Gendrel Dominique, Raymond Josette
Université Paris Cité, 12 de l'École-de-Médecine, 5006 Paris, France.
Med Trop Sante Int. 2023 Nov 22;3(4). doi: 10.48327/mtsi.v3i4.2023.446. eCollection 2023 Dec 31.
Pertussis (whooping cough) is an important cause of morbidity and mortality in infants world-wide, and continues to be a public health concern despite high vaccination coverage. The disease, caused by bacterium is present in all countries. Before vaccines became widely available in the 1950s, pertussis was one of the most common childhood diseases worldwide. According to WHO, estimation of deaths was 4 millions/year in 1950 and 100 000/year in 2015. But morbidity remains important with a high circulation of the bacterium determining atypical clinical forms after whole cell or acellular vaccines use. This is due mainly to the absence of booster doses in adolescents and adults. Major progress are generalisation of PCR and vaccination of mother during pregnancy. A resurgence of pertussis is observed after generalisation of acellular vaccines use. In China the progression of allele was found in all areas following the use of acellular vaccine. This allele, rare before acellullar vaccine, is linked to a macrolide resistance, and reaches more than 30% of strains isolated in hospitalised children.These evolutions must be evaluated in clinical forms and genotyping of all strains, in all areas.
百日咳是全球婴儿发病和死亡的重要原因,尽管疫苗接种覆盖率很高,但它仍然是一个公共卫生问题。这种由细菌引起的疾病在所有国家都存在。在20世纪50年代疫苗广泛使用之前,百日咳是全球最常见的儿童疾病之一。据世界卫生组织统计,1950年估计死亡人数为每年400万,2015年为每年10万。但发病率仍然很高,细菌的高传播率导致在使用全细胞或无细胞疫苗后出现非典型临床症状。这主要是由于青少年和成年人缺乏加强剂量。主要进展包括聚合酶链反应(PCR)的普及和孕期母亲的疫苗接种。在使用无细胞疫苗普及后,观察到百日咳有所复发。在中国,使用无细胞疫苗后,所有地区都发现了等位基因的进展。这种等位基因在无细胞疫苗使用前很罕见,与大环内酯类耐药性有关,在住院儿童分离出的菌株中占比超过30%。必须在所有地区对所有菌株的临床症状和基因分型进行评估,以了解这些演变情况。