Fenichel G M
Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee 37212.
Pediatr Neurol. 1988 Jul-Aug;4(4):201-6. doi: 10.1016/0887-8994(88)90031-8.
Pertussis is a serious respiratory disease in infants. Immunization prevents infection in some; in others it permits infection but prevents disease. Epidemics occur when immunization rates fall. Whole-cell vaccine has proved to be a safe and effective method of disease control. Whole-cell vaccines have been used because the bacterial components responsible for immunity have not been identified. New component vaccines have not been licensed in the United States because they do not meet standards for efficacy. Whole-cell pertussis vaccine has been associated with febrile and afebrile seizures which are generalized and occur within 72 hours of immunization. Permanent brain damage caused by pertussis vaccine is rare. One study suggested a risk of 1:310,000 immunizations which is not precise and probably excessive; however, even using this figure, the risk-benefit ratio for 3 immunizations is favorable when compared to the risks of the natural disease. Child neurologists should recommended immunization for brain damaged infants with static or chronic brain syndromes. Pertussis immunization should be delayed or omitted when the neurologic status is unclear.
百日咳是一种发生于婴儿的严重呼吸道疾病。免疫接种可预防部分婴儿感染；对另一些婴儿而言，免疫接种虽不能预防感染，但可预防发病。当免疫接种率下降时就会发生疫情。全细胞疫苗已被证明是一种安全有效的疾病控制方法。使用全细胞疫苗是因为尚未确定引发免疫的细菌成分。新的组分疫苗在美国尚未获得许可，因为它们不符合疗效标准。全细胞百日咳疫苗与发热性和无热惊厥有关，这些惊厥为全身性，且发生在免疫接种后的72小时内。百日咳疫苗导致的永久性脑损伤很罕见。一项研究表明风险为1:310,000次免疫接种，这一数据并不精确且可能过高；然而，即便采用这一数字，与自然疾病的风险相比，3次免疫接种的风险效益比仍是有利的。儿童神经科医生应建议对患有静态或慢性脑综合征的脑损伤婴儿进行免疫接种。当神经状态不明时，应推迟或不进行百日咳免疫接种。
