von König C H Wirsing, Halperin S, Riffelmann M, Guiso N
German reference laboratory for pertussis, Krefeld, Germany.
Lancet Infect Dis. 2002 Dec;2(12):744-50. doi: 10.1016/s1473-3099(02)00452-8.
Bordetella pertussis continues to circulate even in populations where a high vaccine coverage of infants and children is achieved. Cases in adolescents and adults are reported with increasing frequency in many countries. Adults are a reservoir for infections in very young infants, in whom pertussis may be severe and life-threatening. The salient clinical feature of pertussis in adolescents and adults is prolonged coughing, and recognising that pertussis does occur in these age groups is the most important step in its diagnosis. A laboratory diagnosis can be made by bordetella-PCR from nasopharyngeal swabs or secretions and by detection of antibodies, mainly to pertussis toxin; laboratory diagnosis is, however, not well standardised. Vaccination of adolescents and adults is now possible with acellular pertussis vaccines, which are well tolerated, immunogenic, and effective. Adolescent boosters and the vaccination of health-care workers are already included in vaccination calendars in some countries. Vaccine-recommending bodies and national health-care organisations must have locally relevant information on the transmission of pertussis from adults to infants to be able to make decisions on the advisability, feasibility, and priority for booster immunisation against pertussis.
即使在婴幼儿疫苗接种覆盖率很高的人群中，百日咳博德特氏菌仍在传播。在许多国家，青少年和成人患百日咳的病例报告越来越频繁。成人是非常年幼婴儿感染的传染源，百日咳在这些婴儿中可能很严重，甚至危及生命。青少年和成人百日咳的突出临床特征是咳嗽持续时间长，认识到这些年龄组确实会发生百日咳是诊断百日咳的最重要步骤。实验室诊断可通过对鼻咽拭子或分泌物进行博德特氏菌聚合酶链反应（bordetella-PCR）以及检测抗体（主要是针对百日咳毒素的抗体）来进行；然而，实验室诊断的标准化程度不高。现在可以用无细胞百日咳疫苗对青少年和成人进行接种，这种疫苗耐受性良好、具有免疫原性且有效。一些国家的疫苗接种计划中已经包括了青少年加强免疫和医护人员接种。疫苗推荐机构和国家医疗保健组织必须掌握当地关于百日咳从成人传播给婴儿的相关信息，以便能够就加强接种百日咳疫苗的 advisability、可行性和优先级做出决策。 （注： advisability 这个词在中文语境下较难找到完全对应的简洁词汇，大概意思是“明智性、可取性” ）
