2019年河南省百日咳监测点5岁以下儿童百日咳感染状况及临床症状分析

Analysis of pertussis infection status and clinical symptoms of children under 5 years in pertussis surveillance hospitals of Henan Province in 2019

目的对监测点5岁以下儿童百日咳感染状况及临床特征进行分析,提高对儿童百日咳的认识。方法对2019年河南省内两家监测儿童医院收治的疑似百日咳病例开展主动监测,进行流行病学调查采样和实验室检测,对感染状况及确诊病例的临床特征进行描述性分析。结果2019年两家儿童医院共采样和调查疑似百日咳病例217例,阳性134例,阳性率61.8%,其中<6月龄阳性率最高(62.9%),各年龄组之间阳性率差别无统计学意义;7~9月阳性率最高,为72.6%,各季度之间差别无统计学意义;确诊百日咳病例中阵发性咳嗽的发生率最高,占97.8%;窒息症状的发生率最低,占比17.2%。有免疫史组和无免疫史组除发绀外各临床症状的差别无统计学意义。结论5岁以下儿童百日咳临床症状不典型,导致漏报和误报,造成对百日咳实际发病水平的低估。

Objective To analyze the status and clinical characteristics of pertussis cases of children under 5 years old,for raising the awareness of pertussis of children.Methods Epidemiological investigations and laboratory tests were performed on suspected cases of pertussis admitted in two monitoring children’s hospitals in Henan province in 2019,to analyze the infection status and clinical characteristics of confirmed cases.Results In 2019,217 suspected cases of pertussis were admitted in the two children’s hospitals.After sampling and laboratory testing 134 cases were positive,and the positive rate was 62.1%,the positive rate was highest at<6 months(62.9%).The positive rate had no statistically significant difference between different age groups.The positive rate was the highest in the July to September,which accounted for 72.6%,with no statistically significant difference between quarters.The incidence of paroxysms was highest among the confirmed cases of pertussis,accounting for 97.8%.The incidence of asphyxia was the lowest,accounting for 17.2%.There was no statistically significant difference in clinical symptoms between the immunized group and the non-immunized group.Conclusion The clinical symptoms of pertussis in children under the age of 5 are not typical,leading to underreporting and misreporting,and may leading to underestimates the actual incidence of pertussis in this age group.