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[在充分接种疫苗的儿童和青少年中出现高发病率的百日咳疫情]

[Outbreak of whooping cough with a high attack rate in well-vaccinated children and adolescents].

作者信息

Torres Joan, Godoy Pere, Artigues Antoni, Codina Gemma, Bach Pilar, Mòdol Irma, Duró Maria Àngels, Trilla Carme

机构信息

Unitat d'Epidemiologia, Departament de Salut, Lleida, España.

出版信息

Enferm Infecc Microbiol Clin. 2011 Oct;29(8):564-7. doi: 10.1016/j.eimc.2011.04.005. Epub 2011 Jul 19.

Abstract

INTRODUCTION

Whooping cough is a re-emerging disease. We describe the investigation of an outbreak of whooping cough and the measures of control adopted.

METHODS

The event was reconstructed through a longitudinal study of incidence. In addition to the notified cases, an active search from the list of those who attended summer camps was made through telephone calls. An epidemiological survey was applied to all cases; vaccination history was confirmed with computerised clinical history and the obtaining of samples for analytical confirmation was proposed. The description of the outbreak was made through the epidemic curve, the attack rates, the relative risk and the linear trend by ages and the vaccination coverage.

RESULTS

Of the 30 cases that appeared, 22 (73.3%) were among the members of the summer camps. In these, the attack rate was 21.8%, 26.7% among the children and adolescents increasing linearly with the age. The large majority (86.4%) of this last group were correctly vaccinated, including the fifth dose at the age of 4-6 years. Through the meticulous study of the first cases and the telephone calls to those who attended the summer camp, 90% of the cases of the outbreak were detected.

CONCLUSIONS

The active search of cases allowed an outbreak of whooping cough with a high attack rate to be studied in children and adolescents with a high vaccination coverage, and the application of control measures that contributed to stop the outbreak.

摘要

引言

百日咳是一种再度出现的疾病。我们描述了对一次百日咳疫情的调查及所采取的控制措施。

方法

通过发病率的纵向研究对该事件进行重构。除了已通报的病例外,还通过电话对参加夏令营人员名单进行了主动搜索。对所有病例进行了流行病学调查;通过计算机化临床记录确认疫苗接种史,并提议采集样本进行分析确认。通过疫情曲线、发病率、相对风险以及按年龄和疫苗接种覆盖率的线性趋势对疫情进行描述。

结果

出现的30例病例中,22例(73.3%)是夏令营成员。其中,发病率为21.8%,儿童和青少年中的发病率为26.7%,且随年龄呈线性上升。最后这一组中的绝大多数(86.4%)都接种了正确的疫苗,包括4至6岁时的第五剂。通过对首例病例的细致研究以及给参加夏令营的人员打电话,发现了该疫情90%的病例。

结论

主动搜索病例使得能够对疫苗接种覆盖率高的儿童和青少年中一次发病率高的百日咳疫情进行研究,并实施有助于阻止疫情的控制措施。

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