广东省1951～1996年百日咳流行动态及免疫效果分析

广东省１９５１～１９９６年百日咳经历了８次大小流行，１９６１年报告发病率达２５４３５／１０万，１９８７年实施计划免疫后，发病率明显下降，１９９１年达历史最低水平，但仍未控制百日咳的流行，主要原因是接种疫苗后群体保护率还不够高。１９９０年使用含百日咳菌４５亿／ｍｌ百日破混合制剂（ＤＰＴ），对２０６人检测抗体水平，保护率为３４４７％；１９９４～１９９５年使用含百白咳菌９０亿／ｍｌＤＰＴ后，１９９５年对０～６０岁各地人群检测抗体，保护率为５４７８％。１９９６年广州市试用无细胞吸附精制百白破制剂（ＡＰＤＴ），免疫成功率与ＤＰＴ基本一致，但抗体阳性率高。结果证明：百日咳发病与免疫接种和接种的疫苗含量有很大关系，应加强免疫接种工作和疾病监测，减少疾病的发生。     

衢州市1954～2000年百日咳流行特征和免疫效果

衢州市是百日咳发病较高的地区 ,使用百日咳疫苗或含百日咳疫苗的混合制剂以来 ,尤其是计划免疫的实施和免疫覆盖率逐步提高 ,百日咳流行得到有效控制 ,发病率和死亡率显著下降。现将衢州市 195 4～ 2 0 0 0年百日咳流行特征和疫苗防制效果分析如下。材料与方法1　资料来源　 195 4～ 2 0 0 0年百日咳发病资料来源于省卫生防疫站疫情资料汇编和本站疫情档案资料。百白破疫苗免疫接种资料来源于本站计划免疫档案资料。2　百日咳抗体测定　按照卫生部下发的《计划免疫技术管理规程》所规定的方法进行 ,凝集试验阳性标准定为≥ 1∶2 0 ,保护水…     

河南省1963～2002年百日咳流行动态及控制策略分析

目的掌握河南省40年来百日咳的流行病学特征及其影响因素,为制定免疫策略和预测疫情趋势提供依据。方法对河南省不同免疫阶段的百日咳流行病学特征进行分析。结果河南省40年来共报告百日咳3 065 075例,死亡572例。大致可分4个阶段:1963~1978年,年平均发病率为293.47/10万,死亡43例;1979~1983年,年发病率为87.70/10万~17.78/10万,呈逐年下降趋势,死亡6例;1984~1990年,发病率为1.28/10万~6.73/10万,死亡1例;1990年以后发病率为0.25/10万~1.00/10万,连续10年无死亡病例。表明随着百日咳疫苗接种率的不断提高,不但大大降低了百日咳的发病率和死亡率,也改变了其流行周期。结论目前的免疫策略首先应继续做好儿童常规免疫,其次应加强百日咳疫情管理,提高疫情报告的及时性、准确性。     

太原市1956～2005年百日咳流行特征分析

百日咳是严重威胁儿童健康和生命的主要传染病之一。随着计划免疫的实施，太原市百日咳的流行得到了有效控制，但这一曾给人类带来巨大灾难的传染病并未被彻底消灭，为全面了解太原市实施计划免疫前后百日咳的流行特征，为更好地开展百日咳防治工作提供科学的依据，现将1956年以来百日咳的流行病学资料整理分析，并对太原市三县（市、区）3～5岁儿童进行了百日咳抗体水平测定，现报告如下。     

1956～2012年临沂市人群百日咳抗体水平及流行动态分析

目的了解临沂市人群百日咳抗体水平及流行特征,为预测疫情趋势和制定免疫策略提供依据。方法对临沂市1956～2012年不同免疫阶段百日咳发病资料进行描述性分析;在不同年份随机抽取健康人群,分0～、2～、5～、8～、11～、15～、20～40岁7个年龄组进行百日咳抗体检测。结果 1956～2012年临沂市共报告百日咳578 487例,死亡426例。大致分为4个阶段：1956～1960年年均发病率为86.60/10万,死亡127例;1961～1981年年均发病率为283.82/10万,死亡296例;1982～2002年年均发病率为9.75/10万,死亡3例;2003～2012年年均发病率为0.16/10万,无死亡病例。1986～2012年共检测4 556人,达到抗体保护水平的3 587人,保护率为78.73%,几何平均滴度（GMT）为1∶197.24。结论已实施的免疫策略对控制百日咳发病效果显著,发病率大幅度降低;人群保护率和抗体水平有逐年增高趋势,说明疫苗接种工作质量较高;应警惕大年龄组儿童和成人百日咳的出现和传播。     

