倉敷地区の百日咳流行の現状: とくに, 家庭内二次感染率とワクチンの効果について

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タイトル別名
  • Recent Outbreak of Pertussis in Kurashiki: With Special Reference to Infectivity in Home Exposures and Efficacy of Vaccination
  • クラシキ チク ノ ヒャクニチゼキ リュウコウ ノ ゲンジョウ トクニ カテイ

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Pertussis cases treated in our clinic from January 1975 to December 1977 included: 98 cases in 1975, 179 cases in 1976, and 328 cases in 1977. Among 605 cases, 18 cases were diagnosed by isolation of Bordetella pertussis organisms, and 20 cases by four-fold rise in antibody titer. The diagnosis of the remainder of 567 cases was made from clinical symptoms and peripheral blood findings.<BR>A monthly variation was found in the incidence of the disease. The high incidences were seen in April and August. It was of interest that a number of patients in spring has increased year by year. All patients were in under 8 years of age. The proportion of patients above 3 years of age has become higher year after year: 18.4% in 1975, 37.3% in 1976, and 43.7% in 1977. The reason for this age difference may be attributed to advancing in ages of unvaccinated children after the discontinuation of pertussis immunization in this area since 1973.<BR>Of 87 unvaccinated siblings in 81 homes, 61 were infected in home exposures to pertussis. The average infection-rate was 70%. Between 0 and 4 years, the infection-rates did not vary with ages. On the contrary, of 118 vaccinated siblings in 98 homes, only 10 were infccted, giving the average infection-rate of 8.5%. In this case, the higher infection-rates were obtained in the younger siblings. Based on the results, it is evident that vaccination has contributed to striking reduction in infectionrate.<BR>An analysis on symptoms and laboratory findings was made for 38 cases confirmed bacteriologically and 66 symptomatic cases who had infeted to siblings. The incidence of inspiratory whoop was 70-74%, and that of peripheral white blood cell count over 15, 000/mm3 and of lymphocyte count over 70% at the 2nd week of illness was 50-55% and 45-52% respectively.

収録刊行物

  • 感染症学雑誌

    感染症学雑誌 52 (5), 129-136, 1978

    一般社団法人 日本感染症学会

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