Assuntos
Coqueluche/diagnóstico , Idoso , Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Bordetella pertussis/patogenicidade , Bordetella pertussis/ultraestrutura , Diagnóstico Diferencial , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Humanos , Masculino , Microscopia Eletrônica de Varredura , Reação em Cadeia da Polimerase , Mucosa Respiratória/microbiologia , Coqueluche/classificação , Coqueluche/tratamento farmacológico , Coqueluche/microbiologiaRESUMO
In Sweden, acellular pertussis vaccines were introduced at 3, 5 and 12 months of age in 1996, after a 17-year hiatus without pertussis vaccination. An intensified surveillance of pertussis was initiated in October 1997, including collection of clinical data as well as Bordetella pertussis isolates in culture or PCR-confirmed cases of pertussis among children born from January 1996 to September 2004. We analysed the association of pulsed-field gel electrophoresis (PFGE) profile and serotype with severity of disease for all children followed during the first 7 years of the project. There were in all 927 children for whom both clinical information and strain characterisation data were available. 260 of these children were hospitalised during the pertussis episode. When duration of hospital stay was compared between children with different groups of strains, characterised by PFGE profile or serotype, there was a significantly higher proportion of children with long duration of hospital stay in the most frequent PFGE profile group (BpSR11) compared to the PFGE group of all other profiles (p=0.041). There was no statistically significant association between serotype and hospitalisation rate or duration of hospital stay, neither was there any statistically significant association between serotype or PFGE profile and duration of spasmodic cough or presence of complications.
Assuntos
Bordetella pertussis/química , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Coqueluche/imunologia , Criança , Vacina contra Difteria, Tétano e Coqueluche/imunologia , Eletroforese em Gel de Campo Pulsado , Humanos , Vigilância da População , Sorotipagem , Suécia/epidemiologia , Vacinação , Coqueluche/classificação , Coqueluche/epidemiologia , Coqueluche/prevenção & controleRESUMO
The definition of a case of pertussis is an essential point in evaluating and comparing the results from the seven studies on pertussis vaccines presented at the Symposium. An assessment of the impact of case definition on the evaluation of vaccine efficacy has been performed on the Italian data-set, by comparing the clinical presentation of cough illnesses which were laboratory-confirmed as B. pertussis infection with those not-confirmed, by study vaccine. The results show that the estimate of vaccine efficacy is greatly variable by the choice of case definition and dependent on the study design. The assessment of the effect of each vaccine should be performed by using various clinical endpoints and the method used in detection of suspected cases in each study should be carefully evaluated to verify comparability of results.
