Epidemiology of Whooping cough in Apulia, Italy, 1971-2003

Aim. The aim of this study was to determine the pattern of B. pertussis infection and the level of vaccination coverage (VC) in Apulia in the period 1971-2003. Methods. In Italy, notification of whooping cough has been obligatory since 1962; it is considered a class II illness under Italian law D.M. 15/12/1990, and all reported cases are recorded by the National Institute of Statistics (ISTAT). Data were gathered on cases of whooping cough in Apulia from 1971 to 2003 and on vaccination coverage for the period 1983-2003. Results. Reported cases in Italy increased until the end of the 1980s, reaching a peak in 1987 (54.2 cases per 100,000 inhabitants); subsequently the incidence began to decline (0.7 cases per 100,000 inhabitants in 2003).In Apulia, the pattern of incidence was similar to the national trend for the period considered, with a peak in 1983 (51.9 cases per 100,000 inhabitants) and a low in 2001 (1.8 cases per 100,000 inhabitants), with all the provinces in the region showing a similar pattern except for the province of Bari, where the incidence was higher. Conclusions. Overall, the data point to a correlation between the high number of reported cases and insufficient VC until the 1980s. Subsequently, the launch of the whooping cough project (1996) and the advent of the acellular vaccine led to a significant increase in the level of vaccination coverage and a consequent fall in reported cases.