Connelly K K, Starke J R
Department of Pediatrics, University of Texas Health Science Center, Houston 77030.
Semin Respir Infect. 1991 Dec;6(4):204-16.
In the past decade, immunization rates among preschool-age children in the United States have decreased to levels lower than those in many developing countries. As a result, epidemics of vaccine-preventable diseases have occurred, especially in urban areas. Six of the infections prevented by immunization--those caused by Bordetella pertussis, Streptococcus pneumoniae, Haemophilus influenzae type B, Corynebacterium diphtheriae, measles virus, and influenza virus--frequently cause respiratory tract disease. Pneumonia in children may have subtle presentations and require special considerations depending on the age and condition of the child and the current rate of disease in the community. In addition to the epidemics occurring throughout the country, the growing number of immunocompromised children has also influenced diagnostic, treatment, and prevention considerations. These patients include children with cancer, organ transplants, congenital immune disorders, sickle cell disease, human immunodeficiency virus infection, as well as other disorders that lead to increased risk of infection. The current recommendations for routine and special childhood immunizations are reviewed in this article.
在过去十年中，美国学龄前儿童的免疫接种率已降至低于许多发展中国家的水平。因此，疫苗可预防疾病的疫情已经发生，尤其是在城市地区。免疫接种可预防的六种感染——由百日咳博德特氏菌、肺炎链球菌、B型流感嗜血杆菌、白喉棒状杆菌、麻疹病毒和流感病毒引起的感染——经常导致呼吸道疾病。儿童肺炎可能表现不明显，需要根据儿童的年龄和状况以及社区当前的疾病发病率进行特殊考虑。除了在全国范围内发生的疫情外，免疫功能低下儿童数量的增加也影响了诊断、治疗和预防方面的考虑。这些患者包括患有癌症、接受器官移植、先天性免疫疾病、镰状细胞病、人类免疫缺陷病毒感染以及其他导致感染风险增加的疾病的儿童。本文对当前关于儿童常规和特殊免疫接种的建议进行了综述。
