Clinical and epidemiological picture of B pertussis and B parapertussis infections after introduction of acellular pertussis vaccines
Clinical and epidemiological picture of B pertussis and B parapertussis infections after introduction of acellular pertussis vaccines
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DOI：
10.1136/adc.88.8.684
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发表时间：
2003-08-01
影响因子：
5.2
通讯作者：
Belohradsky, BH
中科院分区：
文献类型：
--
作者：
Liese, JG;Renner, C;Belohradsky, BH
目的：了解德国引入无细胞百日咳（acP）疫苗后百日咳博德氏菌和副百日咳B型感染的临床情况和频率。方法：对14144例幼儿进行百日咳B型和副百日咳B型的前瞻性监测。百日咳疫苗接种率为86%，无论是acP（75%）还是全细胞百日咳（wcP）疫苗（11%）。所有咳嗽超过7天的儿童均通过培养、PCR和血清学（咳嗽持续时间大于或等于21天）检测百日咳B型和百日咳B型。结果：共有180例博德特拉菌感染；百日咳B型116例（64%），百日咳副B型64例（36%）。发病率分别为每1000人年4.8例和2.8例。发作性咳嗽、咳后百日咳和呕吐超过或等于21天分别占所有百日咳B型病例的53%、22%和8%，以及所有百日咳B型病例的22%、5%和0%。81/116例（70%）B型百日咳和56/ 64例（87.5%）B型百日咳至少接种过一次百日咳疫苗。未接种百日咳B型疫苗的病例中有29/35（83%）出现典型百日咳，阵发性咳嗽大于或等于21天，而接种百日咳B型疫苗的病例中有33/81（41%）出现典型百日咳。结论：随着百日咳疫苗接种覆盖率的增加，我们观察到B型百日咳病例相对于B型百日咳病例有所增加。在接种过疫苗的儿童中，百日咳B型病通常表现为轻度疾病，临床上难以与百日咳B型及其他病毒或细菌感染引起的咳嗽相关疾病区分开来。
Aims: To investigate the clinical picture and frequency of Bordetella pertussis and B parapertussis infections after introduction of acellular pertussis (acP) vaccines in Germany.Methods: Prospective surveillance for B pertussis and B parapertussis in 14 144 toddlers. Pertussis vaccination coverage was 86%, either with acP (75%) or whole cell pertussis (wcP) vaccine (11%). All children presenting with cough for more than seven days were examined for B pertussis and B parapertussis by culture, PCR, and serology ( for cough duration greater than or equal to 21 days).Results: There were 180 Bordetella infections; 116 ( 64%) were caused by B pertussis and 64 (36%) by B parapertussis. Incidence rates were 4.8 and 2.8 per 1000 person- years, respectively. Paroxysmal cough, post-tussive whooping, and vomiting greater than or equal to 21 days was found in 53%, 22%, and 8% of all B pertussis cases and in 22%, 5%, and 0% of all B parapertussis cases, respectively. A total of 81/116 (70%) B pertussis cases and 56/ 64 (87.5%) B parapertussis cases had received at least one dose of pertussis vaccine. Typical pertussis with paroxysmal cough greater than or equal to 21 days was present in 29/35 (83%) unvaccinated B pertussis cases, in contrast to 33/81 (41%) vaccinated B pertussis cases.Conclusion: Following the increase of pertussis vaccination coverage, we observed a relative increase of B parapertussis cases in comparison to B pertussis cases. In vaccinated children B pertussis disease frequently presented as a mild disease, clinically difficult to distinguish from diseases associated with coughing caused by B parapertussis and other viral or bacterial infections.