EPIDEMIOLOGY OF PERTUSSIS IN EUROPEAN REG ION

The annual reported rates of pertussis in Europe are high and reach 12 ,2 per 100.000. The coverage for immunization against pertussis is var ious in the countries of the Region : high coverage in France, Netherl ands, Denmark, United Kingdom i.e, lower in many other countries. Germ any (ex Federal) has started again immunization since 1991. Italy is p oorly vaccinated. The United Kingdom has experienced two outbreaks (19 78 and 1982) and since this period coverage for pertussis immunization has raised up to more than 90 %. Conversely Sweden has stopped immuni zation since 1979. Russia is poorly immunized. In well immunized count ries the resurgence of pertussis is observed like in USA. Young adults with pertussis, often immunized in infancy contaminate very young inf ants less than 6 months and not protected. In these countries the age distribution curve for pertussis is quite inverse with two peaks at ex treme ages : before 6 months and after 20 years. This new pertussis ep idemiology implies late boosters for immunization, which become possib le with new acellular pertussis vaccines. The WHO Europe groupe for Im munization suggests pertussis as a new main target for vaccination and surveillance.