RESUMO
In Chile, an increased number of notifications of cases of whooping cough was detected at the beginning of October 2010, and maintained through 2012. Accumulated cases during 2011 were 2,581 (15.0 per 100,000), which is greater than the number of cases registered during the period 2008-2010 (2,460 cases). On the other hand, the local sanitary authority introduced a modification of pertussis vaccination schedule (starting 2012), which consists in the replacement of the second booster of pertussis vaccine (DTwP, administered to 4-year-old children) as well as diphtheria-tetanus toxoid (dT, administered to second grade scholars) for an acellular pertussis vaccine with reduced antigenic content (dTpa), which will be administrated to first grade scholars. The Consultive Committee of Immunizations considers that the modification is adequate, since it extends the age of protection, reducing at least in theory the infection in older scholars and adolescents -who are significant sources of transmission of Bordetella pertussis to infants- using an adequate vaccine formulation (acellular pertussis vaccine). The available evidence regarding vaccination in special groups (adolescents and adults, health-care workers and pregnant women) and cocooning strategy are commented.
Assuntos
Conferências de Consenso como Assunto , Vacinas contra Difteria, Tétano e Coqueluche Acelular/normas , Vacinação em Massa/métodos , Coqueluche/prevenção & controle , Adolescente , Adulto , Pré-Escolar , Chile/epidemiologia , Feminino , Humanos , Esquemas de Imunização , Lactente , Masculino , Avaliação de Resultados em Cuidados de Saúde , Gravidez , Coqueluche/epidemiologia , Adulto JovemRESUMO
In Chile, an increased number of notifications of cases of whooping cough was detected at the beginning of October 2010, and maintained through 2012. Accumulated cases during 2011 were 2,581 (15.0 per 100,000), which is greater than the number of cases registered during the period 2008-2010 (2,460 cases). On the other hand, the local sanitary authority introduced a modification of pertussis vaccination schedule (starting 2012), which consists in the replacement of the second booster of pertussis vaccine (DTwP, administered to 4-year-old children) as well as diphtheria-tetanus toxoid (dT, administered to second grade scholars) for an acellular pertussis vaccine with reduced antigenic content (dTpa), which will be administrated to first grade scholars. The Consultive Committee of Immunizations considers that the modification is adequate, since it extends the age of protection, reducing at least in theory the infection in older scholars and adolescents -who are significant sources of transmission of Bordetella pertussis to infants- using an adequate vaccine formulation (acellular pertussis vaccine). The available evidence regarding vaccination in special groups (adolescents and adults, health-care workers and pregnant women) and cocooning strategy are commented.
En Chile, a comienzos del mes de octubre de 2010 se detectó un aumento en la notiicación de casos de coqueluche, dinámica que se ha mantenido a la fecha (abril 2012). El número de casos acumulados durante 2011 ascendió a 2.581 (15,0/100.000 hab.), cifra superior al número de casos registrados durante el período 2008-2010 (2.460 casos). Por su parte, a partir de 2012 la autoridad sanitaria introdujo una modiicación en el esquema de vacunación anti-pertussis, consistente en el reemplazo del segundo refuerzo de vacuna antipertussis (DTwP, administrada a los 4 años) y del refuerzo de toxoide diftérico-tetánico (dT, administrado en segundo básico) por la vacuna anti-pertussis acelular de contenido antigénico reducido (dTpa), a ser administrada en primero básico. El Comité Consultivo de Inmunizaciones considera la modificación adecuada, por cuanto permite extender el tiempo de protección, reduciendo al menos en teoría la infección en escolares mayores y adolescentes -quienes son importantes fuente de contagio de Bordetella pertussis para los lactantes- utilizando una adecuada formulación de vacuna (vacuna antipertussis acelular). Se comenta la evidencia disponible sobre vacunación anti-pertussis en grupos especiales (adolescentes y adultos, funcionarios de la salud y mujeres embarazadas), y la estrategia de vacunación de capullo.
Assuntos
Adolescente , Adulto , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Gravidez , Adulto Jovem , Conferências de Consenso como Assunto , Vacinas contra Difteria, Tétano e Coqueluche Acelular/normas , Vacinação em Massa/métodos , Coqueluche/prevenção & controle , Chile/epidemiologia , Esquemas de Imunização , Avaliação de Resultados em Cuidados de Saúde , Coqueluche/epidemiologiaRESUMO
This article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associated diseases globally and in Chile, and the scientific information of the licensed HPV vaccines: Gardasil and Cervari. Considering the available information, the Advisory Committee on Immunizations of the Chilean Society of Infectious Diseases recommends vaccination of teenage girls, ideally before initiating sexual activity, i.e., approximately at the age of 12 to 13 years and vaccination of women of any age if they have not started sexual activity. If women are vaccinated after initiating sexual activity, they should be informed of the lower efficacy of immunization if HPV infection has occurred. Education on responsible sexuality and sexually transmitted diseases should be maintained as a priority. Vaccination should be highly considered for inclusion in the National Immunization Program.