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histogram of notification ratios. Keyworth versus England and Wales showing much higher rates in Keyworth


  Each column shows the extent to which I diagnosed cases in my community compared with cases officially notified in the whole country, taking into account population sizes, in each year. For instance, in 1977 I diagnosed forty times as many cases as were officially recognized, but the next year only four times as many.  In 1977 England had not experienced whooping cough outbreaks for 25 years, so when it came along few people recognized it and the ratio was large.  Over the next 15 years it was quite common and people started recognizing it again, so the ratio got smaller.  As it became less common again in the mid nineties, less people were recognizing it (through lack of familiarity,) and the ratio climbed again.  In 2002 I diagnosed 249 times more than nationally.  Another reason for the ratio being even higher then is the fact that a higher proportion of cases are now occurring in older children and adults, and doctors were reluctant to make a diagnosis of whooping cough outside childhood.  Since 2006 the rate has fallen as doctors have understood it affects teens and adults. Since then there is also a simple blood test to confirm their suspicions. This website has contributed by encouraging patients to diagnose themselves and get their doctor to test for it.