杭州市萧山区1954～2001年百日咳流行特征及控制效果分析

目的:了解杭州市萧山区百日咳的流行特征及控制效果。方法:利用萧山区卫生防疫站疫情资料和历年法定传染病、计划免疫年报表等资料进行分析。结果:1954—2001年百日咳年均发病率为52.67／10万，其中自然感染阶段(1954-1955年)发病率为70.19／10万，至计划免疫巩固期(1983—2001年)降至9.21／10万；历年发病高峰主要在3—7月；1980—2001年疫情资料显示，5岁以下百日咳患占总病例数的52.32％。1986—1998年百白破三联混合制剂免疫后百日咳凝集技体水平监测显示抗体滴度(GMT)由1：369．20上升至1：1582.85。结论:由于百日咳疫苗的接种使得百日咳的发病率大幅度下降，因此高质量的免疫接种是控制百日咳流行的关键。     

上海市1950～1997年百日咳流行病学和免疫学效果分析

上海市的百日咳发病率曾经高达1150．16／10万,使用百白破混合制剂（DPT）免疫及全程免疫接种率提高至90％后,使发病得到了有效控制．DPT的免疫学效果观察显示．免疫后较免疫前抗体增长40倍以上,阳转率和达保护抗体水平率分别高至90％和85％,吸附DPT的保护率约为96％．由此可见,有效的疫苗和高质量的免疫接种是控制百日咳流行的关键措施。     

衢州市百日咳流行特征和免疫效果分析

<正>衢州市是百日咳发病较高的地区,使用百日咳疫苗或百白破疫苗以来,尤其是计划免疫的实施和免疫覆盖率逐步提高,百日咳流行得到有效控制,发病率和死亡率显著下降。现将衢州市1954年～2000年百日咳流行特征和疫苗防制效果分析如下:     

2010～2011年济南市百日咳流行特征分析

[目的]探讨济南市百日咳的流行特征,为制定控制和降低百日咳发病的措施提供依据。[方法]利用描述流行病学分析方法,对2010～2011年济南市法定传染病报告系统百日咳疫情资料进行分析。[结果]2010～2011年济南市共报告百日咳病例83例,年均报告发病率为0.64/10万,比2001～2009年的平均年报告发病率明显上升。病例主要集中在婴幼儿,86.75%的病例集中在1岁以下儿童。[结论]2010～2011年济南市百日咳发病率明显上升。     

Prospective pertussis surveillance in Switzerland, 1991-2006

Pertussis has been monitored in Switzerland since 1991 by the nationwide Swiss Sentinel Surveillance Network (SSSN), consisting of approximately 200 general practitioners, internists and pediatricians representing about 3% of the total primary care physicians of these specialities. SSSN members report patients with cough ≥14 days plus either an epidemiological link or characteristic symptoms (paroxysms, whoop, post-tussive vomiting) on a weekly basis to the Federal Office of Public Health. Confirmatory PCR from nasopharyngeal specimens is offered for free. A total of 4992 cases have been reported until 2006. Yearly incidence has dropped from 70 cases per 100,000 inhabitants in 1992 to 40 in 2006, with a single epidemic in 1994-1995 with 280-370 cases/100,000. On average 80% of reported cases were tested by PCR, 24% of these were confirmed as Bordetella pertussis infections. For 2.6% of patients complications were reported, most commonly pneumonia, asthma bronchiale, otitis media, bronchitis and rib fractures. On average, 1.5% of patients were hospitalized. Disease in vaccinated patients was mitigated with less frequent complications (unvaccinated: 5.1%; 3 doses: 3.0%; ≥4 doses: 1.7%), hospitalizations (unvaccinated: 3.6%; ≥1 dose: 1.1%) and various clinical symptoms compared to unvaccinated patients. Comparing the periods 1991-1996, 1997-2001 and 2002-2006, a shift of pertussis from age group 1-9 years to 10-19 and ≥40 years was observed among patients cared for by general practitioners and internists. The benefits of further booster doses in adolescents and/or adults need to be considered.     

