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美国的百日咳感染:青少年和成人接种疫苗的作用

Pertussis infection in the United States: role for vaccination of adolescents and adults.

作者信息

Brooks Dennis A, Clover Richard

机构信息

Johns Hopkins School of Medicine, Baltimore, MD, USA.

出版信息

J Am Board Fam Med. 2006 Nov-Dec;19(6):603-11. doi: 10.3122/jabfm.19.6.603.

Abstract

Pertussis is the only vaccine-preventable disease on the rise in the United States, with increasing incidence in adolescents and adults related to waning immunity. Although often considered a relatively mild infection in these populations, pertussis can be a serious, potentially deadly illness, particularly in children <12 months old. Infected adolescents and adults serve as a reservoir for disease transmission to young children and infants, who are most vulnerable to severe pertussis and its life-threatening complications. In 2005, the US Food and Drug Administration licensed two vaccines that contain tetanus toxoid, reduced diphtheria toxoid and reduced acellular pertussis vaccine (Tdap), one for use in adolescents and the other for use in adolescents and adults. In light of these licensures, the CDC's Advisory Committee on Immunization Practices (ACIP) revised its recommendations for pertussis vaccination to include a Tdap booster dose for all adolescents aged 11 to 12 years as well as catch-up vaccination of those aged 13 to 18 years who did not receive the Td booster. The Committee also recommended a Tdap booster dose for all adults aged 19 to 64 years to replace the next Td booster dose, particularly for those who have close contact with infants <12 months old. In February 2006, the ACIP recommended a Tdap booster dose for health care personnel as soon as feasible. If widely administered, Tdap vaccination should have a substantial impact on pertussis.

摘要

百日咳是美国唯一一种发病率呈上升趋势的疫苗可预防疾病,青少年和成年人发病率上升与免疫力下降有关。尽管在这些人群中百日咳通常被认为是相对轻微的感染,但它可能是一种严重的、有潜在致命风险的疾病,尤其是在12个月以下的儿童中。受感染的青少年和成年人是疾病传播给幼儿和婴儿的传染源,而这些幼儿和婴儿最易患严重百日咳及其危及生命的并发症。2005年,美国食品药品监督管理局批准了两种含有破伤风类毒素、减毒白喉类毒素和无细胞百日咳疫苗(Tdap)的疫苗,一种用于青少年,另一种用于青少年和成年人。鉴于这些许可,美国疾病控制与预防中心免疫实践咨询委员会(ACIP)修订了百日咳疫苗接种建议,包括为所有11至12岁的青少年接种一剂Tdap加强针,以及为13至18岁未接种Td加强针的人群补种。委员会还建议所有19至64岁的成年人接种一剂Tdap加强针以替代下一次Td加强针,特别是对于那些与12个月以下婴儿有密切接触的人。2006年2月,ACIP建议医疗保健人员尽快接种一剂Tdap加强针。如果广泛接种,Tdap疫苗接种应对百日咳产生重大影响。

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