Global burden of pertussis: signs of hope but need for accurate data

In another dataset from the Global Burden of Disease Study 2015, the number of pertussis deaths was estimated to be between roughly 19 000 and 117 000, again mostly occurring in Africa.4 There is a lack of reliable surveillance data and diagnostic laboratory capacity, especially in regions of the world (not only in Africa) where most of the severe cases and deaths are assumed to occur. If, however, reliable data are difficult to gather even in Europe, how can these be obtained in sub-Saharan African and other low-income and middle-income countries? Because the primary aim of pertussis vaccination is to reduce severe cases and deaths in infants, it seems sensible to concentrate on this age group. Here, some progress can be seen: among other organisations, the Bill & Melinda Gates Foundation and the Institut Pasteur have protocols for studying pertussis in low-income and middle-income countries, and, in particular, pertussis deaths in infants.7 Irrespective of all the problems of generalising locally produced results, more reliable data are likely to be reported in forthcoming years.