Strategies to control pertussis in infants

The UK is in the midst of a pertussis outbreak with the highest morbidity and mortality being in young unimmunised infants. Over the last 10–15 years high vaccine coverage, the accelerated infant schedule and the inclusion of pertussis in the preschool booster have contributed to a major overall decline in incidence. However pertussis remains the most common cause of hospitalisation and death from a disease potentially preventable through the current UK immunisation programme, and continues to display 3–4 yearly peaks in activity affecting infants, adolescents and adults. Gayatri Amirthalingam reviews the evidence base for and potential strategies to control pertussis in infants. The challenge is to improve individual immunity and thereby reduce infection and transmission. The potential strategies include the introduction of an adolescent pertussis booster to compensate for waning immunity as has been introduced in USA, Australia and France, immunisation of close household contacts of newborn infants (cocooning), neonatal immunisation and immunisation of pregnant women. As the best potential option—the reasoning is discussed in the paper—immunisation of pregnant women during the third trimester has recently been introduced as …