[Can we control pertussis better? I. Changes in the epidemiology of pertussis]

In many industrialized countries pertussis has been successfully controlled due to introduction of immunization programmes. However, decline trends in pertussis incidence, observed since more than 20 years, has been recently halted in individual countries, including Poland. In some industrialized countries, even absolute increase of pertussis incidence is recorded. Important changes in age distribution of pertussis patients are noted; from one side, there is an increase of pertussis incidence in infants, and a slow but continuous shift towards older age. There is an increasing body of evidence that adults may be the main reservoir of pertussis organisms and play an important role in the transmission of pertussis infection to younger children. Studies on the role of adults in transmission of pertussis infection to younger children should be undertaken in Poland. Early beginning and early completion of series of primary immunizations with DTP vaccine in infants and maintainance of a high immunization coverage with all doses of DTP vaccine specified in the immunization calendar are needed to successful control of pertussis. There is an urgent need to improve the diagnosis of pertussis in Poland, and especially the bacteriological confirmation of the diagnosis.