Abstract
An estimated 60 million children suffer from whooping cough annually, causing half a million deaths. The gradual decline in incidence rates observed in Europe and North America even before the introduction of pertussis immunization is not likely to occur within the near future in developing countries short of widespread immunization efforts. The present pertussis vaccine is effective, and serious adverse effects are rare in comparison with the consequences of the disease itself. A new, acel-lular vaccine is under trial and holds promise for the future. Epidemiological studies and surveillance for pertussis activity are hampered by the fact that the clinical diagnosis is difficult to make under field conditions. New serological techniques may bring improvement in this respect. Immunization does not play a significant role in outbreak control. Outbreak investigations are, however, extremely valuable for assessment of the effectiveness of immunization programmes; they provide valuable information, not easily obtained by other means, on age-specific attack rates and vaccine efficacy if the immunization status of the population is known.
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