Новые возможности вакцинопрофилактики коклюша

The review provides information about the current features of the spread of whooping cough among children and adolescents. It is shown that there is a shift in morbidity to an older age group of the population, which is facilitated by changes in the properties of the pathogen and the widespread use of drugs based on cell-free technology as primary vaccination. Information is given about the possibility of preventing morbidity among schoolchildren and adults by introducing additional revaccinating doses against whooping cough with special drugs in the vaccination calendars. Information is given on effective protection of newborns against this infection by immunization of pregnant women. In our country, there is an opportunity to expand pertussis immunoprophylaxis among children of preschool-school age and adults within regional programs and individual vaccination with acellular pertussis-diphtheria-tetanus vaccines, which has a high profile of safety and immunological effectiveness.В обзоре обобщены данные о современных особенностях распространения коклюша среди детей и подростков. Показано, что происходит смещение заболеваемости в более старшую возрастную группу, чему способствуют изменения свойств возбудителя и повсеместное использование в качестве первичной вакцинации препаратов на основе бесклеточной технологии. Приведены сведения о возможности предотвращения заболеваемости среди школьников и взрослых путём введения в календари прививок дополнительных ревакцинирующих доз против коклюша бесклеточными вакцинами. Даётся информация по эффективной защите новорождённых против данной инфекции путём иммунизации беременных. В качестве ревакцинации против коклюша среди детей дошкольно-школьного возраста и взрослых в рамках региональных программ и индивидуальной вакцинопрофилактики возможно использовать бесклеточные АбКДС-М вакцины, которые имеют высокий профиль безопасности и иммунологической эффективности

Безопасность применения коклюшных вакцин у подростков

Aim: to investigate the safety of acellular pertussis vaccines for adolescents.Materials and methods. The clinical tolerability of revaccination against pertussis (cell-free component), diphtheria and tetanus was analyzed in 107 children aged 13,5–14 years. Group 1 consisted of children revaccinated with DTacP-IPV combined vaccine (Tetraxim), group 2 – vaccinated with Td and group 3 – children who received Tdap vaccine (Adacel).Results. Statistically significant differences in the frequency of local reactions between the group that received Tdap and the other two (DTacP-IPV and Td) were detected (p = 0.001and p = 0.04, respectively). Analysis of the structure of local reactions revealed a difference only in the occurrence of the hyperemia at the site of injection, with the most frequent registration in the groups of children vaccinated with DTacPIPV (29,4%) and Td (14,7%), whereas in patients vaccinated with Tdap – only in 5,9% (χ2 = 6,8 p = 0,03). Systemic reactions occurred with the same frequency in all studied groups and did not require medical correction, as well as local reactions. Thus, revaccination against pertussis, diphtheria and tetanus of adolescents using Tdap, containing the acellular pertussis component, does not exceed the frequency of systemic reactions and the number of local reactions is significantly lower in comparison with the vaccine with a reduced content of diphtheria and tetanus toxoids (Td) that is used in practice for a long time.Цель: изучение безопасности применения ацеллюлярных коклюшных вакцин у подростков.Материалы и методы. Проведен анализ клинической переносимости ревакцинации против коклюша (бесклеточный компонент), дифтерии и столбняка у 107 детей в возрасте 13,5–14 лет. 1 группу составили дети, ревакцинированные препаратом АбКДС-ИПВ (Тетраксим), 2 группу – привитые препаратом АДС-М и 3 группу – дети, получившие вакцину АбКДС-М (Адасель).Результаты. Выявлены статистически значимые различия по частоте встречаемости местных реакций между группой, получившей АбКДС-М, и двумя другими (АбКДС-ИПВ и АДС-М) (p=0,001 и p=0,04 соответственно). Анализ структуры местных реакций выявил различие показателей только по частоте возникновения гиперемии на месте инъекции, которая более часто отмечалась в группах детей, привитых АбКДС-ИПВ (29,4%) и АДС-М (14,7%), тогда как у пациентов, ревакцинированных АбКДС-М, регистрировалась только в 5,9% (χ2 =6,8 p=0,03). Системные реакции встречались с одинаковой частотой во всех исследуемых группах и не требовали медикаментозной коррекции, так же, как и местные реакции. Таким образом, ревакцинация против коклюша, дифтерии и столбняка подростков с использованием препарата АбКДС-М, содержащего бесклеточный коклюшный компонент, не вызывает повышения частоты системных реакций, а количество местных реакций достоверно ниже по сравнению с их встречаемостью при применении давно используемой на практике вакцины с уменьшенным содержанием дифтерийного и столбнячного анатоксинов АДС-М.

