked Questions Aug 7, 2017
10 WHO Pertussis June 21, 2011
11 World Health Organization/UNICEF. A record 123 million children were immunized globally in 2017 but millions of children are still not reached by potential life saving vaccines. 2017.
12 Yeung KHT, Ducios P et al. An update of the global burden of pertussis in children younger than 5 years: a modeling study. Lancet Infect Dis 2017; 9: 974-980.
13 Korte R, Rehle T, Merkle A. Strategies to maintain health in the Third World. Trop Med Parasitol 1991; 42(4): 428-432.
14 CDC Pertussis in Other Countries. Aug. 7, 2017