Cortese Margaret M, Baughman Andrew L, Brown Kristin, Srivastava Pamela
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Am J Prev Med. 2007 Mar;32(3):177-185. doi: 10.1016/j.amepre.2006.10.015.
For the first time, pertussis vaccines for adolescents and adults (combined with tetanus and diphtheria toxoids [Tdap]) became available in the United States in 2005. Despite a fully implemented U.S. childhood pertussis vaccination program, substantial morbidity because of pertussis continues to occur. To reduce this morbidity, the Advisory Committee on Immunization Practices recommended Tdap for all adolescents and adults in place of the next tetanus-diphtheria booster. As background for the basis of these recommendations, we summarize data on the morbidity and incidence of pertussis in U.S. adults and the role of adults in transmitting pertussis to young infants.
A MEDLINE search was performed in March 2006 for data on pertussis incidence rates and cough illness because of pertussis among U.S. adults (prospective, nonoutbreak studies were selected) and pertussis complications in adults. Data from the national passive surveillance system were also analyzed in October 2005.
The true adult burden is estimated at more than 600,000 cases annually in the United States. Adults with pertussis commonly cough for 2-4 months, often resulting in repeated medical visits and missed work. Complications include pneumonia, rib fractures, and cough syncope. Adults are an important source of pertussis for young infants, who have the highest risk of hospitalization and death.
The morbidity from pertussis in adults can be substantial, the incidence of pertussis in U.S. adults is high, and adults transmit infection to young infants. Providers now have the opportunity to reduce the burden of pertussis by vaccinating adults with Tdap.
2005年，美国首次有了针对青少年和成人的百日咳疫苗（与破伤风和白喉类毒素联合制成的Tdap疫苗）。尽管美国儿童百日咳疫苗接种计划已全面实施，但百日咳导致的大量发病情况仍在继续。为降低这种发病率，免疫实践咨询委员会建议所有青少年和成人接种Tdap疫苗，以替代下次破伤风 - 白喉加强疫苗。作为这些建议依据的背景信息，我们总结了美国成人百日咳的发病率和发病情况数据，以及成人在将百日咳传播给幼儿方面所起的作用。
2006年3月对MEDLINE进行检索，以获取美国成人百日咳发病率以及因百日咳导致的咳嗽疾病（选择前瞻性、非暴发研究）和成人百日咳并发症的数据。2005年10月还分析了国家被动监测系统的数据。
据估计，美国每年成人百日咳实际发病数超过60万例。患百日咳的成人通常咳嗽2 - 4个月，常导致多次就医和误工。并发症包括肺炎、肋骨骨折和咳嗽性晕厥。成人是幼儿百日咳的重要传染源，幼儿住院和死亡风险最高。
成人百日咳的发病情况可能很严重，美国成人百日咳发病率很高，且成人会将感染传播给幼儿。医疗服务提供者现在有机会通过为成人接种Tdap疫苗来减轻百日咳负担。
