军事学校百日咳爆发的调查：危险因素和疫苗效果评估。

Investigation on a pertussis outbreak in a military school: risk factors and approach to vaccine efficacy.

机构信息

Institut Pasteur de la Guyane, 23 av. Pasteur, BP6010, 97306 Cayenne cedex, France.

出版信息

Vaccine. 2010 Jul 19;28(32):5147-52. doi: 10.1016/j.vaccine.2010.05.070. Epub 2010 Jun 9.

DOI:10.1016/j.vaccine.2010.05.070

PMID:20541009

Abstract

INTRODUCTION

Pertussis (whooping cough) is a toxic bacterial infection caused mainly by Bordetella pertussis. In mid-January 2006, several cases of pertussis were diagnosed in a military boarding-school. An investigation was carried out at the end of January to identify the risk factors for infection and to evaluate the efficacy of vaccination.

SUBJECTS AND METHODS

Three definitions were used to distinguish the cases; confirmed biologically, confirmed epidemiologically and suspected cases. The risk factor study was carried out after the exclusion of suspect cases. Vaccine efficacy (VE) was evaluated from a case-control study where only biologically confirmed cases were included. For each case, five controls were matched according to age, sex and class. A logistic regression and a conditional logistic regression were performed for the risk factor study and vaccine efficacy, respectively. Statistical analysis was carried out using Stata 9.2 software.

RESULTS

A total of 206 cases were included, 17 of them biologically confirmed, 66 epidemiologically and 123 suspected cases. The attack rate was 17.8 per 100. Girls were 1.8 times more likely to catch pertussis (p=0.04), pupils in the first year of college, as well as those in high school were at 5 times greater risk of catching pertussis (p=0.008) than those in the second year of college. For pupils who benefited from at least 5 doses, the VE was at 80% when the last dose dated from less than 6 years earlier.

DISCUSSION/CONCLUSION: The attack rate observed in our study was similar to those normally seen during epidemics occurring within a community. Vaccine efficacy declined depending on the time lapse since the last vaccination. Since April 2008, the Public Health Authorities have planned to provide pertussis booster vaccinations for children aged 16-18 who missed those for 11-13-year-old, and for adults aged 26-27 and those who have not been vaccinated for more than 10 years.

摘要

简介

百日咳（哮吼）是一种由百日咳博德特氏菌引起的细菌性传染病。2006 年 1 月中旬，在一所军事寄宿学校确诊了几例百日咳病例。1 月底进行了一项调查，以确定感染的危险因素，并评估疫苗接种的效果。

研究对象和方法

使用三种定义来区分病例：生物学确诊、流行病学确诊和疑似病例。在排除疑似病例后进行了危险因素研究。疫苗效果（VE）是通过仅包括生物学确诊病例的病例对照研究来评估的。对于每个病例，根据年龄、性别和班级匹配 5 个对照。进行逻辑回归和条件逻辑回归，分别用于危险因素研究和疫苗效果。使用 Stata 9.2 软件进行统计分析。

结果

共纳入 206 例病例，其中 17 例为生物学确诊，66 例为流行病学确诊，123 例为疑似病例。发病率为每 100 人 17.8 例。女孩患百日咳的风险是男孩的 1.8 倍（p=0.04），大学一年级和高中学生患百日咳的风险是大学二年级学生的 5 倍（p=0.008）。对于至少接种 5 剂疫苗的学生，如果最后一剂疫苗接种时间不到 6 年前，VE 为 80%。

讨论/结论：我们的研究观察到的发病率与社区内发生的流行期间通常看到的发病率相似。疫苗效果随最后一次接种时间的推移而下降。自 2008 年 4 月以来，公共卫生部门计划为错过 11-13 岁和 16-18 岁百日咳加强疫苗接种的儿童以及 26-27 岁和未接种疫苗超过 10 年的成年人提供百日咳加强疫苗接种。