Other notifiers included laboratories, hospitals, a preschool, a school, a family day care centre and a child care centre. The 262 laboratory notifications of pertussis during 1995 were a result of 97 doctors requesting tests. To determine why some medical practitioners on the North Coast do not notify cases of pertussis, we interviewed 21 doctors who treated cases that resulted in laboratory notifications by telephone. Doctors frequently commented that they were often unsure of the diagnosis of pertussis until confirmed by a laboratory, and as the laboratories notify the PHU they did not bother. However, it is difficult for a public health unit to take appropriate and timely action if the first or only notifications of pertussis are made by laboratories up to seven days later than clinical diagnosis.
Early notification can help prevent an outbreak, as previously occurred in Casino.
Difficulties notifying the PHU expressed by respondents included finding notification forms or the PHU telephone number and problems contacting an appropriate person immediately. How the PHU can help The PHU will be supplying doctors on the North Coast with a sticker that will list notifiable diseases and have the PHU's telephone number, as well as fresh notification forms. The response of the PHU to notifications of pertussis, which is always made in consultation with the patient's doctor, may include contact tracing, immunisation advice, advice on treatment, public awareness campaigns and exclusion of unimmunised children from child care facilities. Prompt public health action, combined with the introduction of acellular pertussis vaccinations expected next year, should result in a lower incidence of pertussis in the Northern Rivers area. Improving Infectious Diseases Control.