Epidemiology and Infection

Bordetella pertussis surveillance in England and Wales: 1995–7

P. G. VAN BUYNDER a1, D. OWEN a2, J. E. VURDIEN a1, N. J. ANDREWS a1, R. C. MATTHEWS a2 and E. MILLER a1c1
a1 Communicable Diseases Surveillance Centre, 61 Colindale Ave, Colindale, NW9 5EQ UK
a2 Pertussis Reference Laboratory, 2nd Floor, Clinical Sciences Building, Central Manchester Healthcare NHS Trust, Manchester Royal Infirmary, Manchester, M13 9WL UK


Available data sources on disease due to Bordetella pertussis, including notifications, hospital admissions, deaths, and an enhanced laboratory-based surveillance system commenced in January 1994, were reviewed for the period 1995–7. Pertussis notifications continued their approximately 3-year cycle although at historically reduced levels. A slight seasonal increase in late summer/early autumn existed over and above a relatively constant background rate. Over time, the proportion of pertussis cases in younger, unvaccinated children, and to a lesser extent, adolescents and young adults, is increasing. There is a continuing significant and under- reported mortality associated with pertussis in the very young age group. Disease due to serotype 1,2 is on the increase despite persistent high vaccination levels and this serotype causes more severe disease. The provision of preventative antibiotics prior to disease onset reduced the severity of the disease but its use remains uncommon in England and Wales. While overall levels of pertussis notifications have declined in recent times, vaccination efficacy wanes with increasing age, and pertussis remains a significant cause of mortality and severe morbidity in the very young. This could be reduced by timely booster vaccination and increased recognition of mild disease in older cases followed by early antibiotic therapy for the very young household contacts.

(Accepted July 20 1999)

c1 Author for correspondence.