Institut Pasteur, Molecular Prevention and Therapy Unit, 75724 Paris Cedex 15, France.
Vaccine. 2011 Feb 1;29(6):1115-21. doi: 10.1016/j.vaccine.2010.12.010. Epub 2010 Dec 17.
Pertussis remains endemic worldwide and is an important public health problem, even in countries with sustained high vaccination coverage. Resurgence of pertussis in the post-vaccination era has been reported in many areas of the world. The Global Pertussis Initiative (GPI) was established in 2001 to evaluate the ongoing problem of pertussis worldwide and to recommend appropriate pertussis control strategies. In addition to primary vaccinations, the GPI currently recommends a pertussis booster vaccination to pre-school children, adolescents and those adults at risk of transmitting Bordetella pertussis infection to infants. At a meeting in Paris, France, in January 2010, GPI members discussed pertussis surveillance and testing then prepared recommendations on the implementation and utilisation of these activities. Issues and projects discussed included: national surveillance systems and their suitability for other countries; seroprevalence studies; ideal surveillance methodologies; ongoing efforts in obtaining biological samples; standardisation of sample treatment; culture; real-time polymerase chain reaction (PCR); and likely future advances such as antibody detection in saliva. Previous regional meetings of the GPI have confirmed that many countries have limited laboratory facilities for the detection of pertussis. The GPI hopes that the future introduction of increased laboratory capabilities and greater harmonisation of clinical definitions and detection methods will lead to enhanced surveillance and a better estimate of the burden of pertussis infection worldwide. This article provides a current guide on the appropriate use of laboratory diagnostics and optimal surveillance methodologies to assist countries in the control of pertussis disease.
百日咳在全球范围内仍然流行,是一个重要的公共卫生问题,即使在疫苗接种覆盖率持续高的国家也是如此。在世界许多地区,都有报道称在疫苗接种后时代百日咳出现了反弹。全球百日咳倡议(GPI)成立于 2001 年,旨在评估全球百日咳的持续问题,并推荐适当的百日咳控制策略。除了基础疫苗接种外,GPI 目前还建议为学前儿童、青少年和有传播百日咳博德特氏菌感染给婴儿风险的成年人接种百日咳加强疫苗。2010 年 1 月,在法国巴黎举行的一次会议上,GPI 成员讨论了百日咳监测和检测问题,然后就这些活动的实施和利用提出了建议。讨论的问题和项目包括:国家监测系统及其对其他国家的适用性;血清阳性率研究;理想的监测方法学;正在努力获取生物样本;样本处理的标准化;培养;实时聚合酶链反应(PCR);以及未来可能的进展,如唾液中的抗体检测。GPI 的先前区域会议已经证实,许多国家的实验室检测百日咳的能力有限。GPI 希望未来增加实验室能力和更大程度地协调临床定义和检测方法,将导致更好的监测和对全球百日咳感染负担的更准确估计。本文提供了关于实验室诊断的适当使用和最佳监测方法学的当前指南,以帮助各国控制百日咳疾病。