Deen J L, Mink C A, Cherry J D, Christenson P D, Pineda E F, Lewis K, Blumberg D A, Ross L A
Department of Pediatrics, UCLA Medical Center, USA.
Clin Infect Dis. 1995 Nov;21(5):1211-9. doi: 10.1093/clinids/21.5.1211.
Household contacts of primary pertussis cases were evaluated. Infection was determined by culture, direct fluorescent antibody assay, and serological criteria. Agglutinin titers and values of ELISA IgG and IgA antibodies to lymphocytosis-promoting factor, filamentous hemagglutinin, and pertactin were determined. In 39 households 255 subjects were exposed; 114 remained well (group 1), 53 had mild illness (group 2), and 88 had pertussis (group 3). The infection rates were 46% (group 1), 43% (group 2), and 80% (group 3). In a subgroup of subjects seen within 14-28 days of exposure, it was found that none with clinical pertussis had a value of IgG antibody to pertactin in acute-phase sera of > or = 50 ELISA units (EU) per mL or an agglutinin titer of > 256. Of the primary cases, 53% were > or = 13 years of age. These data point out the importance of Bordetella pertussis infections in adolescents and adults as a source of infection in young children. Our subgroup data suggest that high values of antibody to pertactin and high agglutinin titers may be predictive of protection against clinical pertussis.
对原发性百日咳病例的家庭接触者进行了评估。通过培养、直接荧光抗体检测和血清学标准来确定感染情况。测定了凝集素滴度以及针对淋巴细胞增多促进因子、丝状血凝素和百日咳杆菌黏附素的ELISA IgG和IgA抗体值。在39个家庭中，有255名受试者暴露；114人未发病（第1组），53人有轻微疾病（第2组），88人患百日咳（第3组）。感染率分别为46%（第1组）、43%（第2组）和80%（第3组）。在暴露后14 - 28天内就诊的受试者亚组中，发现患有临床百日咳的患者急性期血清中针对百日咳杆菌黏附素的IgG抗体值均未达到或超过每毫升50 ELISA单位（EU），凝集素滴度也未超过256。在原发性病例中，53%的患者年龄大于或等于13岁。这些数据指出了青少年和成人感染百日咳杆菌作为幼儿感染源的重要性。我们的亚组数据表明，高滴度的百日咳杆菌黏附素抗体和高凝集素滴度可能预示着对临床百日咳具有保护作用。
