Tubiana Sarah, Belchior Emmanuel, Guillot Sophie, Guiso Nicole, Lévy-Bruhl Daniel
From the *Infectious Diseases Department, Institut de veille sanitaire, Saint-Maurice, France; and †Institut Pasteur, Centre national de référence de la coqueluche et autres bordetelloses, Paris, France.
Pediatr Infect Dis J. 2015 Aug;34(8):814-20. doi: 10.1097/INF.0000000000000739.
Despite a high vaccine coverage in France in children, a resurgence of pertussis in infants too young to be protected by vaccination was observed in the 1990 s, leading to additional vaccination strategies in older age groups. This article describes the epidemiologic trends and characteristics of cases among infants 0-5 months of age during 17 years of pertussis surveillance through Renacoq.
Renacoq is a sentinel hospital-based voluntary surveillance network covering about 30% of hospitalized pertussis pediatric cases. It includes microbiologists and pediatricians from 42 large hospitals.
Since March 1996, the network has described 2227 cases of pertussis in infants aged 0-5 months of whom 67.7% were infants 0-2 months of age. Four epidemic peaks occurred. The estimated national average incidence rate for the children aged 0-2 months decreased significantly between 1996-1998 and 2008-2012 from 264 to 179 per 100,000. Globally, 18.4% of cases were admitted to an intensive care unit, and the average case fatality ratio was 1%. Two-thirds (67.1%) of infants aged 3-5 months were not correctly vaccinated according to age. Parents accounted for 41-57% of the infections and siblings for 17-24%.
Renacoq data confirmed the risk for young children and the need of timely pertussis vaccination. Parents and sibling remain the main source of infection, despite addition of boosters targeting sibling and parents. Improving vaccination coverage in adults in contact with young infants is needed. The continuation of Renacoq surveillance will allow monitoring the impact of additional vaccination strategies.
尽管法国儿童疫苗接种率很高，但在20世纪90年代，观察到未接种疫苗的低龄婴儿中百日咳病例有所回升，这促使针对年龄较大人群采取额外的疫苗接种策略。本文描述了通过Renacoq进行的17年百日咳监测期间，0至5个月龄婴儿病例的流行病学趋势和特征。
Renacoq是一个基于医院的哨点自愿监测网络，覆盖约30%的住院百日咳儿科病例。它包括来自42家大型医院的微生物学家和儿科医生。
自1996年3月以来，该网络记录了2227例0至5个月龄婴儿的百日咳病例，其中67.7%为0至2个月龄婴儿。出现了四个流行高峰。1996 - 1998年和2008 - 2012年期间，0至2个月龄儿童的全国估计平均发病率从每10万人264例显著降至179例。总体而言，18.4%的病例入住重症监护病房，平均病死率为1%。三分之二（67.1%）的3至5个月龄婴儿未按年龄正确接种疫苗。父母感染占41 - 57%，兄弟姐妹感染占17 - 24%。
Renacoq的数据证实了幼儿面临的风险以及及时接种百日咳疫苗的必要性。尽管针对兄弟姐妹和父母增加了加强疫苗接种，但父母和兄弟姐妹仍然是主要感染源。需要提高与幼儿接触的成年人的疫苗接种率。继续进行Renacoq监测将有助于监测额外疫苗接种策略的影响。