Burden of pertussis among young infants in Malaysia: A hospital-based surveillance study

BackgroundThe case fatality rate and the risk of complications due to pertussis is very high in infants. Asia has the second highest childhood pertussis burden. The study aimed to assess the prevalence, clinical complications, and mortality rates of pertussis disease requiring hospitalization among young infants in Malaysia.MethodsThe study was a one-year, hospital-based, multi-site surveillance of infants less than six months of age with symptoms consistent with pertussis and a cross-sectional analysis of their mothers for recent pertussis infection. Information was obtained from medical records and interviews with the parents. Pertussis diagnosis was confirmed for all infants through serum anti-PT titration test or PCR test.Results441 possible cases of pertussis were included in this study. Of these, 12.7 % had laboratory confirmation of pertussis. Infants with confirmed pertussis had significantly higher rates of cyanosis (37.5 % vs 8.6 %; p < 0.0001) and apnea (12.5 % vs 3.9 %; p = 0.027) than test-negative infants. Most infants from both groups were in recovery/recovered at discharge. Those with confirmed pertussis had higher case fatality rate than test-negative cases (5.4 % vs 1.0 %; p = 0.094), but the difference did not reach significance. The majority of confirmed pertussis cases (89.3 %) occurred in infants too young to be fully vaccinated or under-vaccinated for their age. Both test-negative and confirmed pertussis resulted in work-day losses and incurred costs for both parents.ConclusionsA high pertussis disease burden persists in infants less than six months of age, especially among those un- and under-vaccinated. Maternal and complete, on-time infant vaccination is important to reduce disease burden.     

2004-2010年上海市卢湾区出生监测分析

【目的】 通过出生监测分析,了解上海市卢湾区人口的生育水平及发展趋势,为本地区的人口发展决策提供科学依据。【方法】 利用上海市卢湾区疾病预防控制中心出生监测系统所获得的2004-2010年户籍活产婴儿的出生资料,利用SPSS统计软件计算其粗出生率、总生育率、总和生育率、出生性别比、剖宫产率、标化月份出生指数等相关出生指标进行分析。【结果】 2004-2010年上海市卢湾区粗出生率为4.00‰~6.26‰,出生人口男女性别比98.50~116.48;生育旺盛期出现在25~34岁年龄组妇女, 孕产妇平均年龄在28~29岁之间;活产婴儿的出生体重随着孕周的增加而增长;六年间,9~11月为出生高峰;剖宫产率为63.35%~70.81%,处于较高水平。【结论】 本地区正处于近年来的出生高峰期,应采取有效的行为干预措施进一步促进全区孕妇和新生儿的健康状况;剖宫产率较高以及高龄孕产妇现象应引起社会关注。     

上海市卢湾区人群麻疹免疫水平监测

[目的 ]　了解卢湾区近 10年人群麻疹免疫水平与麻疹发病情况的关系。 [方法 ]　对卢湾区 1989～1999年人群麻疹免疫水平和麻疹发病情况资料进行分析 ,并计算抗体阳转率、发病率。 [结果 ]　历年接种率维持在97%以上的较高水平。免后抗体阳性率为 99.42 %,几何平均滴度 (GMT)为 39.96。人群麻疹抗体总阳性率为99 .49%,近几年麻疹年均发病率在 0 .19/ 10万以下。 [结论 ]　在保持高接种率和免疫成功率的基础上 ,流动儿童和成人是当今控制麻疹的重点对象     

湖北省2000～2005年流行性脑脊髓膜炎监测分析

目的了解流脑疫苗接种后的流行新特征。方法在全省4个监测点运用流行病学、微生物学等方法对健康人群做带菌调查和不同时期的抗体水平测定及全省病例进行分析。结果湖北省带菌率为4．33％,带菌以B群为主,发病以A群为主,A群抗体水平较高,C群抗体在疫苗免疫前后有显著性差异,病原株对磺胺类药物100％耐药,对青霉素等7种抗生素均敏感。结论病原株的可能变迁和耐药性对此病需继续加强监测与预防。     

上海市卢湾区1956~2004年甲乙类传染病流行特征分析

建国50多年来，随着经济的不断发展和国家对卫生防病工作投入的不断增大，传染病防治工作取得了巨大的成效，传染病发病率不断下降，人民的健康状况得到了极大的改善。为了客观评价卢湾区近50年传染病防治工作的成效，分析传染病流行特征和流行规律，为今后制定传染病防制措施提供依据，现将卢湾区1956～2004年甲乙类传染病的流行病学特征分析如下：     

