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目的对1例脊髓灰质炎疫苗相关病例(VAPP)进行分析,探讨控制策略和异常反应补偿机制。方法对病例开展流行病学调查,结合临床表现和实验室检测结果,由省级专家组作出诊断。结果患儿有明确服苗史,出现早期发热、面瘫和渐进性单侧肢体瘫痪,粪便分离出疫苗相关株病毒,经国家实验室确认为“脊灰疫苗株Ⅲ型”。主动搜索未发现其他类似症状病例,不能排除VAPP。最后诊断为“急性迟缓性麻痹(AFP)”。结论积极推动灭活脊灰疫苗(IPV)+减毒脊灰活疫苗(OPV)序贯免疫程序,可避免VAPP的发生。国家应尽量完善预防接种异常反应补偿机制,以最大保证补偿的公平性。
Objective To analyze a case of poliomyelitis vaccine (VAPP) and discuss the control strategy and the mechanism of abnormal response compensation. Methods To carry out epidemiological investigation of cases, combined with clinical manifestations and laboratory test results, by the provincial expert group to make a diagnosis. Results The children had a clear history of serving Miao, early fever, facial paralysis and progressive paralysis of unilateral limbs, feces isolated vaccine-related strains of viruses, confirmed by the National Laboratory as a “polio vaccine strain Ⅲ type.” Active search found no other similar symptoms, can not rule out VAPP. The final diagnosis was “Acute Delayed Paralysis (AFP)”. Conclusion VAPP can be avoided by actively promoting the sequential immunization program of inactivated poliovirus (IV) + attenuated poliovirus live vaccine (OPV). The state should try its best to improve the compensation mechanism for abnormal response to vaccination, so as to ensure the fairness of compensation.