Pertussis remains one of the most poorly controlled vaccine-preventable diseases around the globe. Universal vaccination has dramatically reduced its incidence but has failed to bring it completely under control. In recent decades, changes in pertussis epidemiology have been noted, likely related to the use of acellular pertussis vaccines, which in many countries have replaced older-generation, whole-cell pertussis vaccines. Several years after their introduction, it is becoming apparent that immunity conferred by acellular vaccines wanes more rapidly than expected. Unlike whole-cell vaccines, acellular vaccines, while protecting against the disease, do not seem to prevent colonization and transmission. Increasing incidence among adolescents and adults makes them a reservoir for transmission to unimmunized infants, who in turn are at risk of severe disease and death. weiterlesen