Pertussis, or whooping cough, is a highly contagious disease caused by the bacteria Bordetella pertussis. The disease is characterised by paroxysmal cough, inspiratory whoop and post-tussive vomiting. 1 Pertussis is transmitted via direct contact with discharges from the respiratory tract of infected individuals (probably via droplets), and the incubation period is 9-10 days on average. 2 A secondary attack rate of 90% has been recorded in non-immune household contacts. 2 Worldwide, the incidence of pertussis has been reported to be highest in children under 5 years, except where infant vaccination programs have achieved consistently high vaccination rates. 2 In NSW, there have been several changes to the immunisation schedule affecting pertussis vaccination in recent years. From 1985, a combined whole cell diphtheria, tetanus and pertussis vaccine (DTPw) was included in the immunisation schedule at ages 2, 4 and 6 months, with a booster at 18 months. 3 In 1994, a fifth dose was introduced Methods: Surveillance data from the NSW Notifiable Diseases Database was reviewed for the period. Results: 35695 cases of pertussis were notified; annual incidence rates varied from 18.4 to 84.2 per 100000 people. The highest rates of pertussis were consistently found in infants aged 0-6 months. Rates of disease in other age groups changed markedly over the study period, with high rates currently observed in adult age groups. Conclusions: New strategies may be needed to control pertussis in infants and in adults who now comprise the largest proportion of cases.