Cardeñosa Neus, Romero Marcos, Quesada Mariela, Oviedo Manuel, Carmona Gloria, Codina Gemma, Jansà Josep M, Domínguez Angela
General Subdirectorate of Surveillance and Response to Emergencies in Public Health, Department of Public Health in Catalonia, Spain.
Vaccine. 2009 May 26;27(25-26):3489-91. doi: 10.1016/j.vaccine.2009.01.046. Epub 2009 Feb 5.
Although vaccination coverage is high in Catalonia, Spain, pertussis is still a significant cause of morbidity and mortality among infants, overall due to adolescent and adult contacts. An epidemiological study from voluntary health care centres to detect confirmed pertussis cases was carried out in Catalonia. From 465 pertussis-suspect-cases, we identified 126 confirmed events, 73 of them confirmed by laboratory tests. Most of cases were infants less than 4 months old 23 (18.3%), adolescents 22 (17.4%) and adults 46 (36.5%). Sixty-one cases (49.6%) presented paroxysmal cough, 33 (26.8%) post-tussive vomiting and inspiratory whoop, and 27 (22%) apnoea. The vaccination status was not known for 46 (36.5%) patients. Of the total vaccine status documented, 59 (73.8%) patients had received at least one dose. Sixty patients (47.6%) were considered index cases, 32 of them (53.3%) were children under 1-year old. Among contacts identified as pertussis cases, 63.6% (42/66) were older than 14 years of age. These contacts were parents (30), siblings (19), grandmother (4), and others (13). These results confirm protective efficacy of pertussis vaccine only during few time. Regular pertussis boosters in teenagers, and/or in adults who take care of young children, could decrease the incidence of the infection.
尽管西班牙加泰罗尼亚地区的疫苗接种覆盖率很高，但百日咳仍是婴儿发病和死亡的一个重要原因，总体上是由于青少年和成人的接触所致。加泰罗尼亚开展了一项来自自愿医疗保健中心的流行病学研究，以检测确诊的百日咳病例。在465例疑似百日咳病例中，我们确定了126例确诊病例，其中73例通过实验室检测确诊。大多数病例为4个月以下的婴儿23例（18.3%）、青少年22例（17.4%）和成人46例（36.5%）。61例（49.6%）出现阵发性咳嗽，33例（26.8%）出现咳嗽后呕吐和吸气性哮吼，27例（22%）出现呼吸暂停。46例（36.5%）患者的疫苗接种状况未知。在记录的总疫苗接种状况中，59例（73.8%）患者至少接种过一剂疫苗。60例（47.6%）被视为指示病例，其中32例（53.3%）为1岁以下儿童。在被确定为百日咳病例的接触者中，63.6%（42/66）年龄超过14岁。这些接触者包括父母（30人）、兄弟姐妹（19人）、祖母（4人）和其他人（13人）。这些结果证实百日咳疫苗仅在短时间内具有保护效力。青少年和/或照顾幼儿的成人定期接种百日咳加强疫苗，可能会降低感染的发生率。
