重新肆虐的百日咳给临床诊治带来新挑战

doi:10.19871/j.cnki.xfcrbzz.2024.03.001

摘要/Abstract

摘要： 百日咳是一种由百日咳鲍特菌感染引起的呼吸道传染性疾病,属于国家法定传染病中的乙类传染病之一。20世纪60–70年代,我国百日咳的发病率达到了10~20/万,给人民的身体健康和生命安全带来了巨大的威胁。自1978年以来我国在全国范围内广泛开展百日咳疫苗接种后,百日咳的发病率和死亡率大幅下降。但据国家疾病预防控制局公布的最新全国法定传染病疫情数据显示,近年来百日咳有卷土重来之势。年长儿童发病率逐年上升,小婴儿感染率也有明显上升趋势,且小婴儿感染症状重,可能发生窒息、心脏停搏等严重并发症甚至死亡,极大地影响了儿童身体健康和生命安全。本述评结合临床病例,就百日咳流行现状、主要临床表现、诊断要点、治疗方案的选择原则和疫苗接种及预防措施等内容进行系统阐述,对临床工作具有指导意义。

关键词: 百日咳, 流行病学, 诊治, 预防

Abstract: Pertussis is a respiratory infectious disease caused by Bordetella pertussis infection, which is one of the Class B infectious diseases in the national notifiable infectious diseases., 60-70s of the 20th century,the incidence of whooping cough in China was very high, reaching 10-20/10 000, which brought a huge threat to people's health and life safety. Since 1978, when pertussis vaccine was widely administered nationwide, the incidence and mortality of pertussis have dropped significantly. However, according to the latest national epidemic data on notifiable infectious diseases released by the National Bureau of Disease Control and Prevention, whooping cough has made a comeback in recent years. The incidence of older children is increasing year by year, and the infection rate of young infants is also on the rise, and the infection symptoms of young infants are severe, and serious complications such as suffocation and cardiac arrest and even death may occur, which greatly affects the health and life safety of children. Based on clinical cases, this article systematically expounds the current situation of pertussis, the main clinical manifestations, diagnosis, the selection principles of treatment regimens, and vaccination and preventive measures, which has important guiding significance for clinical work.

Key words: Pertussis, Epidemiology, Diagnosis and treatment, Prevention

中图分类号:

R516.6

武文艳, 关育红, 刘晶哲. 重新肆虐的百日咳给临床诊治带来新挑战[J]. 新发传染病电子杂志, 2024, 9(3): 1-4.

Wu Wenyan, Guan Yuhong, Liu Jingzhe. The resurgence of pertussis has brought new challenges to clinical diagnosis and treatment[J]. Electronic Journal of Emerging Infectious Diseases, 2024, 9(3): 1-4.

