2005—2023年绵阳市百日咳病例免疫特征的回顾性调查

职业与健康 ›› 2025, Vol. 41 ›› Issue (18): 2517-2522.

2005—2023年绵阳市百日咳病例免疫特征的回顾性调查

凡娅, 何雪, 张驯, 何齐文, 左玲

绵阳市疾病预防控制中心免疫规划所,四川绵阳 621000

收稿日期:2024-11-10 修回日期:2024-11-21 出版日期:2025-09-15 发布日期:2025-12-13
作者简介:凡娅,女,主任医师,主要从事疫苗可预防疾病的监测与防控工作。
基金资助:
绵阳市卫生健康委员会科研课题立项项目（2024010）

Retrospective investigation on immune characteristics of pertussis cases in Mianyang City from 2005 to 2023

FAN Ya, HE Xue, ZHANG Xun, HE Qiwen, ZUO Ling

Institute of Immunization Planning,Mianyang Center for Disease Control and Prevention,Mianyang,Sichuan 621000,China

Received:2024-11-10 Revised:2024-11-21 Online:2025-09-15 Published:2025-12-13

摘要/Abstract

摘要： 目的了解绵阳市百日咳发病异常波动的原因,分析真实世界中含百日咳成分疫苗的免疫持久性。方法通过中国疾病预防控制中心信息系统收集2005—2023年绵阳市各医疗机构报告的百日咳临床诊断和确诊病例,并对数据进行分析。结果 2005—2023年绵阳市百日咳年均报告发病率为1.020 5/10万,报告发病率呈上升趋势（χ²=5 841.464,P<0.01）。2000—2023年出生人群百日咳年均发病率为99.542 9/10万,呈上升趋势（χ²=1 113.018,P<0.01）。2005—2023年绵阳市百日咳病例0~<6岁组构成比是63.93%,其中0~<1岁组的病例占41.12%。接种无细胞百白破联合疫苗（diphtheria and tetanus toxoid with acellular pertussis combined vaccine,DTaP）时期（2009—2023年出生）的病例占所有报告病例的95.37%。无免疫史的病例占18.51%。3~<18月龄病例中未及时完成相应1~3剂次免疫程序的占71.37%,≥18月龄的病例中,93.14%完成了4剂次的全程免疫。完成1~3剂次含百日咳成分疫苗免疫后1月内发病的占比分别是61.54%、41.67%、3.57%。接种百日咳白喉破伤风联合疫苗（diphtheria,tetanus and pertussis combined vaccine,DTP）、吸附无细胞百白破b型流感嗜血杆菌联合疫苗（diphtheria,Tetanus,Acellular Pertussis and Haemophilus Influenzae Type b Combined Vaccine,DTaP-Hib）、吸附无细胞百白破灭活脊髓灰质炎和b型流感嗜血杆菌（结合）联合疫苗[diphtheria,tetanus,pertussis（acellular,component）,poliomyelitis（inactivated） vaccine and Haemophilus type b conjugate vaccine,adsorbed,DTaP-IPV-Hib]全程4剂次免疫后5年内发病的占比分别是67.19%、97.01%、84.62%。结论 2005—2023年绵阳市百日咳发病异常波动受适龄人群未及时完成含百日咳成分疫苗接种、全细胞百白破联合疫苗（diphtheria and tetanus toxoid with whole cell pertussis combined vaccine,DTwP）转换为DTaP、聚合酶链式反应（polymerase chain reaction,PCR）检测技术推广及医生的诊断意识加强等多因素影响。全程完成4剂次含百日咳成分疫苗接种后诱导的免疫持久性不长。建议在全国范围开展百日咳主动监测,按照世界卫生组织的建议,尽早对适龄儿童完成全程接种DTP,优化全人群的百日咳疫苗免疫策略。

关键词: 百日咳, 免疫特征, 回顾性调查, 免疫持久性

Abstract: Objective To analyze the causes of abnormal fluctuations in the incidence of pertussis in Mianyang City,and to explore the immune persistence of pertussis-containing vaccines in the real world. Methods The clinical diagnosis and confirmed cases of pertussis reported from 2005 to 2023 were collected through the information system of China Center for Disease Control and Prevention,and the data were analyzed. Results The average annual reported incidence of pertussis in Mianyang City from 2005 to 2023 was 1.0205/100 000,and the reported incidence was on the rise（ χ²=5 841.464,P<0.01）. The average annual reported incidence of pertussis in the population born from 2000 to 2023 was 99.542 9/100 000,and the reported incidence was on the rise（ χ²=1 113.018,P<0.01）. From 2005 to 2023,the proportion of pertussis cases in the 0-<6 age group in Mianyang City was 63.93%,of which 41.12% were in the 0-<1 year old group. Cases during the diphtheria and tetanus toxoid with acellular pertussis combined vaccine（DTaP） period（born from 2009 to 2023） accounted for 95.37% of all reported cases. The cases without immunization history accounted for 18.51%. Among the cases aged 3-<18 months,71.37% did not complete the corresponding 1-3 doses of immunization program in time. Among the cases aged ≥18 months,93.14% completed the 4 doses of full immunization. The proportion of incidence within 1 month after the completion of 1-3 doses of pertussis-containing vaccine immunization was 61.54%,41.67% and 3.57%,respectively. The proportion of incidence within 5 years after immunization of 4 doses of diphtheria,tetanus and pertussis combined vaccine（DTP）,diphtheria,Tetanus,Acellular Pertussis and Haemophilus Influenzae Type b Combined Vaccine（DTaP -Hib） and diphtheria,tetanus,pertussis（acellular,component）,poliomyelitis（inactivated） vaccine and Haemophilus type b conjugate vaccine,adsorbed,DTaP-IPV-Hib]DTaP-IPV-Hib were 67.19%,97.01% and 84.62%,respectively. Conclusion The abnormal fluctuation of pertussis incidence in Mianyang City from 2005 to 2023 has been affected by many factors,such as the failure of the appropriate age group to complete timely vaccination with pertussis-containing vaccines,the conversion of diphtheria and tetanus toxoid with whole cell pertussis combined vaccine（DTwP） to DTaP,the promotion of polymerase chain reaction detection technology,and the strengthening of doctors' diagnostic awareness. The immune persistence induced by 4 doses of pertussis-containing vaccine was not long. It is recommended to carry out active surveillance of pertussis nationwide,complete the whole course of DTP vaccination for school-age children as soon as possible according to the recommendations of WHO,and optimize the immunization strategy of pertussis vaccine for the whole population.

Key words: Pertussis, Immune characteristics, Retrospective investigation, Immune persistence

中图分类号:

R181.3⁺1

凡娅, 何雪, 张驯, 何齐文, 左玲. 2005—2023年绵阳市百日咳病例免疫特征的回顾性调查. [J]职业与健康, 2025, 41(18): 2517-2522.

FAN Ya, HE Xue, ZHANG Xun, HE Qiwen, ZUO Ling. Retrospective investigation on immune characteristics of pertussis cases in Mianyang City from 2005 to 2023. [J]OCCUPATION AND HEALTH, 2025, 41(18): 2517-2522.

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