What is new in pertussis?
What is new in pertussis?
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DOI：
10.1007/s00431-007-0548-2
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发表时间：
2008-02
影响因子：
3.6
通讯作者：
Srugo, Isaac
中科院分区：
文献类型：
--
作者：
Bamberger, Ellen S.;Srugo, Isaac
尽管疫苗接种覆盖率很高，但在过去的15年里，B在世界范围内死灰复燃。百日咳感染虽然在疫苗时代之前，经典百日咳主要是一种儿童疾病，但随着疫苗的广泛接种，青少年和成人的发病率发生了变化。疾病控制和预防中心2004年的数据显示，10-19岁的人的病例数增加了近19倍，20岁以上的人增加了16倍。事实上，青少年和成年人在百日咳向新生儿和婴儿的传播中起着重要作用，新生儿和婴儿易受百日咳感染的严重发病率和死亡率的影响。人们提出了几种解释来解释疾病发病率的增加，自然感染或免疫接种后免疫力减弱被广泛认为是一个重要因素。分子生物学诊断技术的改进，即PCR检测，也是百日咳实验室诊断增加的原因。扩大疫苗接种战略，包括对青少年进行全面免疫接种，对成年人进行有针对性的免疫接种，特别是对保健工作者、儿童保育提供者和新生儿父母进行免疫接种，可能会改善百日咳控制。由于百日咳继续对婴儿构成严重威胁，并极大地影响青少年和成人，因此仍然需要：（a）提高医生对日益严重的百日咳问题的认识，（B）使诊断技术标准化，（c）实施各种新的疫苗战略以加强对百日咳的控制。
Despite high vaccination coverage, over the last fifteen years there has been a worldwide resurgence of B. pertussis infection. While classical pertussis in the prevaccine era was primarily a childhood disease, today with widespread vaccination, there has been a shift in the incidence of disease to adolescents and adults. Centers of Disease Control and Prevention (CDC) data from 2004 reveal a nearly 19-fold increase in the number of cases in individuals 10–19 years and a 16-fold increase in persons over 20 years. Indeed adolescent and adults play a significant role in the transmission of pertussis to neonates and infants who are vulnerable to substantial morbidity and mortality from pertussis infection. Several explanations have been proposed to explain the increasing incidence of disease, with waning immunity after natural infection or immunization being widely cited as a significant factor. Improving molecular biology diagnostic techniques, namely PCR assays, also accounts for the increasing laboratory diagnosis of pertussis. Expanding vaccination strategies including universal immunization of adolescents, targeted immunization of adults, and in particular, healthcare workers, childcare providers and parents of newborns, will likely improve pertussis control. With pertussis continuing to pose a serious threat to infants, and greatly affecting adolescents and adults, there remains a need to: (a) increase the awareness of physicians as to the growing pertussis problem, (b) standardize diagnostic techniques, and (c) implement various new vaccine strategies to enhance its control.
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