Macina Denis, Evans Keith E
Global Medical, Sanofi Pasteur, 14 Espace Henry Vallée, 69007, Lyon, France.
InScience Communications, Chowley Oak Business Park, Chowley Oak Lane, Tattenhall, Cheshire, UK.
Infect Dis Ther. 2021 Sep;10(3):1115-1140. doi: 10.1007/s40121-021-00439-1. Epub 2021 Apr 29.
Cyclic epidemics of pertussis (whooping cough) have been observed globally over the past twenty years despite high infant vaccine coverage. The resurgence of pertussis in high-income countries is partly due to waning vaccine immunity in older children and adults, as well as better surveillance and diagnostics. Moreover, in adolescents and adults, pertussis symptoms are mild and similar to common cough syndromes, meaning that it is under-diagnosed in older populations. A systematic search of MEDLINE, EMBASE, and BIOSIS was undertaken to identify studies published between 1 January 1990 and 17 June 2019, with information on pertussis epidemiology, burden of illness, and mortality in school-aged children, adolescents, and adults in Asia. Studies identified for inclusion were reviewed narratively because a statistical comparison was not possible due to the mix of methodologies used. The results showed that in East Asia, including Japan, South Korea, China, and Taiwan, pertussis is circulating in older children and adults. Diphtheria-tetanus-pertussis (DTP4) coverage is high in East Asia, yet outbreaks observed in Japan and South Korea suggest that vaccine-acquired immunity had waned in adolescents and adults. Several school outbreaks in China show that pertussis is circulating in young children, with continued circulation in adolescents and adults. There was a lack of information from Southeast/South Asian countries, although pan-Asian serosurveys showed that recent pertussis infection was common in adolescents and in adults with persistent cough. To conclude, the circulation of pertussis in Asian countries with high DTP4 coverage supports the expansion of routine vaccination to include booster doses for children at school entry and adolescents. However, surveillance is weak or absent in many countries, meaning that the true burden of pertussis, particularly among older populations, is unknown.
在过去二十年里，尽管婴儿疫苗接种率很高，但全球范围内仍观察到百日咳（百日咳）的周期性流行。高收入国家百日咳的卷土重来部分归因于大龄儿童和成人疫苗免疫力的下降，以及监测和诊断水平的提高。此外，在青少年和成人中，百日咳症状较轻，与常见咳嗽综合征相似，这意味着在大龄人群中该疾病诊断不足。我们对MEDLINE、EMBASE和BIOSIS进行了系统检索，以确定1990年1月1日至2019年6月17日期间发表的研究，这些研究包含亚洲学龄儿童、青少年和成人百日咳的流行病学、疾病负担和死亡率信息。由于所使用的方法混合，无法进行统计比较，因此对纳入的研究进行了叙述性综述。结果显示，在东亚，包括日本、韩国、中国和台湾地区，百日咳在大龄儿童和成人中传播。东亚白喉-破伤风-百日咳（DTP4）疫苗接种率很高，但在日本和韩国观察到的疫情表明，青少年和成人的疫苗获得性免疫力已经下降。中国的几起学校疫情表明，百日咳在幼儿中传播，并在青少年和成人中持续传播。东南亚/南亚国家缺乏相关信息，尽管泛亚血清学调查显示，近期百日咳感染在青少年和持续咳嗽的成人中很常见。总之，在DTP4疫苗接种率高的亚洲国家中百日咳的传播支持将常规疫苗接种扩大到包括入学儿童和青少年的加强剂量。然而，许多国家的监测薄弱或缺失，这意味着百日咳的真实负担，尤其是在大龄人群中的负担，尚不清楚。
