Study on the establishment of the early diagnosis of Pertussis and the efficacy of vaccination

百日咳早期诊断方法的建立及疫苗接种效果的研究

• 批准号: 04670605
• 负责人: OKADA Kenji
• 金额: $ 1.34万
• 依托单位: KYUSHU UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1992
• 资助国家: 日本
• 起止时间: 1992 至 1994
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-04670605/
• 关键词: Pertussis; Early Diagnosis; Bacterial Isolation; Adult pertussis; DTaP vaccine; IgA抗体; 家族内感染; 百日咳菌分離; DPT三種混合ワクチン

(1) Isolation of bacteria and establishment of the early diagnosis.As an early diagnostic method of pertussis isolation of the bacteria was performed. It has been reported that the positivity of the isolated was low. However, in our current study, the isolation rate was high as 51.8%. Furthermore, 34.2% of our isolated cases were cases who had been treated with antibiotics before the isolation. This shows that isolation of the bacteria is an useful method on the early diagnosis of pertussis. And it is necessary to attempt the isolation on cases suspective of pertussis disregard the medication of antibiotics or not. On the other hand, if case who had been failed in the isolation, evaluation on a method to detect the IgM antibodies serologically as an early diagnosis has been performed, and a system of detection of the PT (pertussis toxin) IgM antibody has been established.(2) Investigation on familial infection and adult pertussisFamilial investigation to isolated cases were performed. … More As a result, bacteria were also isolated from siblings and parents who had been vaccinated. All these cases showed no typical clinical manifestation of pertussis, but only showing long term chronic coughing without serious attacks. And some mothers even did not show any coughing. Laboratory data also showed no obvious leukocytosis or relative lymphocytosis (mean white blood cell count 7040, %lymphocyte 36%). Source of infection to infants was estimated to be siblings and parents. Therefore, investigation on the familial infective status is an effective way to evaluate the efficacy of DTP vaccine, as the number of pertussis cases are decreasing in the recent years. Although the number of subject is small, the efficacy of DTP vaccine was 82%.(3) Evaluation of the efficacy of vaccineThe persistence of antibody level is studied as a method on the evaluations of the efficacy of the vaccine. A comparative study between children vaccinated with the acellular pertussis vaccine (DTaP) improved in 1981 in Japan and children vaccinated with the whole cell pertussis vaccine (DTwP) was performed. As a result, children vaccinated with the DTaP showed higher levels of diphtheria, tetanus antibody and FHA (filmentous hemagglutinin) antibody than those vaccinated with DTwP.It might also be influenced by epidemics of pertussis in the past, the persistence of antibody was better in the DTaP vaccinees. Less

(1)细菌的分离和早期诊断的建立。作为百日咳的早期诊断方法，进行了细菌的分离。据报道，隔离者的阳性率较低。然而，在我们目前的研究中，隔离率高达51.8%。此外，我们的隔离病例中有34.2%是在隔离前接受过抗生素治疗的病例。这表明分离细菌是百日咳早期诊断的有用方法。对于疑似百日咳病例，无论是否服用抗生素，都必须尝试隔离。另一方面，对于隔离失败的病例，对血清学检测IgM抗体的方法进行评估，作为早期诊断，并建立PT（百日咳毒素）IgM抗体检测体系。 （二）家族性感染和成人百日咳调查 对隔离病例进行家族性调查。 … 更多 结果，细菌也从接种疫苗的兄弟姐妹和父母身上分离出来。这些病例均无典型的百日咳临床表现，仅表现为长期慢性咳嗽，无严重发作。有的妈妈甚至没有表现出任何咳嗽的迹象。实验室数据还显示没有明显的白细胞增多或相对淋巴细胞增多（平均白细胞计数7040，淋巴细胞百分比36%）。婴儿的感染源估计是兄弟姐妹和父母。因此，随着近年来百日咳病例数的减少，对家族感染状况的调查是评价百日咳疫苗效果的有效方法。尽管受试者数量较少，但百白破疫苗的功效为82%。(3)疫苗功效的评价研究抗体水平的持续性作为评价疫苗功效的方法。对接种日本1981年改良的无细胞百日咳疫苗（DTaP）的儿童与接种全细胞百日咳疫苗（DTwP）的儿童进行了比较研究。结果，接种DTaP的儿童的白喉、破伤风抗体和FHA（丝状血凝素）抗体水平高于接种DTwP的儿童。也可能是受过去百日咳流行的影响，接种DTaP的儿童抗体持续性更好。较少的

项目成果

堀川和美、石橋哲也、世良暢之、村上光一、小河章、岡田賢司、植田浩司: "福岡県における百日咳菌の分離血清型別および薬剤感受性" 福岡県保健環境研究所年報. 19号. 60-63 (1992)

Kazumi Horikawa、Tetsuya Ishibashi、Nobuyuki Sera、Koichi Murakami、Akira Okawa、Kenji Okada、Hiroshi Ueda：“福冈县百日咳博德特氏菌的分离血清型和药物敏感性”福冈县健康与环境研究所年度报告 19、60-63。 (1992)

植田浩司、岡田賢司、宮崎千明、楠原浩一、日高靖文、門屋 亮、諸熊一則、山口優子、大隅邦夫: "百日咳早期診断のためのELISA法による抗PT特異的IgMIgA抗体価測定の試み" 予防接種の効果と副反応の追跡調査及び予防接種の社会・経済効果に関する研究報告書 厚生省予防接種研究班. 162-166 (1996)

Koji Ueda、Kenji Okada、Chiaki Miyazaki、Koichi Kusuhara、Yasufumi Hidaka、Ryo Kadoya、Kazunori Morokuma、Yuko Yamaguchi、Kunio Osumi：“尝试使用 ELISA 方法测量抗 PT 特异性 IgMIgA 抗体滴度，以用于百日咳的早期诊断”预防研究卫生和福利部免疫研究小组关于疫苗接种效果和副作用以及疫苗接种的社会和经济影响的跟踪调查报告。

木村三生夫、堺 春美、植田浩司、岡田賢司 他: "百日咳家族内二次感染調査集計報告-平成2-6年のまとめ" 予防接種の効果と副反応の追跡調査及び予防接種の社会・経済効果に関する研究報告書 厚生省予防接種研究班. 65-67 (1995)

Miao Kimura，Harumi Sakai，Koji Ueda，Kenji Okada，等：“百日咳家族继发感染汇总报告-1990-1999年总结”疫苗接种效果和副作用的跟踪调查以及疫苗接种社会研究。卫生和福利部免疫研究小组经济影响报告 65-67 (1995)。

岡田賢司(分担執筆): "DPT、DTワクチンの効果と副反応 新・予防接種のすべて" 堺 春美 編著 診断と治療社 東京, 439(分担14) (1997)

Kenji Okada（合著者）：“DPT 和 DT 疫苗的功效和副作用：关于新疫苗的一切” Harumi Sakai（编辑），Diagnosis and Herosha，东京，439（贡献 14）（1997 年）

岡田賢司、宮崎千明、楠原浩一、日高靖文、稲井郁子、門屋 亮、植田浩司: "DPT三種混合ワクチン接種後の副反応-とくに発疹とワクチン添加物との関係-" 小児感染免疫. 第7巻. 99-102 (1995)

Kenji Okada、Chiaki Miyazaki、Koichi Kusuhara、Yasufumi Hidaka、Ikuko Inai、Ryo Kadoya、Koji Ueda：“DPT 三联疫苗接种后的不良反应 - 特别是皮疹与疫苗添加剂之间的关系”《儿科感染免疫学》第 7 卷。 (1995)