Pediatric Infectious Diseases, CHOC Children's, Orange, CA 92868.
Universitäts-Kinderspital beider Basel (UKBB), CH-4031 Basel, Switzerland.
Microbiol Spectr. 2016 Jun;4(3). doi: 10.1128/microbiolspec.EI10-0008-2015.
Pertussis is a highly infectious vaccine-preventable cough illness that continues to be a significant source of morbidity and mortality around the world. The majority of human illness is caused by Bordetella pertussis, and some is caused by Bordetella parapertussis. Bordetella is a Gram-negative, pleomorphic, aerobic coccobacillus. In the past several years, even countries with high immunization rates in early childhood have experienced rises in pertussis cases. Reasons for the resurgence of reported pertussis may include molecular changes in the organism and increased awareness and diagnostic capabilities, as well as lessened vaccine efficacy and waning immunity. The most morbidity and mortality with pertussis infection is seen in infants too young to benefit from immunization. Severe infection requiring hospitalization, including in an intensive care setting, is mostly seen in those under 3 months of age. As a result, research and public health actions have been aimed at better understanding and reducing the spread of Bordetella pertussis. Studies comparing the cost benefit of cocooning strategies versus immunization of pregnant women have been favorable towards immunizing pregnant women. This strategy is expected to prevent a larger number of pertussis cases, hospitalizations, and deaths in infants <1 year old while also being cost-effective. Studies have demonstrated that the source of infection in infants usually is a family member. Efforts to immunize children and adults, in particular pregnant women, need to remain strong.
百日咳是一种高度传染性的可通过疫苗预防的咳嗽疾病,在全球范围内仍然是发病率和死亡率的重要来源。大多数人类疾病是由百日咳博德特氏菌引起的,有些是由副百日咳博德特氏菌引起的。百日咳博德特氏菌是一种革兰氏阴性、多形性、需氧的球杆菌。在过去的几年中,即使是在儿童早期接种率较高的国家,百日咳病例也有所增加。报告的百日咳病例增加的原因可能包括该生物体的分子变化以及对疾病的认识和诊断能力的提高,以及疫苗效力降低和免疫减弱。感染百日咳的发病率和死亡率最高的是那些太小而无法从免疫中受益的婴儿。需要住院治疗的严重感染,包括在重症监护病房,主要发生在 3 个月以下的婴儿。因此,研究和公共卫生行动旨在更好地了解和减少百日咳博德特氏菌的传播。比较隔离策略和孕妇免疫接种成本效益的研究对孕妇免疫接种有利。这种策略有望预防更多的婴儿<1岁的百日咳病例、住院和死亡,同时具有成本效益。研究表明,婴儿感染的源头通常是家庭成员。需要继续努力为儿童和成人,特别是孕妇,进行免疫接种。