Baron S, Njamkepo E, Grimprel E, Begue P, Desenclos J C, Drucker J, Guiso N
Réseau National de Santé Publique, Saint Maurice, France.
Pediatr Infect Dis J. 1998 May;17(5):412-8. doi: 10.1097/00006454-199805000-00013.
Despite widespread vaccination during 30 years, the hypothesis of a resurgence of pertussis in France has been raised by outbreaks and sporadic case reports. No surveillance data were available after 1985.
A survey was undertaken in 1993 and 1994 in a pediatric hospital network able to confirm cases; the network (22 hospitals) represents 19.6% of pediatric admissions in France. Case definition included clinical (> or = 21 days of paroxysmal cough), laboratory-confirmed (culture or serology by immunoblot) or epidemiologically confirmed pertussis (documented contact with a laboratory-confirmed case). The pattern of transmission was studied in the household. Vaccine status was obtained from health records.
during a 15-month period 560 cases (316 index cases, 244 household contact cases) were reported; 49% of index cases and 20% of contact cases were confirmed by culture and/or serology. Sixty-five percent of index cases were younger than 1 year of age (the incidence in this age group could be estimated to be 95/100000) and 66% were hospitalized for a mean duration of 2 weeks. Infection was acquired from parents (34%) and siblings (46%). Seventy-three percent of index cases were unvaccinated.
Although pertussis vaccination coverage is very high in France, the organism is still circulating, affecting, within the pediatric population, mostly non- or incompletely vaccinated infants. These results strongly support the importance of adhering to the immunization schedule and suggest introducing booster dose(s) to prolong vaccine immunity and reduce the exposure to Bordetella pertussis of infants too young to be immunized.
尽管在30年里广泛接种了疫苗，但法国百日咳疫情的爆发和散发病例报告引发了百日咳卷土重来的假说。1985年后没有可用的监测数据。
1993年和1994年在一个能够确诊病例的儿科医院网络中进行了一项调查；该网络（22家医院）占法国儿科住院人数的19.6%。病例定义包括临床诊断（阵发性咳嗽≥21天）、实验室确诊（培养或免疫印迹血清学）或流行病学确诊的百日咳（记录有与实验室确诊病例的接触）。研究了家庭中的传播模式。从健康记录中获取疫苗接种状况。
在15个月的时间里报告了560例病例（316例索引病例，244例家庭接触病例）；49%的索引病例和20%的接触病例通过培养和/或血清学确诊。65%的索引病例年龄小于1岁（该年龄组的发病率估计为95/100000），66%的病例住院，平均住院时间为2周。感染来自父母（34%）和兄弟姐妹（46%）。73%的索引病例未接种疫苗。
尽管法国的百日咳疫苗接种覆盖率很高，但该病原体仍在传播，在儿科人群中，主要影响未接种或未完全接种疫苗的婴儿。这些结果有力地支持了坚持免疫接种计划的重要性，并建议引入加强剂量以延长疫苗免疫力，减少未到免疫接种年龄的婴儿接触百日咳博德特氏菌的机会。
