de Melker H E, Schellekens J F, Neppelenbroek S E, Mooi F R, Rümke H C, Conyn-van Spaendonck M A
Department of Infectious Disease Epidemiology, National Institute of Public Health and the Environment, Bilthoven, the Netherlands.
Emerg Infect Dis. 2000 Jul-Aug;6(4):348-57. doi: 10.3201/eid0604.000404.
We analyzed pertussis reporting, death, hospitalization, and serodiagnostic data from 1976 to 1998 to help explain the cause of the 1996 pertussis outbreak in the Netherlands. The unexpected outbreak was detected by an increase in pertussis reporting and by other surveillance methods. In 1996, according to reporting and serologic data, the increase in pertussis incidence among (mostly unvaccinated) children less than 1 year of age was similar to the increase in hospital admissions. Among older (mostly vaccinated) persons, the increase in hospital admissions was relatively small. The increase in pertussis incidence was higher among vaccinated than among unvaccinated persons of all ages. This resulted in lower estimates of vaccine effectiveness. The proportion of pertussis infections resulting in recognizable symptoms may have increased among vaccinated persons because of a mismatch of the vaccine strain and circulating Bordetella pertussis strains. The small immunogenicity profile of the Dutch vaccine may have resulted in greater vulnerability to antigenic changes in B. pertussis.
我们分析了1976年至1998年期间的百日咳报告、死亡、住院和血清诊断数据，以帮助解释1996年荷兰百日咳疫情爆发的原因。此次意外疫情是通过百日咳报告的增加以及其他监测方法发现的。1996年，根据报告和血清学数据，1岁以下（大多未接种疫苗）儿童百日咳发病率的增加与住院人数的增加相似。在年龄较大（大多接种过疫苗）的人群中，住院人数的增加相对较小。所有年龄段接种疫苗者的百日咳发病率增幅高于未接种疫苗者。这导致了对疫苗效力的估计较低。由于疫苗菌株与循环的百日咳博德特氏菌菌株不匹配，接种疫苗者中出现可识别症状的百日咳感染比例可能有所增加。荷兰疫苗较小的免疫原性特征可能导致对百日咳博德特氏菌抗原变化的易感性更高。
