Seçkin Hakan, Ormeci Ahmet Rıfat, Sandal Gonca, Kaya Selçuk
Suleyman Demirel University Faculty of Medicine, Department of Pediatrics, Neonatology Unit, Isparta, Turkey.
Mikrobiyol Bul. 2013 Jul;47(3):507-13. doi: 10.5578/mb.5598.
Pertussis, a highly contagious respiratory disease, commonly affects infants and young children and can be fatal, especially in babies less than one year of age. Bordetella pertussis continues to circulate even in populations where a high vaccine coverage of infants and children is achieved. Adults are reservoirs for infections in infants, in whom pertussis may be severe and life-threatening. Despite the rising rates of vaccination in our country and all over the world for the past 25 years, the number of pertussis cases among adolescents and adults has been increasing. To decrease the risk of pertussis infection and thus protect adults and adolescents against pertussis, booster doses should be administered to preschool children and adolescents. In order to decide when to administer the booster doses in a country, age-specific seropidemiology of the disease should be known. The aim of this study was to determine the pertussis toxin antibody levels of fully vaccinated healthy children in Isparta, Turkey, aged 10-15 years old. A total of 296 participants, that comprised fully vaccinated 254 healthy elementary-school students aged between 10-15 years (126 male, 128 female) and 42 adults between 18-39 years old (21 male, 21 female) were included in the study with informed consent. The sensitivities of subjects to pertussis were tested by the determination of pertussis toxin IgG levels with the use of commercial ELISA test (Genzyme Virotech, Germany). In our study, the seropositivity rate was found 12.6% (32/254) for 10-15 age group, however all the adult subjects were seronegative. Thus the total seropositivity rate was estimated as 10.8% (32/296). Pertussis toxin IgG seropositivity rate was 12.7% (16/126) for males and 12.5% (16/128) for females, and there was no significant gender difference (p> 0.05). The highest seropositivity rates were detected at 10(th) (23.8%) and 11(th) (19%) years in males, and 12(th) and 14(th) (23.8%) years in females. No seropositivity was detected in individuals over age 15 in our study. Since adults lose their immune protection gained by pertussis vaccination, they start becoming an infection source for infants. Therefore, a booster dose of acellular pertussis vaccine should be considered in preschool period and at ages 14-18. Further studies regarding diagnosis and surveillance of pertussis disease are required, as well as enhancement of vaccination rates.
百日咳是一种极具传染性的呼吸道疾病，通常影响婴幼儿，可能致命，尤其是对一岁以下的婴儿。即使在婴幼儿疫苗接种覆盖率很高的人群中，百日咳博德特氏菌仍在传播。成人是婴儿感染的储存宿主，婴儿感染百日咳可能很严重并危及生命。尽管在过去25年里我国和全世界的疫苗接种率都在上升，但青少年和成人中的百日咳病例数却一直在增加。为降低百日咳感染风险，从而保护成人和青少年免受百日咳侵害，应给学龄前儿童和青少年接种加强剂量疫苗。为了决定在一个国家何时接种加强剂量疫苗，应该了解该疾病按年龄划分的血清流行病学情况。本研究的目的是确定土耳其伊斯帕尔塔10至15岁完全接种疫苗的健康儿童的百日咳毒素抗体水平。共有296名参与者纳入研究并获得知情同意，其中包括254名10至15岁完全接种疫苗的健康小学生（126名男性，128名女性）和42名18至39岁的成年人（21名男性，21名女性）。通过使用商业ELISA检测（德国Genzyme Virotech公司）测定百日咳毒素IgG水平来检测受试者对百日咳的敏感性。在我们的研究中，10至15岁年龄组的血清阳性率为12.6%（32/254），然而所有成年受试者均为血清阴性。因此，总血清阳性率估计为10.8%（32/296）。男性的百日咳毒素IgG血清阳性率为12.7%（16/126），女性为12.5%（16/128），性别差异无统计学意义（p>0.05）。男性在10岁（23.8%）和11岁（19%）时血清阳性率最高，女性在12岁和14岁（23.8%）时最高。在我们的研究中，15岁以上个体未检测到血清阳性。由于成年人失去了百日咳疫苗接种所获得的免疫保护，他们开始成为婴儿的感染源。因此，应考虑在学龄前以及14至18岁时接种一剂无细胞百日咳疫苗加强针。还需要开展关于百日咳疾病诊断和监测的进一步研究，以及提高疫苗接种率。
