[全球百日咳:为儿童和成人接种疫苗]。

Medecine tropicale et sante internationale Pub Date : 2023-11-22 eCollection Date: 2023-12-31 DOI:10.48327/mtsi.v3i4.2023.446
Dominique Gendrel, Josette Raymond
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引用次数: 0

摘要

百日咳(百日咳)是全世界婴儿发病和死亡的重要原因,尽管疫苗接种率很高,但它仍然是一个公共卫生问题。这种由百日咳杆菌引起的疾病在所有国家都存在。在 20 世纪 50 年代疫苗普及之前,百日咳是全球最常见的儿童疾病之一。据世界卫生组织估计,1950 年的死亡人数为每年 400 万,2015 年为每年 10 万。但是,在使用全细胞或无细胞疫苗后,由于细菌的高流通性决定了非典型临床形式,因此发病率仍然很高。这主要是由于青少年和成年人没有接种加强剂所致。目前的主要进展是 PCR 的普及和母亲在怀孕期间接种疫苗。在普遍使用无细胞疫苗后,百日咳再次流行。在中国,使用无细胞疫苗后,所有地区都发现了等位基因ptxPl的增长。在接种无细胞疫苗之前,这种等位基因非常罕见,它与大环内酯类药物耐药性有关,在住院儿童中分离出的菌株中,这种等位基因占 30% 以上。
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[Pertussis worldwide. Vaccinating children and adults].

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 Bordetella pertussis, 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 ptxPl 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.

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