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Whooping Cough

Volume 978: debated on Wednesday 6 February 1980

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asked the Secretary of State for Social Services if he will issue figures as to the percentage of apparent pertussis (whoopingcough) cases during the epidemic year of 1978, that were bacteriologically diagnosed as positive; and what percentage were diagnosed on clinical grounds alone.

It is not possible to say what percentage of notifications were bacteriologically confirmed. The whooping cough organism is difficult to isolate unless specialised techniques are used and this is not considered clinically necessary in most cases. The published number of notifications—65,942 for England and Wales in 1978—is that of notifications based on clinical diagnosis. The Public Health Laboratory Service

Directly employed staff* (whole-time equivalents) (1)Independent contractors (number) (2)Total (3)=(1)+(2)
1. Northern RHA49,0822,39751,479
2. Yorkshire RHA56,3373,00559,342
3. Trent RHA65,3733,58568,958
4. East Anglia RHA26,4531,58828,041
5. North West Thames RHA56,8694,25061,119
6. North East Thames RHA67,0923,74970,841
7. South East Thames RHA64,4553,55568,010
8. South West Thames RHA47,4943,18650,680
9. Wessex RHA38,4162,56440,980
10. Oxford RHA30,9502,02132,971
11. South-Western RHA49,0343,22552,259
12. West Midlands RHA75,7274,24579,972
13. Mersey RHA43,3852,17045,555
14. North Western RHA66,6943,39270,086
Total regional manpower737,36141,621778,982
* The figures for directly employed staff include whole-time equivalents of hospital and community health, medical and dental staff, excluding locum staff, hospital practitioners and part-time medical (or dental) officers (clinical assistants). Also excluded are GPs participating in hospital staff funds and occasional sessional staff in community health services for whom no whole-time equivalent is collected. The figures exclude agency nurses and midwives.
†The figures for independent contractors are numbers of general medical practitioners, general dental practitioners, ophthalmic medical practitioners, ophthalmic opticians and dispensing opticians in the general ophthalmic services. Estimated numbers of general practice pharmacists (that is chemists, drug stores and appliance contractors) are based on the number of establishments, not the actual number practising, and the estimates for 1978 are not yet available. These have, therefore, been excluded. The figures for general medical practitioners relate to 1 October 1978, and those for the general ophthalmic services relate to 31 December 1978. There is a minor element of double counting between general medical practitioners and ophthalmic medical practitioners. In addition, the sum of the regional figures for independent contractors is greater than the total for England because both qualified medical practitioners who also hold an ophthalmic qualification and ophthalmic medical practitioners may register in more than one region.

isolated whooping cough organisms in 4,273 cases in 1978 but swabs would also have been sent to other laboratories from which figures are not available. The total number is, therefore, not known. In recent years, however, the number of isolations of whooping cough organisms by the Public Health Laboratory service has closely corresponded with whooping cough notifications and this trend continued during the recent epidemic.