论文部分内容阅读
贵州省 1999～ 2 0 0 1年从急性弛缓性麻痹 (AFP)病例粪便标本中分离到脊髓灰质炎 (脊灰 )疫苗病毒 5 3株 ,对其进行了流行病学分析。 5 3例AFP病例分布在全省 8个地区 (州、市 ,下同 )的 31个县 (市、区 ) ,发病时间无明显的聚集趋势。≤ 3岁儿童 4 8例 ,占 90 .6 % ;未免疫和未全程免疫的 38例 ,占 71.7%。其特点是 :全省 9个地区中 8个有病例 ,病例呈散在分布 ;分离出的脊灰疫苗病毒以Ⅱ型为主 (32例 ,占 6 0 .4 % ) ,3年分离的Ⅱ型脊灰疫苗病毒数均超过本年Ⅰ型和Ⅲ型的总和 ;病例中零剂次免疫儿童发病 6 0d后仍残留麻痹的占 82 .4 % ;8例高度怀疑疫苗相关麻痹型脊灰 (VAPP)病例均为 <3岁儿童 ;免疫史为零剂次和 1剂次 ;麻痹时伴发热 ,为不对称麻痹 ,发病 6 0d随访仍残留麻痹并有肌肉萎缩。提示贵州省AFP病例中检出脊灰疫苗病毒的病例 ,集中在 <3岁未免疫和未全程免疫的儿童。因此要高度重视VAPP病例 ,提高和保持高水平的常规免疫覆盖率 ,巩固AFP病例监测质量是保持无脊灰状态、及时发现输入病例和防止疫苗衍生脊灰病毒病例发生的关键。
Fifty-three strains of poliovirus (poliovirus) were isolated from stool samples of acute flaccid paralysis (AFP) cases from 1999 to 2001 in Guizhou province and epidemiological analysis was conducted. 53 cases of AFP were distributed in 31 counties (cities and districts) in 8 districts (state, city, the same below) in the province, with no obvious trend of aggregation at the time of onset. 38 cases of children ≤ 3 years old, accounting for 90.6%; 38 cases of unimmunized and incomplete immunization, accounting for 71.7%. Its characteristic is: There are 8 cases in 9 districts in the province, the cases are scattered; the isolated poliovirus is mainly type Ⅱ (32 cases, 60.4%), type Ⅱ The number of poliovirus in poliovirus was more than the sum of type I and type III in this year; children with zero-dose immunization still remained paralysis after 82 days, accounting for 82.4%; 8 highly suspected vaccine-associated paralytic poliovirus (VAPP ) Cases were all <3 years old children; immunization history was zero dose and 1 dose; paralysis with fever, asymmetric paralysis, the incidence of 60d follow-up remains paralysis and muscle atrophy. The cases of poliovirus detected in AFP cases in Guizhou Province were promptly concentrated in children less than 3 years old who were not immunized and not fully immunized. Therefore, to attach great importance to VAPP cases, to improve and maintain a high level of routine immunization coverage, and to consolidate the quality of AFP case monitoring remain polio-free, timely detection of imported cases and prevention of vaccine-derived poliovirus cases are the key.