儿童百日咳临床流行特征及其密切接触者感染现况

Clinical epidemiological characteristics of pertussis in children and the status of infection in their close contacts

目的了解儿童百日咳临床流行病学特征及其密切接触者的感染情况。方法收集深圳市儿童医院2015—2018年百日咳儿童临床资料及其密切接触者的病原学检测数据,进行描述性流行病学分析。结果2015—2018年百日咳儿童报告病例共2716例,各年分别为504、425、796及991例;2015年以5月份最多(72例),2016年和2018年以8月份最多(68例和144例),2017年以7月份最多(115例)。4年共报告男性1517例,女性1199例,男女比为1.3∶1。<1岁龄儿童占比79.7%(2165/2716),其中<6月龄儿童占比74.4%(1610/2165)。报告病例中门诊治疗者1605例(59.1%),年龄M(Q_(1),Q_(3))为5(3,11)月龄,住院治疗者1111例(40.9%),年龄为4(2,7)月龄;门诊治疗者和住院治疗者<6月龄分别有876例(54.4%)和734例(45.6%),6月~2岁龄分别有575例(63.5%)和331例(36.5%),>2岁龄分别有154例(77.0%)和46例(23.0%),两种治疗方式在不同年龄组中比较差异有统计学意义(P<0.001);住院治疗者中年龄为<6月龄的住院时间是(8.5±3.9)d,6月龄~2岁龄的是(7.1±3.7)d,>2岁龄的是(6.8±3.3)d,差异有统计学意义(P<0.001)。共收集到270例的617名家庭密切接触者的百日咳病原学检测数据,患儿母亲阳性检出率最高(34.9%)。结论2015—2018年百日咳报告病例逐年波动性上升,夏季高发,1岁以下儿童为主,男性多于女性。门诊治疗者多于住院治疗者,其年龄明显比后者大;患儿年龄越小住院比例越高,随着年龄的增长,其住院时间明显缩短。家庭密切接触者中,母亲可能是儿童感染百日咳的主要传染源。

Objective To investigate the clinical epidemiological characteristics of children with pertussis and the infection of their close contacts.Methods The clinical data of children with pertussis and the etiological detection results of close contacts in Shenzhen Children′s Hospital from 2015 to 2018 were collected and descriptive epidemiological analysis was carried out.Results The cases of pertussis from 2015 to 2018 were reported as 504,425,796 and 991 respectively,with a total of 2716 cases.The most cases was in May in 2015(72 cases),in August in 2016 and 2018(68 cases and 144 cases),and in July in 2017(115 cases).A total of 1517 male and 1199 female children were reported from 2015 to 2018,the ratio of male-to-female was 1.3∶1.The proportion of children under 1 year old was 79.7%(2165/2716),of which 74.4%(1610/2165)was less than 6 months old.Among the reported cases,1605(59.1%)were treated as outpatients,aged M(Q_(1),Q_(3))5(3,11)months,and 1111(40.9%)were hospitalized,aged 4(2,7)months.There were 876 outpatients(54.4%)and 734 inpatients(45.6%)under 6 months of age,575 outpatients(63.5%)and 331 inpatients(36.5%)between 6 months and 2 years of age,and 154 outpatients(77.0%)and 46 inpatients(23.0%)with above 2 years old,respectively.There were statistically significant differences between the two treatment methods in different age groups(P<0.001).The average hospitalization time of inpatients under 6 months of age was(8.5±3.9)days,that of inpatients between 6 months and 2 years of age was(7.1±3.7)days,and that of inpatients above 2 years old was(6.8±3.3)days.The difference was statistically significant(P<0.001).The etiological test results of pertussis were collected from 617 close contacts of 270 reported cases,the positive detection rate of mothers was the highest(34.9%).Conclusions From 2015 to 2018,the number of reported cases of pertussis in our hospital fluctuated and increased year by year,with high incidence in summer,mainly in children under 1 year old,and more males than females.Outpatient treatment was more than inpatient treatment,its age was obviously older than the latter.The younger the children,the higher the proportion of hospitalization,and with the increase of the age,the hospitalization time was obviously shortened.Among the close family contacts,the mother might be the main source of pertussis infection in children.