Liu, Q., Wang, S., Shalev, N. et al. (324 more authors) (2026) Global, regional and national burden of pertussis in 1990–2023: a Global Burden of Disease study. Nature Medicine. ISSN: 1078-8956
Abstract
Despite long-standing immunization programs, pertussis remains a major cause of vaccine-preventable mortality, particularly among infants. Here we present a primary assessment of global pertussis incidence, mortality and disability-adjusted life years across 204 countries and territories from 1990 to 2023. We show that despite short-term pandemic-period fluctuations, the dominant global pattern from 1990 to 2023 was long-term decline: age-standardized mortality decreased by 61.2% and age-standardized incidence by 41.6%. Relative to the anomalously low pandemic-period estimates, incidence and mortality rebounded by 102.6% (95% uncertainty interval, 77.0–128.2%) and 66.1% (95% uncertainty interval, 2.4–174.5%), respectively, between 2020 and 2023. In 2023 alone, we estimated 18.9 million cases and 115,000 deaths attributable to pertussis. This burden remains profoundly inequitable and inversely correlated with the sociodemographic index; sub-Saharan Africa now accounts for roughly 65% of global deaths, with the highest population-adjusted risk concentrated among infants younger than 6 months. Our findings highlight a modeled geographic concentration of pertussis mortality and support strengthening timely infant vaccination, maternal immunization where recommended and feasible and robust surveillance in highly susceptible regions.
Metadata
| Item Type: | Article |
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| Copyright, Publisher and Additional Information: | © 2026 The authors. This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. |
| Keywords: | Biomedical and Clinical Sciences; Public Health; Health Sciences; Prevention; Vaccine Related; Rare Diseases; Biodefense; Burden of Illness; Infectious Diseases; Emerging Infectious Diseases; Women's Health; Immunization; Pediatric Research Initiative; Surveillance and distribution; Infection; Good Health and Well Being |
| Dates: |
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| Institution: | The University of Sheffield |
| Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > Department of Infection, Immunity and Cardiovascular Disease |
| Date Deposited: | 11 Nov 2026 10:52 |
| Last Modified: | 11 Nov 2026 10:52 |
| Status: | Published online |
| Publisher: | Springer Science and Business Media LLC |
| Refereed: | Yes |
| Identification Number: | 10.1038/s41591-026-04660-8 |
| Related URLs: | |
| Sustainable Development Goals: | |
| Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:247773 |
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