• Olivera Ostojić Children’s Hospital for Lung Diseases and Tuberculosis, CBC “Dr Dragiša Mišović”, Belgrade, Serbia
  • Marija Sredojević Clinical Hospital Center “Dr Dragiša Mišović”, Children’s Hospital for Lung Diseases and Tuberculosis, Belgrade, Serbia
  • Vesna Veković Children’s Hospital for Lung Diseases and Tuberculosis, Medical Center “Dr Dragiša Mišović”, Belgrade, Serbia
  • Zorica Živković 1Children’s Hospital for Lung Diseases and Tuberculosis, Medical Center “Dr Dragiša Mišović”, Belgrade, Serbia, 2Faculty of Pharmacy Novi Sad, University Business Academy, Novi Sad, Serbia



Pertussis, whooping cough, epidemic, vaccination, infants


Pertussis, or whooping cough, is a contagious acute respiratory infection caused by the bacterium Bordetella pertussis. Before the widespread immunization, pertussis was one of the most common infectious causes of morbidity and death. Despite widespread immunization, the pathogen continues to circulate in the population with cyclical outbreaks. Recent data from the Institute of Public Health of Serbia "Dr Milan Jovanović Batut" for the territory of the Republic of Serbia reveals a significant rise in pertussis cases in the last year, which creates a need for careful analysis of the current epidemic. The aim of our study was to show the current epidemiological situation related to pertussis illness, along with an analysis of patients hospitalized at the Children's Hospital for Pulmonary Diseases and Tuberculosis, Clinical Hospital Center "Dr Dragiša Mišović" from August 2023 to February 2024, who were laboratory confirmed with B. Pertussis infection. During this period, 23 patients were hospitalized with confirmed B. Pertussis infection. The laboratory method for isolating the bacterium was a nasopharyngeal swab that was sent for PCR analysis. The average age of hospitalized children was 4.6 months, with the majority being 2 months old. The youngest infants were 1 month old, while the oldest patient was 35 months old. B. Pertussis infection was confirmed in children who were either not vaccinated or were incompletely vaccinated due to their age. The most commonly associated conditions with B. Pertussis infection were acute bronchiolitis and pneumonia, with SARS COV-2 virus isolated in two cases. Based on the results of our analysis and data from the literature, we observed an increase in the number of pertussis cases. Although vaccination has significantly contributed to reducing the incidence of pertussis, this analysis highlights challenges and the need for continued following of the epidemiologic situation. Additionally, it is crucial to consider factors contributing to the resurgence of the epidemic to develop more effective strategies for disease control and prevention.


Halperin SA. Pertussis and other Bordetella infections. In: Kasper DL, Fauci AS, editors. Harrison’s Infectious Diseases. New York: The McGraw-Hill Companies; 2010. p. 487–492

Decker MD, Edwards KM. Pertussis (Whooping Cough). J Infect Dis. 2021; (1), 224:S310–20. PMID: 34590129; doi: 10.1093/infdis/jiaa469

Van der Zee A, Schellekens JFP, Mooi FR. Laboratory diagnosis of pertussis. Clin Microbiol Rev. 2015; 28(4):1005–26. PMID: 26354823; doi: 10.1128/CMR.00031-15

Weaver KL, Blackwood CB, Horspool AM, et al. Long-Term Analysis of Pertussis Vaccine Immunity to Identify Potential Markers of Vaccine-Induced Memory Associated With Whole Cell But Not Acellular Pertussis Immunization in Mice. Front Immunol. 2022; (8), 13. PMID: 35211125; doi: 10.3389/fimmu.2022.838504

Gradski zavod za javno zdravlje Beograd. Kalendar imunizacije (Internet). (Feb 2024). Dostupno na:

De Greeff SC, Mooi FR, Westerhof A, et al. Pertussis disease burden in the household: How to protect young infants. Clin Infect Dis. 2010; 50(10):1339–45. PMID: 20370464; doi: 10.1086/652281

Institut za javno zdravlje Srbije “Dr Milan Jovanović Batut”. Izvеštај о еpidеmiоlоšкој situаciјi pеrtusisа nа tеritоriјi Rеpubliке Srbiје u 2024. gоdini zакljučnо sа 18.2.2024. gоdinе (Internet). (Feb 2024). Dostupno na:

Wrotek A, Czajkowska M, Jackowska T. Seasonality of Respiratory Syncytial Virus Hospitalization. In: Pokorski M, editor. Health and Medicine. Advances in Experimental Medicine and Biology. Springer, Cham; 2020. p. 1279.

Maitre G, Schaffner D, Natterer J, et al. Leukemoid Reaction in Infant Pertussis: Is There a Place for Hydroxyurea? A Case Report. Front Pediatr. 2018; 6:261. doi: 10.3389/fped.2018.00261. PMID: 30356838

Gradski zavod za javno zdravlje Beograd. Veliki kasalj (Internet). (Feb 2024). Dostupno na:

Domenech de Cellès M, Magpantay FM, King AA, Rohani P. The pertussis enigma: reconciling epidemiology, immunology and evolution. Proc Biol Sci. 2016;283(1822):20152309. doi: 10.1098/rspb.2015.2309. PMID: 26763701; PMCID: PMC4721090

Smallridge WE, Rolin OY, Jacobs NT, Harvill ET. Different effects of whole-cell and acellular vaccines on Bordetella transmission. J Infect Dis. 2014;209(12):1981–8. PMID: 24443545; doi: 10.1093/infdis/jiu030

Bertilone C, Wallace T, Selvey LA. Finding the 'who' in whooping cough: vaccinated siblings are important pertussis sources in infants 6 months of age and under. Commun Dis Intell Q Rep. 2014;38(3):E195-200. PMID: 25391405

Bernstein H, McNally VV. Pertussis Vaccination-A Critical Priority for Us All. JAMA Netw Open. 2021;4(8):e2119365. PMID: 34374776; doi: 10.1001/jamanetworkopen.2021.19365

Agrawal A, Singh S, Kolhapure S, Kandeil W, Pai R, Singhal T. Neonatal Pertussis, an Under-Recognized Health Burden and Rationale for Maternal Immunization: A Systematic Review of South and South-East Asian Countries. Infect Dis Ther. 2019;8(2):139-153. doi: 10.1007/s40121-019-0245-2. Epub 2019 May 3. PMID: 31054089

Centers for Disease Control and Prevention. Get a Whooping Cough Vaccine During Each Pregnancy (Internet). (Feb 2024). Dostupno na:

Paragraf. Pravilnik o programu obavezne i preporučene imunizacije stanovništva protiv određenih zaraznih bolesti (Internet). (Feb 2024). Dostupno na:






Original Articles