百日咳感染的家庭聚集性特征分析  

Recognizing the vaccination strategy of pertussis according to the family aggregation feature of transmission

作　　者：李亚绒[1] 刘小乖[1] 雷玲霞[1] 贺方智 李瑞娜[1] 彭晓康[1] 张晓芳[1] 刘莹[2] 习艳丽[2] 黄河清[1] 王增国[1] 

机构地区：[1]710002,西安市儿童医院感染三科 [2]西安市疾病预防控制中心

出　　处：《中华流行病学杂志》2014年第8期953-955,共3页Chinese Journal of Epidemiology

基　　金：陕西省科技计划（2012k16-05-08）;西安市卫生局科技项目（J2011049）

摘　　要：目的 了解百日咳就诊患者年龄分布、传染源并分析传播模式.方法 对2012年1月至2013年8月于西安市儿童医院就诊的婴幼儿和/或儿童病例及其流行病学相关病例（有咳嗽症状的密切接触者）进行百日咳实验室检测并确诊,采用Excel 2007软件统计百日咳就诊病例及其传染源或后续病例的临床症状和年龄分布.结果 254例百日咳临床疑似病例和54例流行病学相关病例经实验室检测分别确诊165例和38例.实验室确诊的临床病例中＜1岁者共138例（83.6％）;流行病学相关病例中＞20岁者36例（94.7％）,所有流行病学相关病例均被误诊或漏诊.实验室诊断病例中其传染源为父母共计25起（78.1％）,并可见由儿童传播至成年人的现象.结论 百日咳的流行呈家庭聚集性.就诊者中多为＜1岁婴儿,而成年人病例是婴幼儿病例的主要传染源,且存在严重误诊或漏诊.有必要调整目前百日咳加强免疫策略.Objective To understand the age distribution of pertussis patients admitted in the children hospital and to analyze the source of infection as well as its transmission patterns.Methods Patients visiting to the Children Hospital and epidemiologically related cases during Feb.2012 to Aug.2013 were laboratorially tested to confirm the diagnosis.Excel 2007 software was used to analyze the age distribution and clinical symptoms of clinic cases,the source of infection or subsequent cases.Results 165 out of 254 clinically suspicious pertussis cases and 38 out of the 54 epidemiologically related cases were confirmed of having pertussis infection.There were 138 （83.6%） cases under 1 year of age in the confirmed clinical cases and 36 （94.7%） cases older than 20 years of age among the confirmed epidemiologically related pertussis cases.All the confirmed epidemiologically related cases were misdiagnosed or missed for diagnosis.As the source of pertussis infection in confirmed clinical cases,parents played an imported role among 25 of the 32 cases.Transmission from infants and/or little children to adults were also observed in this study.Conclusion Infants accounted for the most among the pertussis patients that visiting the clinics.Adults,being misdiagnosed or missed diagnosed,were the main sources of infection to infants.Epidemics of pertussis occurred under family aggregation.Further study was in need to develop the proper strategy for pertussis booster vaccination.

关 键 词：百日咳 传播 疫苗接种 

分 类 号：R186[医药卫生—流行病学]