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百日咳的复发:一个巨大的"百日咳"
1Department of Child (Pediatrics) and Adolescent Health, (Pediatric Infectious Diseases, Epidemiology and Public Health), University of the West Indies.
Current opinion in pediatrics
|August 22, 2025
概括
尽管疫苗接种率很高,但咳在全球范围内急剧增加,原因是免疫逃生菌株和潜在的疫苗/类抗药性. 控制需要加强监测,优化免疫和公共卫生措施.
科学领域:
- 公共卫生
- 传染性疾病
- 免疫学
背景情况:
- 世界卫生组织报告说,全球喉咳 (DPT) 初级疫苗接种覆盖率为84%.
- 百日咳正在复发, 需要对促成因素和控制策略进行审查.
研究的目的:
- 描述全球性咳的复发情况.
- 确定导致百日咳爆发的因素.
- 概述控制百日咳的措施.
主要方法:
- 全球百日咳流行病学和疫苗接种覆盖率数据的审查.
- 波多菌菌株特征的分析,包括免疫逃避和抗菌素耐药性.
- 检查可能影响咳复发的因素,例如COVID-19的流行影响和免疫力减弱.
主要成果:
- 美国和中国的高DPT免疫率 (94-97%) 与 pertussis 的显著增加相关 (分别是6倍和65倍).
- 百日咳疫情正在从婴儿转移到老年人群,其中普遍存在对大肠杆菌的耐药性 (98%在中国).
- 鉴定出可以避开疫苗的B. pertussis菌株 (菌素缺乏突变菌株) 和不一致的循环菌株,影响非细胞和全细胞疫苗.
结论:
- 咳复发是多因素的,包括免疫逃脱疫苗,抗菌药物耐药性,免疫力减弱和潜在的流行病影响.
- 有效控制需要公众教育,强有力的监测 (临床和微生物),适当的抗菌策略和优化的免疫计划.
- 公共卫生报告,感染控制和有针对性的免疫接种对于减少与咳相关的发病率和死亡率至关重要.
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