Kowalzik Frank, Barbosa Arnaldo Prata, Fernandes Vera Regina, Carvalho Paulo Roberto, Avila-Aguero Maria Luisa, Goh Daniel Y T, Goh Anne, de Miguel Jesus Garcia, Moraga Fernando, Roca Joan, Campins Magda, Huang Ming, Quian Jorge, Riley Nicole, Beck Dominique, Verstraeten Thomas
University of Mainz, Mainz, Germany.
Pediatr Infect Dis J. 2007 Mar;26(3):238-42. doi: 10.1097/01.inf.0000256750.07118.ee.
Increased incidence of pertussis has been noted among infants too young to be immunized. We studied the disease burden of pertussis in pediatric intensive care units and the source of infection in several Asian, European and Latin American countries.
The study was conducted in 7 countries from September 2001 to January 2004. Children <1 year of age were enrolled from pediatric intensive care units (PICU) and pediatric wards if they presented with respiratory failure, apnea, bradycardia, or cough accompanied by paroxysms, vomiting, whoop or cyanosis. Household members of pertussis-positive index cases were asked to answer a questionnaire and provide diagnostic specimens.
Pertussis was confirmed in 99 infants (12%) of 823 infants included in the analysis: 10 of 90 (11%) in Brazil, 9 of 88 (10%) in Costa Rica, 11 of 145 (8%) in Germany, 13 of 147 (9%) in Singapore, 29 of 67 (43%) in Spain, 2 of 86 (2%) in Taiwan and 25 of 200 (13%) in Uruguay. However, sensitivity analysis indicated that these figures were conservative. The mean (+/- SD) average age of infection was 2.6 +/- 2.2 months. Pertussis was found among 96 of 269 (36%) of household contacts investigated. At least one household contact was identified as the source of infection in 24 of 88 (27%) of the PICU cases and mothers were identified as being the most frequent source of infection.
Although regional differences exist, severe pertussis represents a considerable global disease burden. Since most infants are infected before vaccination and concomitant protection is completed, household contacts should be targeted for booster vaccination to reduce the pertussis reservoir.
在太小无法接种疫苗的婴儿中，百日咳发病率有所上升。我们研究了几个亚洲、欧洲和拉丁美洲国家儿科重症监护病房中百日咳的疾病负担及感染源。
该研究于2001年9月至2004年1月在7个国家进行。年龄小于1岁的儿童若出现呼吸衰竭、呼吸暂停、心动过缓或伴有阵发性咳嗽、呕吐、鸡鸣样吸气吼声或发绀，则从儿科重症监护病房（PICU）和儿科病房纳入研究。百日咳阳性索引病例的家庭成员被要求回答一份问卷并提供诊断标本。
在纳入分析的823名婴儿中，99名（12%）确诊为百日咳：巴西90名中有10名（11%），哥斯达黎加88名中有9名（10%），德国145名中有11名（8%），新加坡147名中有13名（9%），西班牙67名中有29名（43%），台湾86名中有2名（2%），乌拉圭200名中有25名（13%）。然而，敏感性分析表明这些数字较为保守。感染的平均（±标准差）年龄为2.6±2.2个月。在接受调查的269名家庭接触者中，96名（36%）发现患有百日咳。在88例PICU病例中，24例（27%）至少有一名家庭接触者被确定为感染源，母亲被确定为最常见的感染源。
尽管存在地区差异，但严重百日咳仍是一项相当大的全球疾病负担。由于大多数婴儿在接种疫苗及获得相应保护完成之前就已感染，因此应针对家庭接触者进行加强免疫接种，以减少百日咳传染源。
