Fatal case of pertussis in an infant–West Virginia, 2004

In December 2004, an infant aged 29 days in West Virginia died from pertussis after exposure to adult family members with probable undiagnosed pertussis. Pertussis (i.e., whooping cough) is a prolonged respiratory illness caused by the bacterium Bordetella pertussis and characterized by a violent cough, inspiratory whoop, and posttussive vomiting. The cough often lasts from several weeks to up to 3 months. However, adolescents and adults, even those previously vaccinated as children, often have disease not recognized as pertussis, leading to intrafamilial and nosocomial transmission. In the United States, children aged <6 months are at the highest risk for severe illness or death from pertussis because most infants do not complete their primary vaccination series until age 6 months. This report summarizes results of the West Virginia Department of Health and Human Resources (WVDHHR) case investigation, which underscore the critical need to prevent pertussis transmission to infants from adolescents and adults with undiagnosed disease.