Abstract：Objective To investigate the epidemiological and clinical characteristics of cases with pertussis in Yiwu City, Zhejiang Province, so as to provide insights into pertussis diagnosis and control. Methods A total of 186 patients with definitive diagnosis of pertussis in medical institutions in Yiwu City from November 1, 2020 to August 31, 2022 were recruited, and subjects' demographic, clinical symptoms and history of pertussis vaccination were collected using questionnaire surveys. The temporal, population, and spatial distribution and clinical symptoms of pertussis were analyzed using a descriptive epidemiological method, and the clinical characteristics of pertussis patients with different doses of pertussis vaccination were compared. Results Pertussis was found to predominantly occur during the period between July and November (101 cases, 54.30%), and the three highest-incidence regions included Jiangdong Street, Beiyuan Street and Choujiang Street (87 cases, 46.77%). The 186 pertussis cases included 105 males (56.45%) and 81 females (43.55%), and included 144 cases with age of onset under 7 year (77.42%). Preschool and diaspora children were predominant among all pertussis cases, and the main clinical symptoms included spasmodic cough (97 cases, 52.15%), post-tussive vomiting (82 cases, 44.09%) and aggravated cough at night (77 cases, 41.40%). Routine blood tests measured 119 cases with abnormal white blood cell counts (63.98%), 137 cases with abnormal lymphocyte counts (73.66%), 39 cases with abnormal neutrophil counts (20.97%), 21 cases with abnormal platelet counts (11.29%) and 111 cases with abnormal hemoglobin concentrations (59.68%). There were 55 cases that were unvaccinated (29.57%), 23 cases that were not fully vaccinated (12.37%), and 108 cases that were fully vaccinated (58.06%). There were significant differences among pertussis cases with different doses of vaccination in terms of age, incidence of post-tussive vomiting, percentage of abnormal platelet counts and percentage of hemoglobin concentrations (all P<0.05). Conclusions The majority of pertussis cases are preschool and diaspora children in Yiwu City from November 1, 2020 to August 31, 2022, and the clinical symptoms mainly include spasmodic cough, post-tussive vomiting and aggravated cough at night, with atypical symptoms. The capability for differential diagnosis of pertussis is required to be improved in medical institutions.
[1] 姚开虎,胡亚红,袁林.婴儿百日咳的流行病学意义及其临床特点[J]. 中国当代儿科杂志,2022,24(9):955-959. [2] 张莉萍,汪梦,王鹏飞,等.百日咳再现的原因分析及防控策略研究[J]. 中国初级卫生保健,2022,36(7):80-83. [3] SCANLON K,SKERRY C,CARBONETTI N.Role of major toxin virulence factors in pertussis infection and disease pathogenesis[J]. Adv Exp Med Biol,2019,1183:35-51. [4] 中华人民共和国国家卫生健康委员会.2019年全国法定传染病疫情概况[EB/OL]. [2023-10-10]. http://www.nhc.gov.cn/jkj/s3578/202004/b1519e1bc1a944fc8ec176db600f68d1.shtml. [5] 中华人民共和国卫生部.卫生部公布2010年1月及2009年度全国法定传染病疫情[EB/OL]. [2023-10-10]. http://www.nhc.gov.cn/jkj/s3578/201002/8f762b4fc0a04305b5b75e27d6ffe5b8.shtml. [6] 陈海燕,蒋剑文,张毅,等.2020—2021年绵阳市百日咳患儿临床特征及影响因素探讨[J]. 四川医学,2023,44(2):173-177. [7] 中华医学会儿科学分会临床药理学组,国家儿童健康与疾病临床医学研究中心,中华医学会儿科学分会呼吸学组,等.中国儿童咳嗽诊断与治疗临床实践指南(2021版)[J]. 中华儿科杂志,2021,59(9):720-729. [8] 田红霞,任重,刘兰,等.2005—2019年株洲市百日咳流行特征分析[J]. 预防医学,2021,33(4):395-397,403. [9] 刘艳,沈建勇,张超,等.2012—2022年湖州市百日咳流行特征分析[J]. 预防医学,2023,35(9):811-813,819. [10] 杜艳,任佳,张莉萍,等.上海市闵行区2017—2019年百日咳监测分析[J]. 上海预防医学,2021,33(11):1040-1045. [11] ACOSTA A M,DEBOLT C,TASSLIMI A,et al.Tdap vaccine effectiveness in adolescents during the 2012 Washington State pertussis epidemic[J]. Pediatrics,2015,135(6):981-989. [12] MCGIRR A,FISMAN D N.Duration of pertussis immunity after DTaP immunization:a meta-analysis[J]. Pediatrics,2015,135(2):331-343. [13] 中华医学会儿科学分会感染学组,《中华儿科杂志》编辑委员会.中国儿童百日咳诊断及治疗建议[J]. 中华儿科杂志,2017,55(8):568-572. [14] MIKELOVA L K,HALPERIN S A,SCHEIFELE D,et al.Predictors of death in infants hospitalized with pertussis:a case-control study of 16 pertussis deaths in Canada[J]. J Pediatr,2003,143:576-581. [15] 唐学雯,周洋,汪颖,等.浙江省百日咳报告病例流行特征分析[J]. 预防医学,2020,32(7):712-714. [16] 王志刚,林献丹,杨晓霞,等.温州市健康人群百日咳和白喉抗体水平调查[J]. 预防医学,2016,28(6):565-569,573. [17] CRUZ A,PARKINSON A J,HALL D,et al.Associations of early childhood infections and reduced hemoglobin levels in a historic cohort of Alaska native infants[J]. Arctic Med Res,1990,49(4):175-179.
