上海市虹口区中小学生和成人百日咳抗体水平监测

Monitoring on antibodies against Bordetella pertussis whole-cell in healthy adolescents and adults in Hongkou District of Shanghai

目的了解上海市虹口区中小学生和成年人群中百日咳抗体水平,为预防控制百日咳提供依据。方法随机抽取中小学生214人,成年人85人,孕妇24人,应用酶联免疫吸附试验,检测中小学生和成年人(包括孕妇)百日咳全抗体;调查青少年百日咳疫苗免疫史和持续2周及以上咳嗽史。对百日咳抗体水平、抗体阳性率和高抗体水平进行统计分析。结果百日咳全抗体几何平均滴度水平(GMT)29.85 U/mL,人群百日咳全抗体阳性(IgG≥50 U/mL)率37.15%,总人群百日咳高抗体水平(IgG≥100 U/mL)阳性率17.65%。各年龄组百日咳全抗体GMT、抗体阳性率和高抗体水平阳性率均有明显差异,且随年龄增长均呈明显上升趋势。社区人群百日咳抗体水平明显高于孕妇和中小学生。1年内有持续2周以上咳嗽史的中小学生百日咳全抗体GMT、抗体阳性率和高抗体水平均明显高于无2周以上咳嗽史者。结论虹口区中小学生和成年人群中可能存在被漏诊或未发现的百日咳感染病例,现行百日咳疫苗免疫程序对青少年持久的保护作用不够,有待进一步开展医院/社区百日咳病例的前瞻性主动监测,为中小学生和成年人群加强接种百日咳疫苗提供科学依据。

Objective To ascertain antibodies level against Bordetella pertussis whole-cell in healthy primary and secondary school students and adults in Hongkou District, and to provide evidence for the pre- vention and control of pertussis. Methods The antibody levels against pertussis whole-cell in primary and secondary school students and adults （ including pregnant women） in Hongkou District were determined by quantitative ELISA. Those with immunization history of pertussis vaccine and continuous cough history for more than two weeks in primary and secondary school students were investigated. Pertussis antibody GMTs, positive rate of antibody and high antibody levels were statistically analyzed. Results The anti- body GMTs of pertussis whole-cell were 29.85U/mL in general. The positive rates of pertussis antibody （IgG≥50 U/mL）were 37.15%. The positive rates of high pertussis antibody level （IgG≥ 100 U/mL） were 17.65%. The antibody GMTs, positive rate of antibody and high antibody level were with highly sig- nificant difference in different age groups. They showed a trend of significant increase significantly along with the age growth. The antibody level of community people was significantly higher than that of pregnant women and students. The antibody GMTs, positive rate of antibody and high antibody levels in adolescents with a continuous cough history for more than two weeks during the last year were significantly higher than those without a continuous cough history for more than two weeks. Conclusion Pertussis infection might have missed diagnosis without being found in primary and secondary school students and adults in Hongkou District. The pertussis vaccination program does not have adequate lasting protection for primary and secondary school students. To provide a basis for immune strategy of pertussis in primary and secondary school students and adults, it is important to carry out active prospective monitoring on pertussis cases of primary and secondary school students and adults in hospital/community.