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Pertussis was first recognized as an epidemic disease in the 16th century. The classic illness is a three-stage illness (catarrhal, spasmodic, and convalescent), with a distinctive cough, and its characteristics today are similar to those in the prevaccine era. In the prevaccine era, the calculated attack rate was 872/100,000 population, and the majority of cases occurred in children &lt;5 years of age. On average, there were 7,300 deaths/year; the death rate began to decline before antimicrobial therapy and vaccination. Reported pertussis in adults was rare, but numerous investigators noted that atypical cases of pertussis were common in adults.

Pertussis in the Preantibiotic and Prevaccine Era, with Emphasis on Adult Pertussis