Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics, Laboratory of Infection and Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
Pediatric Respiratory Department, Wuhu No.1 People's Hospital, Wuhu, Anhui, China.
Vaccine. 2024 Oct 3;42(23):126239. doi: 10.1016/j.vaccine.2024.126239. Epub 2024 Aug 22.
The reported number of pertussis cases declined after the implementation of COVID-19 prevention and control measures, however, the burden of pertussis among adults in China remains largely unknown. Additionally, the waning of natural antibody level has also rarely been assessed.
A total of 762 healthcare workers (HCWs) who had underwent the health examinations in 2021 and 2022 were included. Serum anti-PT IgG and IgA levels were determined by ELISA. Recent B. pertussis infection was defined as anti-PT IgG ≥100 IU/ml and/or anti-PT IgA ≥10 IU/ml.
In 2021, the seroprevalence of recent B. pertussis infection was 10.1 %, and those HCWs in outpatient department had a higher percentage (18.6 %), and geometric mean concentration (GMC) (6.3 IU/ml) than those in other departments. This seroprevalence decreased to 2.4 % in 2022, although the difference remained significant. In the 77 subjects with recent B. pertussis infection in 2021, anti-PT IgG was undetectable in 18 cases the following year. Majority (68/76) of the subjects with anti-PT IgA ≥10 IU/ml in 2021 no longer had detected this antibody in 2022. Among 95 pertussis cases, approximately 60.0 % of cases reported no history of cough. Among those with a documented cough history, 36 cases with suspected pertussis courses who had never been diagnosed. Prolonged cough with nocturnal exacerbation (29/38) was the most commonly reported clinical symptom, and whoop was confirmed in six cases. Uroclepsia and syncopes during the cough attacks were reported by three and one subjects, respectively. One case presented with subconjunctival hemorrhage and tensionic purpura during the course.
The results suggested a high prevalence of B. pertussis infection among HCWs. The presence of unrecognized adult pertussis cases and the rapid waning of antibody indicate the need to improve clinical management for suspected pertussis in adults, and to updated immunization schedule after childhood program.
实施 COVID-19 防控措施后，百日咳报告病例数有所下降，但中国成年人百日咳负担仍不清楚。此外，自然抗体水平的下降也很少被评估。
共纳入 2021 年和 2022 年接受健康检查的 762 名医护人员（HCWs）。采用 ELISA 法测定血清抗-PT IgG 和 IgA 水平。近期 B. pertussis 感染定义为抗-PT IgG≥100 IU/ml 和/或抗-PT IgA≥10 IU/ml。
2021 年，近期 B. pertussis 感染的血清流行率为 10.1%，门诊科室的 HCWs 感染率（18.6%）和几何平均浓度（GMC）（6.3 IU/ml）均高于其他科室。2022 年该流行率下降至 2.4%，但差异仍有统计学意义。2021 年 77 例近期 B. pertussis 感染者中，18 例次年抗-PT IgG 不可检测。2021 年抗-PT IgA≥10 IU/ml 的 76 例受试者中，大多数（68/76）在 2022 年不再检测到该抗体。95 例百日咳病例中，约 60.0%的病例无咳嗽史。在有记录咳嗽史的病例中，有 36 例疑似百日咳病程但从未被诊断。夜间加重的持续性咳嗽（29/38）是最常见的临床症状，6 例确诊为百日咳。咳嗽发作时，3 例出现尿失禁，1 例出现晕厥。1 例在病程中出现结膜下出血和张力性紫癜。
结果表明 HCWs 中 B. pertussis 感染率较高。存在未被识别的成人百日咳病例和抗体迅速下降表明需要改进成人疑似百日咳的临床管理，并在儿童计划后更新免疫接种时间表。
