Segura del Pozo Javier, Sanz Moreno Juan Carlos, Gascón Sancho María Jesús, Ramos Lledó Esther, de Ory Manchón Fernando, Fernández Díaz Marisa
Servicio de Salud Pública del Area III. Consejería de Sanidad. Comunidad de Madrid. Alcalá de Henares. Madrid. Spain.
Med Clin (Barc). 2002 Nov 9;119(16):601-4.
The aim of this study was to describe the clinical, serological and epidemiological findings of a pertussis outbreak in an insufficiently vaccinated gipsy community.
Ten cases (catarrhal illness with cough of 2 weeks duration) were identified through an active search. In four of them, two paired serum samples were obtained and total IgG against Bordetella pertussis and IgG and IgA against pertussis toxin (PT) and filamentous hemagglutinin (FHA) were determined. The diagnostic criteria was seroconversion. A comparative analysis between cases and healthy children younger than 15 years (gipsy community) was carried out and we estimated, by means of a logistical regression analysis, the odds ratio (OR) of several factors.
The highest attack rate (50%) was found in the 5 to 9 year-old group; 30% cases had not been vaccinated while 50% had been incorrectly vaccinated. No significant differences for age, gender or the vaccine status were detected. Three cases showed seroconversion for total IgG and two for IgG-PT and IgA-PT. Other possible pathogens were ruled out by serology.
Despite the high vaccine coverage against pertussis in paediatric age in Spain, some susceptible population groups remain, mainly due to an incorrect vaccination. Our serological results firmly support the suspicion of B. pertussis as the etiologic agent of the outbreak.
本研究旨在描述在疫苗接种不足的吉普赛社区中百日咳暴发的临床、血清学和流行病学特征。
通过主动搜索确定了10例（持续2周咳嗽伴卡他症状的疾病）。其中4例获取了两份配对血清样本，测定了针对百日咳博德特氏菌的总IgG以及针对百日咳毒素（PT）和丝状血凝素（FHA）的IgG和IgA。诊断标准为血清转化。对病例与15岁以下健康儿童（吉普赛社区）进行了比较分析，并通过逻辑回归分析估计了几个因素的比值比（OR）。
5至9岁年龄组的发病率最高（50%）；30%的病例未接种疫苗，50%的病例接种错误。未发现年龄、性别或疫苗接种状况有显著差异。3例总IgG出现血清转化，2例IgG-PT和IgA-PT出现血清转化。血清学排除了其他可能的病原体。
尽管西班牙儿童百日咳疫苗接种覆盖率较高，但仍存在一些易感人群，主要原因是接种错误。我们的血清学结果有力地支持了百日咳博德特氏菌是此次暴发病原体的怀疑。
