Bordetella pertussis surveillance in England and Wales: 1995–7

• Published in: Epidemiology and infection Vol. 123; no. 3; pp. 403 - 411
• Main Authors: VAN BUYNDER, P. G., OWEN, D., VURDIEN, J. E., ANDREWS, N. J., MATTHEWS, R. C., MILLER, E.
• Format: Journal Article
• Language: English
• Published: Cambridge Cambridge University Press 01-12-1999
• Subjects: Adolescent; Adult; Age Factors; Age groups; Antibiotic Prophylaxis; Bacterial Vaccines - therapeutic use; Bacteriology; Biological and medical sciences; Bordetella pertussis; Bordetella pertussis - pathogenicity; British Isles, England; British Isles, Wales; Child; Child, Preschool; Children; Disease Notification; England - epidemiology; Epidemics; Epidemiology; Family Health; Female; Fundamental and applied biological sciences. Psychology; Hospital admissions; Humans; Incidence; Infant; Infant, Newborn; Male; Microbiology; Mortality; Population Surveillance; Seasons; Seroepidemiologic Studies; Surveillance; Vaccination; Wales - epidemiology; Whooping cough; Whooping Cough - mortality; England; United Kingdom; Great Britain; Europe; Wales; United Kingdom > UK; Infection; Human; Population survey; Respiratory disease; Bacteriosis; Bacteria; Bordetella pertussis; Epidemiology; Biological monitoring; Whooping cough
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268899003052

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.