BMJ  2006;333:304 (5 August), doi:10.1136/bmj.333.7562.304

Letter

Is public health action worth while if many cases are being missed?

The first 150 words of the full text of this article appear below.

EDITOR—Harnden et al seem to propose that the incidence of pertussis is grossly underestimated.¹ They comment on the low notification rates for pertussis (barely 500 notifications in the past two years, according to the Health Protection Agency²). Forty per cent of children with persistent cough having pertussis infection sounds like a lot but depends on the prevalence of persistent cough, which cannot be deduced from their article.

Eighteen practices in Oxfordshire participated in the study, which ran for three and a half years; 289 children were "eligible for recruitment," or only four or five per practice per year. If 40% of them had pertussis, that would make roughly 110 cases of pertussis, 30 each year, and roughly two cases of pertussis per practice per year, implying that the number of notifications might not be such a gross underestimate.

Given that the study also showed that children with . . . [Full text of this article]

Leatherhead, Surrey KT22 9RX peter_english@bigfoot.com

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