参考文献

[1] WINTER K, HARRIMAN K, ZIPPRICH J, et al.California pertussis epidemic[J]. Pediatr, 2012, 16(6):1091-1096.
[2] TAN T, DALBY T, FORSYTH K, et al.Pertussis Across the Globe: Recent Epidemiologic Trends From 2000 to 2013[J]. Pediatr Infect Dis J, 2015, 34(9):e222-e232.
[3] 中华医学会感染病学分会儿科感染学组, 国家卫生健康委能力建设和继续教育儿科专委会感染组, 中国临床实践指南联盟方法学专委会, 等. 中国百日咳诊疗与预防指南(2024版)[J]. 中华医学杂志, 2024, 104(15): 1258-1279.
[4] WORLD HEALTH ORGANIZATION. Pertussis reported cases and incidence[EB/OL]. (2023-12-27) [2023-12-30]. https://immunizationdata.who.int/pages/incidence/PERTUSSIS.html?CODE=CHN&YEAR=.
[5] 吴丹, 郑徽, 李明爽, 等. 中国2018-2021年百日咳流行病学特征[J]. 中国疫苗和免疫, 2022, 28(6):638-643.
[6] EUROPEAN CENTRE FOR DISEASE PREVENTION AND CONTROL. Pertussis in:ECDC. Annual epidemiological report for 2018[EB/OL]. [2023-12-20]. https://www.ecdc.europa.eu/en/publications-data/pertussis-annual-epidemiological-report-2018.
[7] 陈一然, 邓继岿. 百日咳家庭聚集发病2例[J/CD].新发传染病电子杂志, 2023, 8(2):68-70.
[8] MONTERO DA, VIDAL RM, VELASCO J, et al.Two centuries of vaccination: historical and conceptual approach and future perspectives[J]. Front Public Health, 2024, 11:1326154.
[9] 许红梅, 郑佳佳. 百日咳临床特点及流行病学研究进展[J].中华实用儿科临床杂志, 2014, 29(22):1681-1682.
[10] TESSIER E, NEWPORT D, TRAN A,et al.Pertussis immunization strategies to optimize infant pertussis control: A narrative systematic review[J]. Vaccine. 2023,41(41):5957-5964.
[11] 康小娟, 彭晓康, 李亚绒, 等. 儿童百日咳痉挛性咳嗽演变与白细胞和淋巴细胞水平的关系[J]. 中国妇幼健康研究, 2023, 34(8):63-69.
[12] DOMINGUEZ DC.A profile of the Simplexa™ Bordetella Direct assay for the detection and differentiation of Bordetella pertussis and Bordetella parapertussis in nasopharyngeal swabs[J]. Expert Rev Mol Diagn, 2020, 20(9):889-894.
[13] SUN C, XIAO F, FU J, et al.Loop-Mediated Isothermal Amplification Coupled With Nanoparticle-Based Lateral Biosensor for Rapid, Sensitive, and Specific Detection of Bordetella pertussis[J]. Front Bioeng Biotechnol, 2022, 9:797957.
[14] SPRAUER MA, COCHI SL, ZELL ER, et al.Prevention of secondary transmission of pertussis in households with early use of erythromycin[J]. Am J Dis Child, 1992, 146(2):177-181.
[15] WINTER K, ZIPPRICH J, HARRIMAN K, et al.Risk factors associated with infant deaths from pertussis: a case-control study[J]. Clin Infect Dis, 2015,61(7):1099-1106.
[16] 姚开虎, 孟庆红, 史伟, 等. 国内当前百日咳治疗的抗菌药物选择之我见[J].中华实用儿科临床杂志, 2024, 39(2):85-88.
[17] 中华医学会感染病学分会儿科感染学组, 《中华儿科杂志》编辑委员会,深圳市儿童医院感染科等. 中国儿童百日咳诊断与治疗建议[J]. 中华儿科杂志, 2017, 55(8):568-572.
[18] MIYASHITA N, AKAIKE H, TERANISHI H, et al.Diagnostic value of symptoms and laboratory data for pertussis in adolescent and adult patients[J]. BMC Infect Dis, 2013, 13:129.
[19] WORLD HEALTH ORGANIZATION.Pertussis vaccines: WHO position paper, August 2015-Recommendations[J]. Vaccine, 2016, 34(12):1423-1425.
[20] BAISSAS T, BOISNARD F, CUESTA ESTEVE I, et al.Vaccination in pregnancy against pertussis and seasonal influenza: key learnings and components from high-performing vaccine programmes in three countries: the United Kingdom, the United States and Spain[J]. BMC Public Health, 2021, 21(1):2182.
[21] ABU-RAYA B, FORSYTH K, HALPERIN SA, et al.Vaccination in pregnancy against pertussis: a consensus statement on behalf of the global pertussis initiative[J]. Vaccines (Basel), 2022, 10(12):1990.
[22] GODOY P, GARCIA-CENOZ M, RIUS C, et al.Effectiveness of maternal pertussis vaccination in protecting newborn: a matched case control study[J]. J Infect, 2021, 83(5):554-558.
[23] BECKER-DREPS S, BUTLER AM, MCGRATH LJ, et al.Effectiveness of prenatal tetanus, diphtheria, acellular pertussis vaccination in the prevention of infant pertussis in the US[J]. Am J Prev Med, 2018, 55(2):159-166.
[24] 吴诗品. 防控新发传染病,人类的永恒课题[J/CD]. 新发传染病电子杂志, 2017,2(1):1-4.