Etiology and Epidemiology

Although included among the more important diseases of childhood, whooping cough has been relatively neglected, and various aspects of its epidemiology are not yet fully understood. Transmission seems to be mainly airborne, apparently by droplet infection. Human beings are the only reservoir of the disease; B. pertussis cannot survive long outside the host, and quickly succumbs to drying, ultraviolet light, and temperatures above 120° to 130°F. It spreads primarily through household and schoolroom contact, although mild subclinical cases, perhaps in adolescents and adults, may play a further (undemonstrated) role in transmission. One attack confers immunity, and rare second attacks are probably explained by infection with the much milder, and less common, Bordetella parapertussis.

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