河南省2018-2019年青少年和成人百日咳病例哨点监测

Sentinel surveillance of pertussis among adolescents and adults in Henan province,2018-2019

目的分析河南省哨点监测医院青少年和成人百日咳病例的发病特征。方法在河南省4家哨点监测医院收集2018-2019年10-19岁青少年和≥20岁成人百日咳病例流行病学、临床、病原学和血清学信息,分析百日咳发病特征。结果共监测到百日咳病例289例,其中青少年30例(10.38%)、成人259例(89.62%)。百日咳病例高峰为9-11月(119例,41.18%)。总病例、青少年病例中有含百日咳成分疫苗接种史的比例分别为9.34%(27/289)、60.00%(18/30)。在所有病例中,有阵发性咳嗽、类感冒症状、鸡鸣样吸气声、窒息、发绀、咳嗽后呕吐的病例分别占94.46%、40.14%、24.22%、20.76%、27.68%、35.29%。鼻咽拭子PCR、血清PT-IgG抗体检测阳性率分别为4.84%(14例)、7.61%(22例),实验室确诊率为11.07%(32例)。结论河南省青少年和成人百日咳发病风险较高,部分病例临床症状不典型;建议加强百日咳的实验室诊断能力。

Objective To analyze the incidence and characteristics of adolescent and adult pertussis in sentinel surveillance hospitals of Henan province.Methods We obtained epidemiological,clinical,etiological,and serological data on pertussis cases aged 10-19 years(adolescents)and aged≥20 years(adults)during 2018-2019 in 4 sentinel surveillance hospitals of Henan and analyzed pertussis incidence.Results A total of 289 pertussis cases were reported,among which 30(10.38%)were adolescents and 259(89.62%)were adults.The pertussis incidence peaked between September and November(119 cases,41.18%).Cases who had received pertussis containing vaccine accounted for 9.34%(27/289)of all cases and 60.00%(18/30)of adolescent cases.Cases with paroxysmal cough,flu-like symptoms,whoop,asphyxia,cyanosis,and vomiting after coughing accounted for 94.46%,40.14%,24.22%,20.76%,27.68%,and 35.29%of all cases;4.84%(14 cases)were positive to pertussis PCR from nasopharyngeal swabs and 7.61%(22 cases)were positive to serum PT-IgG antibody;11.07%(32 cases)were laboratory-confirmed.Conclusions Adolescents and adults in Henan had a high risk of pertussis;some of their symptoms were atypical.We recommend strengthening laboratory diagnosis of pertussis.