连云港市赣榆区1～10岁健康儿童流行性脑脊髓膜炎A、C群、百日咳、白喉、破伤风抗体水平的监测

目的 了解江苏省连云港市赣榆区1～10岁健康儿童流行性脑脊髓膜炎A、C群（分别简称A群流脑和C群流脑）、百日咳、白喉、破伤风特异性抗体水平,从而为免疫规划工作提供参考依据。方法 通过儿童计划免疫管理系统,从本地25个接种点接种数据库中随机抽取1～10岁全程免疫健康儿童,采集末梢血样18 747份,采用酶联免疫吸附试验法检测上述5 种传染病特异性IgG抗体水平,并对结果进行统计学分析。结果 调查的18 747份末梢血样中,A群流脑、C群流脑、百日咳、白喉、破伤风IgG 抗体阳性率分别为97.9%、98.0 %、 99.1%、 98.5%、99.0%,各个年龄组的5种抗体阳性率均在94.9%以上。城镇儿童和农村儿童间5种抗体阳性率差异均有统计学意义,城镇儿童5种抗体阳性率均低于农村儿童。 结论 赣榆区1～10岁儿童上述5类传染病特异性抗体均维持在较高水平,城镇儿童5种抗体阳性率均低于农村儿童,应加强流动人口的免疫规划疫苗接种工作。     

Effectiveness of acellular pertussis vaccine and evolution of pertussis incidence in the community of Madrid from 1998 to 2015

IntroductionPertussis is a communicable disease that primarily affects infants. Vaccination has led to an important reduction in the incidence of the disease, however, resurgence of the disease has been observed. This study aimed to analyze the incidence of pertussis and assess the vaccination effectiveness (VE) of different schedules of acellular pertussis vaccination in the community of Madrid.MethodsPertussis cases notified to the Mandatory Disease Reporting System from 1998 to 2015 were analyzed. Five comparison periods were created: 1998–2001 (reference), 2002–2005, 2006–2009, 2010–2012 and 2013–2015. The incidence ratio (IR) between inter-epidemic periods was analyzed using a Poisson regression. VE was calculated using the screening method. Vaccine status data were collected from the vaccine registry.ResultsIn total, 3855 cases were notified. Inter-epidemic periods were observed every 3–4 years. The incidence increased (IR: 5.99, p < 0.05) in the 2013–2015 period, particularly among infants younger than 1 month (IR: 32.41, p < 0.05). Vaccination data were available in 89% of cases. For those receiving the last dose at ≤6-month VE was 89.9% (95% confidence interval (CI): 87.3–92.0) after one year of follow-up, and 85.5% (95% CI: 82.4–88.1) after 11 years of follow-up. For those receiving the last dose at 18-months VE decreased from 98.8% (95% CI: 98.3–99.1) to 85.1% (95% CI: 81.9–87.7) in the same period, and for those receiving the last dose at 4-year VE decreased from 99.6% (95% CI: 99.3–99.7) to 79.3% (95% CI: 74.6–83.1).ConclusionsB. pertussis is circulating in our population, as shown by the epidemic peaks and increased incidence of pertussis in recent years. VE increased with the number of doses and decreased with the follow-up period. The effect of this and other vaccination strategies must be monitored to control the disease.     

上海市闵行区157例疑似麻疹病例IgM抗体测定结果分析

目的:探讨如何提高麻疹IgM抗体检测的准确率,揭示闵行区麻疹疾病的流行特点。方法:采用ELISA法检测麻疹IgM抗体。结果:157例疑似麻疹病例中,麻疹病毒IgM抗体阳性检出108例,检出率为68.8%。全年均有散发病例,高峰期为7月份,高发期是4月-9月。本地与外来人口麻疹IgM抗体阳性率差别有显著意义(P<0.05)。5个不同年龄组麻疹IgM抗体检出率差别有显著意义(P<0.01),麻疹IgM抗体阳性主要分布在<1.5岁和>18岁年龄范围。结论:症状和采血时间是影响IgM抗体检测的准确率的两个关键因素。闵行区麻疹发病的流行特点具有较明显的季节性,未免疫是麻疹发病的主要原因,发病年龄呈低龄化和成年化双向位移。     

Effectiveness of two pertussis vaccines in preterm Danish children

Reduced immunogenicity in preterm children has been observed for pertussis vaccines. How immunogenicity relates to clinical protection is not well-established for pertussis, and the corresponding reduction, if any, in post-licensure vaccination effectiveness among preterm children has not been determined. We conducted a nationwide cohort study of 879,424 Danish children including 1553 cases of pertussis hospitalisation. The effectiveness of pertussis vaccination, both whole-cell and acellular, was evaluated in preterm and full-term children. The effectiveness of a completed primary series of pertussis vaccination, whole-cell or acellular, was similar in preterm and full-term children.