INFECTION WITH BORDETELLA PERTUSSIS IS STILL AN IMPORTANT public health problem, and outbreaks of pertussis continue to occur in Canada. In 1992, over 3700 cases of pertussis infection were reported in Canada . Moreover, 7049 and 3218 cases of pertussis were reported for 1993 and the first half of 1994, respectively, indicating a rise in the incidence of this disease in Canada (personal communication). The incidence of this disease varies by age group, but is highest in infants less than a year old, with an annual rate reaching one case per 1000. The incidence of pertussis in adolescents and adults is underreported, in part because symptoms are often less characteristic than with childhood disease.
Yet adolescents and adults act as an important reservoir for transmitting disease to susceptible populations of young children . Recently, the first case of B pertussis disease caused by a strain highly resistant to erythtomycin, the antibiotic of choice against pert ussis, was reported in the United States. It is estimated that approximately 0.04% of infected children in developed countries die every year from this disease and its consequences, especially pneumonia. Efficient treatment that is now easy to get and fast to receive: you can finally buy your ventolin inhalers knowing that it will be there soon and you will start the treatment knowing this is in fact the efficient medicine you needed an can pay a lot less for.
In general, the curtently used whole-cell pert ussis vaccines are efficacious as indicated by a reduction of 93% in annual incidence compared with the prevaccine period. However, pertussis is still a major concern and was ranked as the fifth priority disease for national surveillance by the Canadian Advisory Committee on Epidemiology. In 1993, a consensus conference on pertussis was sponsored by the Childhood Immunization Division, Bureau of Communicable Disease Epidemiology, Laboratory Centre for Disease Control (lcdc) to establish national goals and recommendations for the control of pertussis. One of the recommendations specifically stated that the development and standardization of rapid diagnostic tests were urgently required.