Kirby Institute, University of New South Wales, Australia.
Clin Infect Dis. 2012 Dec;55(11):1450-6. doi: 10.1093/cid/cis627. Epub 2012 Jul 17.
There is limited information on the incidence, morbidity and risk factors for pertussis in adults, particularly those aged over 65 years.
Population-based prospective cohort study of 263094 adults aged over 45 years (mean 62.8 years) recruited in the Australian state of New South Wales (the 45 and Up Study) between 2006 and 2008, and followed by record-linkage to laboratory-confirmed pertussis notifications, hospitalizations, and death records. The incidence of pertussis notifications and hospitalizations and relative risk (RR) of pertussis according to various participant characteristics was estimated using proportional hazards models.
Over a total follow-up of 217524 person-years, 205 adults had a pertussis notification and 12 were hospitalized; the incidence rate was 94 (95% confidence interval [CI], 82-108) and 5.5 (95% CI, 3.1-9.7) per 100000 person-years, respectively. The incidence of a pertussis notification did not differ by age but hospitalization rates progressively increased (2.2, 8.5, and 13.5 per 100000 person-years in age groups 45-64, 65-74, and 75+ years, respectively; P(trend) = .01). After adjusting for age, sex, and other factors, adults with a high body mass index (BMI; RR=1.52; 95% CI, 1.06-2.19 for BMI 30+kg/m(2) vs BMI <25 kg/m(2)) and with preexisting asthma (RR=1.64; 95% CI, 1.06-2.55 compared to those without asthma) were more likely to be notified.
Adults older than 65 years are more likely to be hospitalized for pertussis than those aged 45-64 years. Obesity and preexisting asthma were associated with a higher likelihood of pertussis notification. These findings suggest that pertussis vaccination would be particularly important for adults with these characteristics.
成人百日咳的发病率、发病率和危险因素的信息有限，特别是年龄在 65 岁以上的成人。
这是一项基于人群的前瞻性队列研究，纳入了 2006 年至 2008 年间澳大利亚新南威尔士州年龄在 45 岁以上（平均 62.8 岁）的 263094 名成年人（45 岁以上研究），并通过记录链接到实验室确诊的百日咳通知、住院和死亡记录进行随访。使用比例风险模型估计了各种参与者特征下百日咳通知和住院的发病率以及百日咳的相对风险（RR）。
在 217524 人年的总随访期间，205 名成年人有百日咳通知，12 人住院；发病率分别为 94（95%置信区间[CI]，82-108）和 5.5（95%CI，3.1-9.7）/100000 人年。年龄不同，百日咳通知的发病率无差异，但住院率逐渐增加（45-64 岁、65-74 岁和 75 岁及以上年龄组分别为 2.2、8.5 和 13.5/100000 人年；趋势 P 值<.01）。在调整年龄、性别和其他因素后，身体质量指数（BMI）较高的成年人（RR=1.52；95%CI，BMI 30+kg/m2 与 BMI<25 kg/m2 相比，1.06-2.19）和患有哮喘的成年人（RR=1.64；95%CI，1.06-2.55 与无哮喘者相比）更有可能被通知。
65 岁以上的成年人因百日咳住院的可能性高于 45-64 岁的成年人。肥胖和哮喘是与百日咳发病率较高相关的因素。这些发现表明，这些特征的成年人接种百日咳疫苗尤为重要。
