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Pertussis (whooping cough), once well controlled by childhood immunization, has been making a comeback: Incidence rates for 2004 and 2005 were triple that for 2001. Waning of immunity due to lack of exposure to natural infection followed by a rapid increase in circulating Bordetella pertussis is thought to be the cause, and vigilance has been encouraged.
From 2004 through 2006, three outbreaks occurred involving hundreds of presumed cases of pertussis. The first, in Tennessee, began in April 2004, when B. pertussis was isolated from a 5-week-old infant. During the next 2 months, 1459 individuals in the community who were seen for upper respiratory symptoms were evaluated for pertussis and offered postexposure prophylaxis (PEP) or treatment w…