Coqueluche du nourrisson, de l’enfant et de l’adulte

Abstract

Whooping cough is a human respiratory infection, dramatic for newborns. The first descriptions of this disease are recent, from the 16^th century. Soon after the discovery of the causal agent of the disease, the bacterium Bordetella pertussis, whole cell vaccines, composed of bacterial suspensions inactivated by heat, were developed and their use generalized. These vaccines could be very efficacious but are very difficult to produce and not well tolerated. Because of the characterization of the bacterial proteins involved in the pathogenicity of Bordetella pertussis, an other type of vaccine was developped. This new type is called acellular vaccine because composed of purified bacterial proteins. The generalization of the vaccination with whole-cell vaccines conducted to an important decrease of mortality and morbidity. However, thirty years after the introduction of the vaccination, a resurgence is observed in vaccinated countries. This resurgence is principally due to the short duration of vaccinal immunity and the lack of vaccinal or natural boosters. The disease affects now adolescents and adults who present an atypical cough which difficult to diagnose. These adolescents and adults contaminate non vaccinated new borns. Vaccinal boosters are necessary and are now possible with acellular vaccines since 1998. France was the first country to introduce a booster for adolescents at 11-13 years of age and a booster for young adults is under discussion. Nevertheless, surveillance of the disease is of great importance and must continue to analyse the consequences of such boosters which are introduced to reduce the transmission of the disease to infants too young to be vaccinated