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The incidence of pertussis cannot be directly measured; estimates are generally based on data sources such as notifications, hospitalisations and deaths. However, these data represent only a proportion of the total cases occurring in the community. The accuracy of notification data may vary between states and territories or over time due to different surveillance practices and as new diagnostic tests are introduced. These surveillance issues, and the typical three-to-five-year cycles of pertussis epidemics, make comparisons over time and between states and territories difficult.

nsw public health bulletin/new south wales public health bulletin/new south wales public health bulletin (online)

Do variations in pertussis notifications reflect incidence or surveillance practices? A comparison of infant notification rates and hospitalisation data in NSW