Pertussis is increasing in unimmunised infants: is a change in policy needed?

The proportion and trend in absolute number of pertussis notifications in y oung infants has increased each year in England and Wales since the acceler ated immunisation schedule was introduced. We report five infants all less than 3 months of age admitted with life threatening pertussis infection to two paediatric intensive care units. Despite aggressive cardiorespiratory s upport measures, three of the infants died. Pertussis remains a significant cause of morbidity and mortality in unimmunised infants. In this age group presentation is likely to be atypical and infection more severe. Public he alth measures to prevent the disease could be strengthened. Chemoprophylaxi s should be offered to susceptible contacts and booster vaccinations agains t pertussis considered.