Pertussis, or whooping cough, caused by Bordetella pertussis, still occurs despite vaccination. Most of the cases occurring in adolescents and adults are mild or have a subclinical course, but these patients can be a source of transmission to unvaccinated or partially vaccinated infants. Symptoms of infant pertussis are often not specific, but pertussis can be fatal. In this article, we present one case of unvaccinated twins who each presented with initial signs of a viral respiratory disease. Within a few days, each developed rapidly progressive respiratory failure complicated by refractory pulmonary hypertension due to malignant pertussis. Both patients died eventually. It is important for paediatricians, general practitioners, midwives and gynaecologists to be alert to coughing in their patients. More efficient vaccination strategies should be discussed to prevent both the transmission of B. pertussis and the occurrence of severe and fatal pertussis in young infants.
Conflict of interest and financial support: a disclosure form provided by the author is available along with the full text of this article at www.ntvg.nl; search for A5573, click on ‘Belangenverstrengeling’ (‘Conflict of interest’).