{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T16:09:32Z","timestamp":1784909372692,"version":"3.55.0"},"reference-count":95,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Pertussis, or whooping cough, can be life threatening in infants, yet the concept of severe pertussis remains poorly defined in the literature. Lack of standardization may impair research and public health interventions.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess the variability in terminology and criteria used to define severe pertussis in the published literature.<\/jats:p>\n <\/jats:sec>\n \n Evidence Review<\/jats:title>\n A systematic review of the literature drawn from PubMed and Web of Science databases was performed. Studies involving infants with pertussis that provided a definition for severe pertussis and published from database inception to April 2025 were included without language restrictions. Study characteristics and detailed definitions of severe pertussis were extracted. Variations in terminology and criteria used across definitions were described.<\/jats:p>\n <\/jats:sec>\n \n Findings<\/jats:title>\n \n Of the 914 unique studies identified, 133 underwent full-text review, and 78 were included in the study, encompassing 49 observational studies, 22 case reports, 3 case-control studies, and 4 reviews; no randomized clinical trials were included. Five different terms used to define severe pertussis were identified:\n severe<\/jats:italic>\n (44 of 78 studies [56%]),\n malignant<\/jats:italic>\n (12 of 78 studies [15%]),\n critical<\/jats:italic>\n (9 of 78 studies [12%]),\n fatal<\/jats:italic>\n (9 of 78 studies [12%]), and\n fulminant<\/jats:italic>\n (4 of 78 studies [5%]). Across studies, 22 different criteria were used to define clinical severity, which were classified into 3 categories (ie, clinical, biological, and outcome). The most commonly reported criteria included respiratory failure (40 of 78 studies [51%]), pulmonary hypertension (30 of 78 studies [38%]), leukocytosis (28 of 78 studies [36%]), death (29 of 78 studies [37%]), and intensive care unit admission (29 of 78 studies [37%]).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This systematic review revealed substantial heterogeneity in the definition of severe pertussis in the literature. A consensus-based definition of severe pertussis is urgently needed to improve the understanding of its pathophysiology and to enhance clinical management, clinical research, and public health decision-making.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.22211","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T15:30:25Z","timestamp":1784907025000},"page":"e2622211","source":"Crossref","is-referenced-by-count":0,"title":["Variability in the Diagnostic Criteria for Severe Pertussis"],"prefix":"10.1001","volume":"9","author":[{"given":"Pauline","family":"Labe","sequence":"first","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, Institut Pasteur, Biodiversity and Epidemiology of Bacterial pathogens, Paris, France"},{"name":"Department of General Paediatrics and Paediatric Infectious Diseases, APHP, H\u00f4pital Necker-Enfants malades, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Meunier","sequence":"additional","affiliation":[{"name":"Department of General Paediatrics and Paediatric Infectious Diseases, APHP, H\u00f4pital Necker-Enfants malades, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Leroux","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, Institut Pasteur, Biodiversity and Epidemiology of Bacterial pathogens, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirko","family":"Sadi","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, Institut Pasteur, Biodiversity and Epidemiology of Bacterial pathogens, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, Institut Pasteur, Biodiversity and Epidemiology of Bacterial pathogens, Paris, France"},{"name":"National Reference Center for Whooping Cough and other Bordetella infections, European Reference Laboratory for Pertussis and Diphtheria, Institut Pasteur, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Bouchez","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, Institut Pasteur, Biodiversity and Epidemiology of Bacterial pathogens, Paris, France"},{"name":"National Reference Center for Whooping Cough and other Bordetella infections, European Reference Laboratory for Pertussis and Diphtheria, Institut Pasteur, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Grimaud","sequence":"additional","affiliation":[{"name":"Department of Pediatric Intensive Care Unit, Necker-Enfants Malades Hospital, APHP, Universit\u00e9 Paris Cit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Brisse","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, Institut Pasteur, Biodiversity and Epidemiology of Bacterial pathogens, Paris, France"},{"name":"National Reference Center for Whooping Cough and other Bordetella infections, European Reference Laboratory for Pertussis and Diphtheria, Institut Pasteur, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00e9mie F.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of General Paediatrics and Paediatric Infectious Diseases, APHP, H\u00f4pital Necker-Enfants malades, Paris, France"},{"name":"Centre for Research in Epidemiology and Statistics (Inserm UMR 1153), OPPaLE team, Universit\u00e9 Paris Cit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Toubiana","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, Institut Pasteur, Biodiversity and Epidemiology of Bacterial pathogens, Paris, France"},{"name":"Department of General Paediatrics and Paediatric Infectious Diseases, APHP, H\u00f4pital Necker-Enfants malades, Paris, France"},{"name":"National Reference Center for Whooping Cough and other Bordetella infections, European Reference Laboratory for Pertussis and Diphtheria, Institut Pasteur, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"issue":"25","key":"zoi260619r1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2022.27.25.2100933","article-title":"Association between the COVID-19 pandemic and pertussis derived from multiple nationwide data sources, France, 2013 to 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