Principi Nicola, Esposito Susanna
a Paediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation , Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy.
Expert Rev Vaccines. 2016 Jul;15(7):897-905. doi: 10.1080/14760584.2016.1183484. Epub 2016 May 6.
Vaccination is an important strategy to control endemic enteric fever (EF) and to interrupt transmission during outbreaks. The main aim of this paper is to discuss the efficacy of available EF vaccines in children and to highlight novel vaccination possibilities against EF and non-typhoid invasive salmonelloses.
Two types of typhoid vaccines are presently available in the industrialized world. One of these vaccines is administered parenterally and is based on the virulence-associated (Vi) capsular polysaccaride of Salmonella typhi. The second vaccine is based on a live attenuated strain of the pathogen and is given orally. In addition, a Vi-tetanus toxoid conjugated vaccine is currently licensed in India; however, it is not available anywhere else. Expert commentary: Unfortunately, only typhoid fever is addressed by the currently licensed typhoid vaccines. Moreover, they are unsuitable for infants and remain a possible aid for reducing the risk of EF only in older subjects. They should be used in developing countries with endemic EF. New vaccines able to confer long-term protection to subjects in the first years of life and those with immature immune systems could significantly reduce incidence rates of EF in younger children. Vi-conjugate preparations are promising solutions in this regard.
接种疫苗是控制地方性肠热病(EF)以及在疫情暴发期间阻断传播的一项重要策略。本文的主要目的是探讨现有EF疫苗在儿童中的疗效,并强调针对EF和非伤寒侵袭性沙门氏菌感染的新型疫苗接种可能性。
目前在工业化国家有两种伤寒疫苗。其中一种疫苗通过肠胃外途径接种,基于伤寒沙门氏菌的毒力相关(Vi)荚膜多糖。第二种疫苗基于病原体的减毒活菌株,口服给药。此外,一种Vi-破伤风类毒素结合疫苗目前在印度获得许可;然而,在其他任何地方都无法获得。专家评论:不幸的是,目前获得许可的伤寒疫苗仅针对伤寒热。此外,它们不适用于婴儿,并且仅对年龄较大的受试者降低EF风险可能有帮助。它们应用于EF地方性流行的发展中国家。能够为生命最初几年的受试者以及免疫系统不成熟的受试者提供长期保护的新型疫苗,可显著降低年幼儿童中EF的发病率。Vi结合制剂在这方面是有前景的解决方案。