Active case finding in homeless shelters resulted in a decrease in case clustering, mainly in shelter users. Genotyping contributed to confirming the positive impact of the intervention.

was replaced in 2005 by a pertussis subunit vaccine. This acellular pertussis vaccine for children, which had been used since 1998 for adolescents only, contains either two or three bacterial proteins. The acellular pertussis vaccine for adults contains either three or five bacterial proteins in reduced doses compared with those used for children. Since 1966, childhood vaccination against these four diseases has been via a combined diphtheria-tetanus-wholecell-pertussis-inactivated-poliomyelitis vaccine, to which a vaccine against Haemophilus influenza b was added in 1992.The French vaccine calendar originally consisted of a primary vaccination against diphtheria, tetanus, polio and pertussis at age 3, 4 and 5 months and one booster at age 16-18 months. Since 1995, the primary vaccination has been administered at age 2, 3 and 4 months. 1 Boosters comprising a combined diphtheria-tetanus-inactivated-polio vaccine were administered at age 5-7 years, 11-13 years and 16-18 years, followed by a combined tetanus-inactivated-polio vaccine every 10 years thereafter. In 1998, recommendations stated that a combined vaccine including acellular pertussis vaccine and the three other vaccines should be administered at age 11-13 years and these recommendations were extended in 2004 to young adults of reproductive age and health-care workers in contact with newborn babies. A booster with a reduced dose of diphtheria toxoid was added for adult travellers in 1994. In 2005, adults were advised to receive a diphtheria-vaccine booster every 10 years.Since 1966, vaccination coverage has always been very high for primary vaccination (>93%) and the first booster (85-92%) in France. 2,3 In contrast, vaccination coverage is lower in people aged more than 16 years: 88.5% for tetanus vaccine, 66% for poliomyelitis and 57.1% for diphtheria in a study performed in 2002. 3 In subjects aged more than 65 years, boosters for tetanus, poliomyelitis and diphtheria had been received by only 60.5%, 19.3% and 10.5%, respectively, of the study population. 3 Vaccination against tetanus has resulted in the disappearance of this disease in children and adolescents in France. However, 67 cases of tetanus were reported between 2002 and 2004: 64 cases occurredIn this sero-epidemiological study, we investigated humoral immunity to three vaccine-preventable diseases-tetanus, diphtheria and pertussis-among 331 adults (aged 18-60 years) attending vaccination centres for travellers and who had been vaccinated according to national recommendations in France. Serological results showed that the percentage of subjects with antibodies to diphtheria and tetanus decreases with age. Results also confirmed surveillance data on vaccination in France, with 7.6% of the study population (13.4% of those aged 18-29 years) having recently acquired a pertussis infection. These results confirm the importance of following French recommendations for regular boosters for tetanus and diphtheria among adults. They also indicate the need for better implementation of the current recomm...

This study was to assess the humoral immune response induced by a vaccination schedule routinely used in France in 18-50 year old adults with unknown vaccination history. In this monocentric, prospective study, subjects received one dose of REVAXIS® (dT-IPV, diphtheria, tetanus and poliomyelitis (inactivated) vaccine (adsorbed, reduced antigen(s) content)) (Visit 1) followed by one dose of REPEVAX® (dTap-IPV, diphtheria, tetanus, pertussis (acellular, component) and poliomyelitis (inactivated) vaccine (adsorbed, reduced antigen(s) content)) one month later (Visit 2). Antibodies against diphtheria, tetanus, poliomyelitis types 1, 2 and 3, and pertussis toxin (PT) were measured one month after the administration of REPEVAX® (Visit 3). A total of 136 subjects were included in the study, but blood samples were available for only 73 subjects. Their mean age at inclusion was 33.2 ± 7.3 years. 49.3% of the 73 subjects originated from the WHO African Region, 6.8% from the WHO Western Pacific Region and 5.5% from the WHO European Region. One month after REPEVAX® administration, all subjects had seroprotective antibody titers against diphtheria and tetanus (≥0.1 IU/mL), poliomyelitis types 2 and 3 (≥ 8 1/dil); one subject (1.4%) did not have antibodies against poliomyelitis type 1. The rate of anti-PT seropositivity (≥8 EU/mL) was 94.4%. One dose of REPEVAX® administered one month after a dose of REVAXIS® in subjects with unknown vaccination history induced a high humoral response. These results validate a vaccination schedule routinely used for years that rapidly elicits effective immunization against diphtheria, tetanus, poliomyelitis and pertussis.

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A multidisciplinary panel of specialists and general practitioners provided definitions for the different forms of acute pediatric rhinosinusitis, with a description of the main symptoms and signs. They emphasized the role of concomitant systemic diseases, such as allergy and immunological disorders. Incidence, description, and management of complications are presented. They also provided the indications for radiological examination and microbiological investigations. The adequate medical management, particularly the place and the type of antibiotics, is analyzed and discussed, and guidelines for practical situations are suggested.

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