Crespo Inma, Broner Sonia, Soldevila Núria, Martínez Ana, Godoy Pere, Sala-Farré Maria-Rosa, Company Maria, Rius Cristina, Domínguez Angela, Group Of Catalonia The Pertussis Working
a CIBER Epidemiología y Salud Pública; Carlos III Institute of Health; Madrid, Spain.
Hum Vaccin Immunother. 2015;11(1):231-5. doi: 10.4161/hv.36156. Epub 2014 Nov 1.
In Catalonia, pertussis outbreaks must be reported to the Department of Health. This study analyzed pertussis outbreaks between 1997 and 2010 in general and according to the characteristics of the index cases. The outbreak rate, hospitalization rate and incidence of associated cases and their 95%CI were calculated. Index cases were classified in two groups according to age (<15 years and ≥15 years) and the vaccine type received: whole cell vaccine (DTwP) or acellular vaccine (DTaP). During the study period, 230 outbreaks were reported. The outbreak rate was 2.43 × 10(-6) persons-year, and outbreaks ranged from 2 to 32 cases, with a median duration of 18 days. There were 771 associated cases, with an incidence rate of 0.8 × 10(-5) persons-year. After classifying outbreaks according to the age of the index case, 126 outbreaks (1.3 × 10(-6) persons-year) had an index case aged <15 y and 87 (0.87 × 10(-6) person-year) had an index case aged ≥15 y (RR = 1.44, 95%CI 1.10-1.90; P = 0.007). Between 2003 and 2010, after the introduction of the acellular vaccine, the index case was vaccinated with DTwP vaccine in 25 outbreaks (0.43 × 10(-6) persons-year) and with DTaP vaccine in 32 outbreaks (0.55 × 10(-6) person-year) (RR = 0.78, 95%CI 0.46-1.31; P = 0.35). Of cases, 37.2% were correctly vaccinated, suggesting waning immunity of pertussis vaccine protection and endogenous circulation of pertussis. A greater number of outbreaks had an index case aged <15 y. No changes in the disease incidence, associated cases and hospitalization rate were observed after the introduction of DTaP.
在加泰罗尼亚，百日咳疫情必须上报给卫生部。本研究分析了1997年至2010年期间的百日咳疫情总体情况，并根据指示病例的特征进行了分析。计算了疫情发生率、住院率以及关联病例的发病率及其95%置信区间。指示病例根据年龄（<15岁和≥15岁）以及所接种的疫苗类型进行分组：全细胞疫苗（DTwP）或无细胞疫苗（DTaP）。在研究期间，共报告了230起疫情。疫情发生率为2.43×10⁻⁶人/年，疫情规模从2例至32例不等，中位持续时间为18天。有771例关联病例，发病率为0.8×10⁻⁵人/年。
根据指示病例的年龄对疫情进行分类后，126起疫情（1.3×10⁻⁶人/年）的指示病例年龄<15岁，87起疫情（0.87×10⁻⁶人/年）的指示病例年龄≥15岁（相对风险=1.44，95%置信区间1.10 - 1.90；P = 0.007）。2003年至2010年期间，在引入无细胞疫苗后，25起疫情（0.43×10⁻⁶人/年）的指示病例接种的是全细胞疫苗，32起疫情（0.55×10⁻⁶人/年）的指示病例接种的是无细胞疫苗（相对风险=0.78，95%置信区间0.46 - 1.31；P = 0.35）。病例中，37.2%接种疫苗正确，这表明百日咳疫苗保护的免疫力在下降，且百日咳存在内源性传播。年龄<15岁的指示病例引发的疫情数量更多。引入无细胞疫苗后，未观察到疾病发病率、关联病例及住院率的变化。
