Aristimuño H, Muga O, Cilla G, Piñeiro L, Zapico M S, Pérez-Yarza E G
Servicio de Pediatría, Hospital Universitario Donostia-Instituto BioDonostia, San Sebastián, Guipúzcoa, España.
An Pediatr (Barc). 2011 Sep;75(3):194-8. doi: 10.1016/j.anpedi.2011.03.016. Epub 2011 May 4.
Despite vaccination, reports of cases and outbreaks of pertussis (whooping cough) continue to appear sporadically, sometimes in young children who are at higher risk of severe disease. The aim of the present study was to evaluate the impact of this infection in infants in a region with high vaccination coverage in the pediatric population.
We performed a retrospective observational chart-review study of pertussis cases occurring over a decade (1999-2008), microbiologically confirmed through a polymerase chain reaction technique that amplifies the IS481 Bordetella pertussis sequence.
There were 54 confirmed cases, of which 33 (61.1%) occurred in infants aged less than 3 months. Cases were detected in all the study years, with periodic outbreaks (1999, 2004 and 2008). Half of the cases occurred in summer. Due to their young age, 55% of the infants had not received a vaccine dose and only 11% had received the first three doses. Hospitalization was required in 39 cases (72%) and admission to the pediatric intensive care unit in 17 cases (31.5%). One premature infant, with symptoms compatible with malignant pertussis, died at 49 days of life.
Despite the high pertussis vaccination coverage, infants aged less than 6 months continue to be at risk of severe disease. New preventive strategies are required to further reduce the impact of this infection.
尽管进行了疫苗接种，但百日咳病例和疫情报告仍时有出现，有时发生在患重病风险较高的幼儿身上。本研究的目的是评估在儿科人群疫苗接种覆盖率较高的地区，这种感染对婴儿的影响。
我们对十年间（1999 - 2008年）发生的百日咳病例进行了回顾性观察图表审查研究，通过聚合酶链反应技术对百日咳博德特氏菌IS481序列进行扩增，从微生物学角度确诊。
共确诊54例病例，其中33例（61.1%）发生在3个月以下的婴儿中。在所有研究年份均检测到病例，并有周期性疫情爆发（1999年、2004年和2008年）。一半的病例发生在夏季。由于年龄小，55%的婴儿未接种过一剂疫苗，只有11%的婴儿接种了前三剂。39例（72%）需要住院治疗，17例（31.5%）入住儿科重症监护病房。一名有恶性百日咳症状的早产儿在出生49天时死亡。
尽管百日咳疫苗接种覆盖率很高，但6个月以下的婴儿仍然面临患重病的风险。需要新的预防策略来进一步降低这种感染的影响。
