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| Discussion This study gives a general practice perspective of the natural course of whooping cough at a time when the consequences of a fall and rise in immunisation became clear. It has the advantage of being by a single observer in a stable and discrete practice, although it was too small to measure rare events such as convulsions and death. The overall impression was of a disease much less severe than suggested by textbook descriptions or parents' fears. |
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| If whooping cough is commonly a mild disease and likely to be missed, what are the implications for clinical practice? If whooping cough were perceived as a less severe disease it might have an adverse effect on immunisation uptake. Since early diagnosis is difficult, and neither isolation nor treatment with antibiotics is sufficiently effective, it is important to emphasise the vaccine's major role in maintaining herd immunity. Information for professionals and the public should give a more balanced view of the natural course of whooping cough, recognising the high prevalence of mild cases as well as the continued seriousness for infants. |
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