摘要
百日咳再现原因复杂,与疫苗免疫效力持久性不足、疫苗接种策略差异、流行病学特征改变、抗生素耐药、百日咳鲍特菌的变异、诊断标准的改进及监测系统的完善度等因素均有关。疫苗接种后,由于自然感染病例减少,导致当前百日咳流行规律已经发生改变。由于人群群体免疫水平下降,经母体胎传给新生儿的血清抗体滴度降低,导致未接种疫苗的婴儿早期免疫水平不足,1岁以下的婴儿易出现重症病例。由于疫苗免疫效力并不持久,儿童、青少年也是百日咳的易感人群,感染后表现以慢性咳嗽较为常见,成人病例可因症状不典型或隐匿性感染难以引起重视,成为婴儿感染的传染源。为了加强百日咳的诊治能力,有必要改进诊断标准、关注细菌变异与耐药、加强百日咳的监测、寻求更为优化的免疫接种策略及进行新疫苗的开发。现就当前百日咳再现原因进行综述,以期为国内百日咳防控提供参考。
There are a variety of factors contributing to pertussis resurgence,which is related to short duration of immunity provided by the vaccine,the difference of vaccination strategies,the change of epidemiological characteristics,antibiotic resistance,the variation of bordetella pertussis,the improvement of diagnostic criteria and the advancement of the monitoring system.There has been a decrease in the number of cases of natural infection since the vaccination,leading to a change in the prevalence of pertussis currently.The decline in population group immunity causes a decrease of serum antibody titer transmitted from the mother to the newborn.As a result,unvaccinated infants have poor immunity against pertussis in the early stage,and infants under 1 year old are prone to severe pertussis.Children and adolescents are also susceptible to pertussis owing to the short-term efficacy of the vaccine.They often present with chronic cough after infection.Adults infected with pertussis are unheeded because of atypical symptoms or occult infection,and they would infect young babies.To improve the diagnosis and treatment of pertussis,it is necessary to meliorate the laboratory diagnosis,study bacterial variation and drug resistance,strengthen disease surveillance,seek more optimized immunization strategies and develop new vaccines.In this paper,the causes of pertussis resurgence were reviewed,in order to provide reference for prevention and control of pertussis in China.
作者
汪丙松
李振
徐济宝
Wang Bingsong;Li Zhen;Xu Jibao(Department of Pediatric Respiratory Medicine,Wuhu No.1 People′s Hospital/Wuhu Children′s Medical Center,Wuhu 241000,Anhui Province,China;Laboratory Microbiology,Wuhu No.1 People′s Hospital/Wuhu Children′s Medical Center,Wuhu 241000,Anhui Province,China)
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2021年第4期311-315,共5页
Chinese Journal of Applied Clinical Pediatrics
基金
芜湖市第一人民医院院内科研项目(2020WYY001I)
芜湖市科技局资助项目(2020ms-318)。
关键词
百日咳再现
原因
免疫策略
Pertussis resurgence
Reason
Immunization strategy
