Published: 06.10.05 Updated: 07.10.2005 09:24:18

Hans Blystad, Lars Blad, Johan Giesecke, Swedish Institute for Infectious Disease Control, Sweden, the Steering Group of the project Building a Network for Infections Disease Surveillance in the Baltic Sea Region

Incidence of pertussis in 2001 per 100 000 inhabitants


Pertussis is a notifiable disease in all countries of the region, except in Germany. In Denmark, only cases in children < 2 years of age are reported.


Since the introduction of a pertussis vaccine in the 1950s most countries in the region have had stable incidences of pertussis with periodically slight increases in incidence. In Sweden, vaccination ceased in 1979 resulting in high numbers of cases until childhood vaccination was re-introduced in 1996. In 1997 Norway and Poland experienced a sharp, epidemic-like increase in reported cases of pertussis. This rise was not related to a fall in immunisation coverage, and the overwhelming majority of cases were diagnosed among older children and adults and the high rates may be partly explained by increased awareness of the disease. Incidence rates have remained high in Norway.

High-risk groups

Children below 2 years of age remain the only risk group for contracting serious pertussis disease.

Prevention strategies

Vaccination, usually given as a combined vaccine together with diphtheria and tetanus components, is the best measure to decrease the incidence and subsequent risk of children under 2 years of age contracting the disease. In all countries in the region pertussis vaccine is given as a part of the national immunisation programmes. Russia, the Baltic countries and Germany give four doses, the last at 18 months of age (14 months in Germany). In Germany and Iceland an additional dose at school age is recommended. The remaining countries give three doses, the last at approximately at 12 months of age. Many of these countries are considering a fourth dose given at school age.