【摘要】 目的:分析《百日咳诊疗标准(2023年版)》实施后江苏省百日咳病例的流行特征及其免疫史分布，为今后防控百日咳提供理论依据。方法:以江苏省为现住址从传染病监测报告系统上收集发病时间为2024年的百日咳病例，病例的疫苗接种史根据身份证号、姓名、出生日期等关键字段从江苏省免疫规划信息系统匹配获取，描述性流行病学分析其三间分布特征，频数(n)与构成比(%)描述疫苗接种情况，χ~2检验比较组间差异，趋势检验分析完全接种比例(4剂次)的年龄变化趋势。结果:2024年江苏省累计报告22 428例百日咳病例，其中临床诊断病例1 961例(8.74%)，确诊病例20 467例(91.26%)，年报告发病率为26.31/10万，是2016—2023年年均报告率(0.25/10万)的105.24倍。病例集中分布于春夏季(3～8月)，5月报告病例数最多。0～9岁儿童所占的比例为84.43%(18 936例)，其中5～9岁年龄组人数(14 282例)远多于0～4岁年龄组的人数(4 654例)。绝大多数病例是学生(12 494例)和幼托儿童(5 948例)，占比为82.23%。所有病例中，20 268例发病时已接种过百白破疫苗，1 146例无疫苗接种史，1 014例接种记录不详。发病时百白破疫苗完成1剂次、2剂次、3剂次、4剂次接种的病例数分别为415例、228例，1 341例、18 284例。结论:江苏省在百日咳的流行期间，报告的病例数较往年(2016—2023年)显著升高，PCR等实验室确诊技术在其中发挥了重要作用，学生和托幼儿童是主要感染者，疫苗接种策略存在漏洞，应加强对学生和托幼儿童的监测与防控，及时调整免疫策略，保护人群健康。更多还原

【Abstract】 Objective: To analyze the epidemiological characteristics and vaccination history distribution of pertussis cases in Jiangsu Province after the implementation of the Diagnosis and Treatment Standards for Pertussis( 2023 Edition),providing a theoretical basis for future pertussis prevention and control. Methods: Pertussis cases with onset dates in 2024 were retrospectively retrieved from the infectious disease surveillance and reporting system,with Jiangsu Province designated as the current residence. Vaccination histories were obtained by matching key fields such as ID number,name,and date of birth from the Jiangsu Provincial Immunization Planning Information System.Descriptive epidemiological methods were used to analyze the temporal,regional,and population distributions. Frequency( n) and proportions( %) described vaccination status,with χ~2 tests comparing group differences and trend tests analyzing the age-related trend in full vaccination( 4 doses). Results: From January to December 2024,22 428 pertussis cases were reported in Jiangsu Province,of which 1 961( 8. 74%) were clinical diagnosis cases and 20 467( 91. 26%) were confirmed cases. The annual reported incidence rate was 26. 31/100 000,105. 24 times higher than the average annual rate from 2016—2023( 0. 25/100 000). Cases were concentrated in spring and summer( March to August),with the highest number reported in May. Children aged 0-9 years accounted for84. 43%( 18 936 cases) of the total cases,with the 5-9 age group( 14 282 cases) significantly outnumbering the0-4 age group( 4 654 cases). Students( 12 494 cases) and kindergarten children( 5 948 cases) collectively represented 82. 23% of all cases. Vaccination records indicated that 20 268 cases had received at least one dose of the diphtheria,tetanus,and pertussis( DTP) vaccine prior to onset,while 1 146 were unvaccinated and 1 014 had undocumented vaccination status. Specifically,the numbers of cases who had completed 1,2,3,and 4 doses of DTP vaccination were 415,228,1 341,and 18 284. Conclusion: During the pertussis epidemic in Jiangsu Province,reported cases increased significantly compared to previous years( 2016—2023),with PCR and other laboratory confirmation techniques playing a crucial role. Students and kindergarten children emerged as the primary vulnerable populations,indicating potential deficiencies in the existing vaccination strategy. To effectively mitigate the spread of pertussis,it is imperative to enhance surveillance and implement targeted prevention and control measures among these high-risk groups,while also promptly revising and optimizing the immunization program to safeguard public health.更多还原