New features of pertussis vaccination

The review provides information about the current features of the spread of whooping cough among children and adolescents. It is shown that there is a shift in morbidity to an older age group of the population, which is facilitated by changes in the properties of the pathogen and the widespread use of drugs based on cell-free technology as primary vaccination. Information is given about the possibility of preventing morbidity among schoolchildren and adults by introducing additional revaccinating doses against whooping cough with special drugs in the vaccination calendars. Information is given on effective protection of newborns against this infection by immunization of pregnant women. In our country, there is an opportunity to expand pertussis immunoprophylaxis among children of preschool-school age and adults within regional programs and individual vaccination with acellular pertussis-diphtheria-tetanus vaccines, which has a high profile of safety and immunological effectiveness

Kawasaki syndrome: Risk factors for coronary artery aneurysms

Kawasaki syndrome is a childhood systemic vasculitis that may affect coronary arteries, further leading to myocardial ischemia or myocardi-al infarction. This investigation is our country's first experience with regression analysis to find risk factors for coronary artery involvement in Kawasaki syndrome. The outpatient and inpatient medical records of 168 KD patients aged 1 month 13 days to 13 years 6 months were retrospectively analyzed. Results. The investigators revealed risk factors for coronary artery involvement: persistent fever; prolonged fever prior to immunoglobulin infusion; low hemoglobin in acute phase; leukocytosis more than 17* 109/l in acute phase; thrombocytosis more than 790-109/! and obviously increased erythrocyte sedimentation rate; a more than 5-fold rise in normal C-reactive protein; immunoglobulin administration after day 10; and no immunoglobulin therapy. The dose of immunoglobulin of 2 g/kg reduces the risk of coronary artery aneurysms, but its effect depends on the day of administration. Cervical lymphadenopathy and immunoglobulin resistance may be risk factors for coronary artery aneurysms, but further investigations are needed to solve this problem

Safety of pertussis vaccines for adolescents

Aim: to investigate the safety of acellular pertussis vaccines for adolescents.Materials and methods. The clinical tolerability of revaccination against pertussis (cell-free component), diphtheria and tetanus was analyzed in 107 children aged 13,5–14 years. Group 1 consisted of children revaccinated with DTacP-IPV combined vaccine (Tetraxim), group 2 – vaccinated with Td and group 3 – children who received Tdap vaccine (Adacel).Results. Statistically significant differences in the frequency of local reactions between the group that received Tdap and the other two (DTacP-IPV and Td) were detected (p = 0.001and p = 0.04, respectively). Analysis of the structure of local reactions revealed a difference only in the occurrence of the hyperemia at the site of injection, with the most frequent registration in the groups of children vaccinated with DTacPIPV (29,4%) and Td (14,7%), whereas in patients vaccinated with Tdap – only in 5,9% (χ2 = 6,8 p = 0,03). Systemic reactions occurred with the same frequency in all studied groups and did not require medical correction, as well as local reactions. Thus, revaccination against pertussis, diphtheria and tetanus of adolescents using Tdap, containing the acellular pertussis component, does not exceed the frequency of systemic reactions and the number of local reactions is significantly lower in comparison with the vaccine with a reduced content of diphtheria and tetanus toxoids (Td) that is used in practice for a long time