2022年山东省1起百日咳疫苗高覆盖率小学百日咳暴发调查  

Investigation of a pertussis outbreak in a primary school that had high pertussis vaccination coverage, Shandong province, 2022

作　　者：孙炜玮 陶泽新[3] 张岩[3] 刘桂芳[3] 冯蕾[3] 贾金丽 汤娜 马超[6] 张金忠 张丽[3] Sun Weiwei;Tao Zexin;Zhang Yan;Liu Guifang;Feng Lei;Jia Jinli;Tang Na;Ma Chao;Zhang Jinzhong;Zhang Li(Hexi District Center for Disease Control and Prevention,Hexi 300211,Tianjin,China;Chinese Field Epidemiology Training Program,Chinese Center for Disease Control and Prevention,Beijing 100050,China;Shandong Provincial Center for Disease Control and Prevention,Jinan 250014,Shandong,China;Liaocheng Municipal Center for Disease Control and Prevention,Liaocheng 252000,Shandong,China;Chiping District Center for Disease Control and Prevention,Liaocheng 252100,Shandong,China;National Immunization Program,Chinese Center for Disease Control and Prevention,Beijing 100050,China)

机构地区：[1]天津市河西区疾病预防控制中心,天津300211 [2]中国疾病预防控制中心中国现场流行病学培训项目,北京100050 [3]山东省疾病预防控制中心,山东济南250014 [4]山东省聊城市疾病预防控制中心,山东聊城252000 [5]山东省聊城市茌平区疾病预防控制中心,山东聊城252100 [6]中国疾病预防控制中心免疫规划中心,北京100050

出　　处：《中国疫苗和免疫》2022年第6期644-649,共6页Chinese Journal of Vaccines and Immunization

基　　金：山东省泰山学者工程(ts201511105);泰山学者青年专家计划项目(tsqn202103187)。

摘　　要：目的 探讨山东省1起小学百日咳暴发疫情特征和可能原因。方法 开展百日咳疑似病例主动搜索和流行病学调查,采集血清和咽拭子标本分别进行PT-IgG抗体和百日咳鲍特菌(Bordetella pertussis, Bp)核酸检测,分析Bp感染率。结果 2022年4月28日至7月5日该小学共发现50例Bp感染者(教师1例、学生49例),其中百日咳临床诊断病例1例、实验室诊断病例39例、无症状感染者10例。该校全部学生、Bp感染学生百日咳疫苗全程接种率分别为98.2%(2 152/2 191)、98.1%(48/49)。学生Bp感染率为2.2%(49/2 191),接种至感染/发病的中位数时间为6年(范围:4-10年)。44.4%(20/45)的检测感染者PT-IgG小于10IU/mL。2个班级学生感染率(30.0%和29.5%)高于其他班级(4.4%)(χ^(2)=49.33,P=0.000)。结论 本起疫情为1起百日咳疫苗高覆盖率下的学校百日咳暴发,可能与百日咳疫苗保护效果随时间推移而下降有关。建议学龄前儿童加强接种1剂百日咳疫苗,将Bp核酸和PT-IgG检测作为百日咳诊断依据。Objective To explore epidemiological characteristics and possible causes of a pertussis outbreak in a primary school in Shandong province.Methods We conducted an epidemiological investigation with active search for suspected pertussis cases. We collected serum and throat swab samples to test for PT-IgG antibody and Bordetella pertussis(Bp) nucleic acid for confirming Bp infection.Results Between April 28 and July 5, 2022, one teacher and 49 students in the primary school were identified with Bp infection, among which 1, 39, and 10 were clinically-confirmed pertussis cases, laboratory-confirmed pertussis cases, and asymptomatic cases, respectively. Full-series pertussis vaccination coverage levels were 98.2%(2 152/2 191) among all students and 98.1%(48/49) among infected students. The Bp infection rate among students was 2.2%(49/2 191). The median interval from last pertussis vaccine dose to infection onset was 6 years, with a range of 4-10 years. PT-IgG titers were less than 10 IU/mL among the 44.4%(20/45) of infected persons who were tested. Infection rates in two classes were higher than in the other classes(30.0% and 29.5% vs 4.4%;χ^(2)=49.33, P=0.000).Conclusions This pertussis outbreak in a school that had high pertussis vaccine coverage may indicate a decline of pertussis vaccine effectiveness over time. We recommend pertussis booster vaccination of preschool children and suggest using Bp nucleic acid and PT-IgG testing for diagnosing pertussis.

关 键 词：百日咳 暴发 无细胞百白破联合疫苗 覆盖率 小学 

分 类 号：R183.3[医药卫生—流行病学]