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[1980 - 1986年间丹麦1岁以下儿童的百日咳情况]

[Whooping cough in Denmark among children under 1 year of age during 1980-1986].

作者信息

Nielsen A M, Larsen S O, Zoffmann H

机构信息

Epidemiologisk afdeling, Statens Seruminstitut, København.

出版信息

Ugeskr Laeger. 1991 May 20;153(21):1482-5.

PMID:2053196
Abstract

On the basis of individual notifications, reports of cases verified by culture and letters of discharge or case reports of infants under one year with whooping cough during the period 1980-1986, the distribution of the disease is described together with vaccine efficacy and the presumed sources of infection for infants in this age group. The incidence of whooping cough in infants under one year is estimated to be approximately three cases per 1,000 per annum as compared with 150 per 1,000 at the beginning of this century and 60 per 1,000 in the nineteen fifties before routine vaccination was introduced in 1961. The first vaccination is calculated to provide a vaccine efficacy of 39%, after the second vaccination the vaccine efficacy rises to 86% and after the third vaccination the vaccine efficacy is about 98% during the remainder of the first year of life. Even although the times of vaccination were advanced in 1970, this has not reduced the frequency of whooping cough in infants as the vaccination programme has simultaneously been weakened because children are now vaccinated only three times with a weaker vaccine and the immunity is of briefer duration. The commonest sources of infection for infants are siblings. A lower infective risk is desirable and this could be obtained by vaccinating infants an extra time. Alterations in the system of notification in 1980 have resulted in increased under-notification of whooping cough in children under one year while, simultaneously, the notified cases have been described better.

摘要

根据1980 - 1986年期间的个别通报、经培养证实的病例报告、出院信件或一岁以下婴儿百日咳病例报告,描述了该病的分布情况以及疫苗效力和该年龄组婴儿的推测感染源。据估计,一岁以下婴儿百日咳的发病率约为每年每1000人中有3例,而在本世纪初这一数字为每1000人中有150例,在1961年引入常规疫苗接种之前的20世纪50年代为每1000人中有60例。首次接种疫苗的效力计算为39%,第二次接种后疫苗效力升至86%,第三次接种后在生命的第一年剩余时间里疫苗效力约为98%。尽管1970年接种时间提前了,但这并没有降低婴儿百日咳的发病率,因为疫苗接种计划同时被削弱了,现在儿童只接种三次效力较弱的疫苗,而且免疫力持续时间较短。婴儿最常见的感染源是兄弟姐妹。降低感染风险是可取的,这可以通过给婴儿额外接种一次疫苗来实现。1980年通报系统的改变导致一岁以下儿童百日咳的漏报增加,与此同时,通报的病例描述得更好了。

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