Pertussis re-emergence in the post-vaccination era.
Pertussis re-emergence in the post-vaccination era.
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DOI：
10.1186/1471-2334-13-151
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发表时间：
2013-03-26
影响因子：
3.7
通讯作者：
de Martino M
中科院分区：
文献类型：
--
作者：
Chiappini E;Stival A;Galli L;de Martino M
西方国家曾报告百日咳在接种疫苗后的时代死灰复燃。过去十年中，病例从学龄儿童转向青少年、成人和1岁以下儿童，婴儿死亡率仍然居高不下。我们的目的是审查和讨论可能采取的疫苗接种策略，以改善百日咳控制，通过检索Pubmed，以及美国和欧洲疾病控制和预防中心的网站，2002年1月1日至2013年3月1日。检索并分析了以下疫苗接种战略：茧战略、孕妇和新生儿免疫接种、学龄前儿童、青少年、成人和保健工作者疫苗接种方案。成本效益研究提供了一些对比数据，主要支持母亲接种疫苗和茧。青少年和/或成人接种疫苗似乎具有成本效益，但观察性研究的数据表明，单独使用这种疫苗接种策略可降低全球百日咳负担，但不会影响婴儿的发病率。此外，还必须克服大量的后勤和经济困难，才能为最多的人接种疫苗。同时使用一种以上的策略，包括茧策略加上青少年和成人的疫苗接种，似乎是最合理的预防措施。开发新的高免疫原性和有效的百日咳疫苗仍然是控制百日咳的主要目标。
Resurgence of pertussis in the post-vaccination era has been reported in Western countries. A shift of cases from school-age children to adolescents, adults and children under 1 year of age has been described in the last decade, and mortality rates in infants are still sustained. We aimed to review and discuss the possible vaccination strategies which can be adopted in order to improve the pertussis control, by searches of Pubmed, and websites of US and European Centers for Disease Control and Prevention, between 1st January 2002, and 1st March 2013. The following vaccination strategies have been retrieved and analysed: the cocooning strategy, the immunization of pregnant women and newborns, vaccination programs for preschool children, adolescents, adults and health-care workers. Cost-effectiveness studies provide some contrasting data, mainly supporting both maternal vaccination and cocooning. Adolescent and/or adult vaccination seems to be cost-effective, however data from observational studies suggest that this vaccination strategy, used alone, leads to a reduced pertussis burden globally, but does not affect the disease incidence in infants. Moreover, substantial logistical and economic difficulties have to be overcome to vaccinate the largest number of individuals. The simultaneous use of more than one strategy, including cocooning strategy plus vaccination of adolescents and adults, seems to be the most reasonable preventive measure. The development of new highly immunogenic and efficacious pertussis vaccines continues to be a primary objective for the control of pertussis.
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