Study on the establishment of the early diagnosis of Pertussis and the efficacy of vaccination
Grant-in-Aid for Scientific Research (C).
|Research Institution||KYUSHU UNIVERSITY|
OKADA Kenji KYUSHU UNIVERSITY Department of Pediatrics Assistant professor, 医学部, 講師 (80224012)
KUSUHARA Koichi KYUSHU UNIVERSITY Department of Pediatrics Instructor, 医学部, 助手 (20243941)
MIYAZAKI Chiaki KYUSHU UNIVERSITY Department of Pediatrics Assistant professor, 医学部, 講師 (30190763)
UEDA Kohji KYUSHU UNIVERSITY Department of Pediatrics Professor, 医学部, 教授 (00038647)
HIDAKA Yasufumi KYUSHU UNIVERSITY Department of Pediatrics Instructor, 医学部, 助手 (10253410)
|Project Fiscal Year
1992 – 1994
Completed(Fiscal Year 1994)
|Budget Amount *help
¥2,100,000 (Direct Cost : ¥2,100,000)
Fiscal Year 1994 : ¥400,000 (Direct Cost : ¥400,000)
Fiscal Year 1993 : ¥400,000 (Direct Cost : ¥400,000)
Fiscal Year 1992 : ¥1,300,000 (Direct Cost : ¥1,300,000)
|Keywords||Pertussis / Early Diagnosis / Bacterial Isolation / Adult pertussis / DTaP vaccine / 百日咳 / 早期診断法 / 菌分離 / IgM抗体 / 抗体持続 / IgA抗体 / 家族内感染 / 百日咳菌分離 / DPT三種混合ワクチン|
(1) Isolation of bacteria and establishment of the early diagnosis.
As an early diagnostic method of pertussis isolation of the bacteria was performed. It has been reported that the positivity of the isolated was low. However, in our current study, the isolation rate was high as 51.8%. Furthermore, 34.2% of our isolated cases were cases who had been treated with antibiotics before the isolation. This shows that isolation of the bacteria is an useful method on the early diagnosis of pertussis. And it is necessary to attempt the isolation on cases suspective of pertussis disregard the medication of antibiotics or not. On the other hand, if case who had been failed in the isolation, evaluation on a method to detect the IgM antibodies serologically as an early diagnosis has been performed, and a system of detection of the PT (pertussis toxin) IgM antibody has been established.
(2) Investigation on familial infection and adult pertussis
Familial investigation to isolated cases were performed.
As a result, bacteria were also isolated from siblings and parents who had been vaccinated. All these cases showed no typical clinical manifestation of pertussis, but only showing long term chronic coughing without serious attacks. And some mothers even did not show any coughing. Laboratory data also showed no obvious leukocytosis or relative lymphocytosis (mean white blood cell count 7040, %lymphocyte 36%). Source of infection to infants was estimated to be siblings and parents. Therefore, investigation on the familial infective status is an effective way to evaluate the efficacy of DTP vaccine, as the number of pertussis cases are decreasing in the recent years. Although the number of subject is small, the efficacy of DTP vaccine was 82%.
(3) Evaluation of the efficacy of vaccine
The persistence of antibody level is studied as a method on the evaluations of the efficacy of the vaccine. A comparative study between children vaccinated with the acellular pertussis vaccine (DTaP) improved in 1981 in Japan and children vaccinated with the whole cell pertussis vaccine (DTwP) was performed. As a result, children vaccinated with the DTaP showed higher levels of diphtheria, tetanus antibody and FHA (filmentous hemagglutinin) antibody than those vaccinated with DTwP.It might also be influenced by epidemics of pertussis in the past, the persistence of antibody was better in the DTaP vaccinees.
ワクチン有効性評価の一つとして、抗体価の持続を検討した。1981年に改良された無菌体ワクチン(DTaP)を接種されている児童と従来の全菌体ワクチン(DTwP)を接種された児童とを比較検討した。この結果、DTaPを接種された児童は、DTwPを接種された児童よりジフテリアおよび破傷風抗毒素抗体やFHA 抗体に関して高い抗体価を保有していた。過去の百日咳の流行状況などにも影響されるが、DTaPの方が抗体持続が良好であった。 Less
Research Output (8results)