婴儿、儿童和成人的百日咳

N Guiso , L Bassinet , P Reinert
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引用次数: 2

摘要

百日咳是一种人类呼吸道感染,对新生儿来说非常严重。对这种疾病的第一次描述是最近的,从16世纪开始。在百日咳病菌博德特拉被发现后不久,由细菌悬浮液经热灭活制成的全细胞疫苗被研制出来,并得到广泛应用。这些疫苗可能非常有效,但很难生产,而且耐受性不好。由于百日咳博德泰拉致病性中涉及的细菌蛋白质的特征,开发了另一种类型的疫苗。这种新型疫苗被称为无细胞疫苗,因为它是由纯化的细菌蛋白质组成的。全细胞疫苗接种的推广大大降低了死亡率和发病率。然而,在采用疫苗接种三十年后,在接种疫苗的国家观察到死灰复燃。这种死灰复燃主要是由于疫苗免疫持续时间短以及缺乏疫苗或天然增强剂。这种疾病现在影响青少年和成年人,他们表现出难以诊断的非典型咳嗽。这些青少年和成年人感染了未接种疫苗的新生儿。疫苗加强剂是必要的,自1998年以来,无细胞疫苗现已成为可能。法国是第一个为11-13岁青少年提供强化疫苗的国家,目前正在讨论为年轻人提供强化疫苗。然而,对这种疾病的监测是非常重要的,必须继续分析这种增强剂的后果,这些增强剂是为了减少疾病传播给年龄太小而不能接种疫苗的婴儿
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Coqueluche du nourrisson, de l’enfant et de l’adulte

Whooping cough is a human respiratory infection, dramatic for newborns. The first descriptions of this disease are recent, from the 16th century. Soon after the discovery of the causal agent of the disease, the bacterium Bordetella pertussis, whole cell vaccines, composed of bacterial suspensions inactivated by heat, were developed and their use generalized. These vaccines could be very efficacious but are very difficult to produce and not well tolerated. Because of the characterization of the bacterial proteins involved in the pathogenicity of Bordetella pertussis, an other type of vaccine was developped. This new type is called acellular vaccine because composed of purified bacterial proteins. The generalization of the vaccination with whole-cell vaccines conducted to an important decrease of mortality and morbidity. However, thirty years after the introduction of the vaccination, a resurgence is observed in vaccinated countries. This resurgence is principally due to the short duration of vaccinal immunity and the lack of vaccinal or natural boosters. The disease affects now adolescents and adults who present an atypical cough which difficult to diagnose. These adolescents and adults contaminate non vaccinated new borns. Vaccinal boosters are necessary and are now possible with acellular vaccines since 1998. France was the first country to introduce a booster for adolescents at 11-13 years of age and a booster for young adults is under discussion. Nevertheless, surveillance of the disease is of great importance and must continue to analyse the consequences of such boosters which are introduced to reduce the transmission of the disease to infants too young to be vaccinated

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