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目的 探讨早期发现与处理高危急性弛缓性麻痹 (AFP)病例。方法 开展高危AFP病例早期流行病学调查与评估 ,针对性实施脊灰疫苗应急强化免疫。结果 发现高危AFP16例 ,发病年龄 0～ 3岁 ,1岁占 5 6 2 5 % ;2例有聚集性 ;13例检出脊灰疫苗病毒 ,其中 4例为Ⅱ型疫苗重组株 ,密切接触者检出 3株与病例同源脊灰Ⅱ型疫苗重组株病毒 ;13例残留麻痹 ;14例为超生儿童其基础免疫为“0”剂次 ,15县病例当地乡镇脊灰疫苗接种率平均值 72 18% ,低于 85 %者 9个县 ,且流动和超生儿童明显低于常住和计生儿童 ,病例所在县均实施脊灰疫苗应急强化免疫 ,评估接种率均达95 %以上。结论 四川省曾有脊灰Ⅱ型疫苗变异病毒在自然界的局部循环 ,脊灰疫苗应急强化免疫能有效阻断该变异病毒。增强AFP监测敏感性 ,尽早发现和及时调查处理高危AFP病例 ,有利于提高敏锐发现、有力阻断输入性脊灰野病毒传播循环的整体能力。
Objective To explore the early detection and treatment of high-risk acute flaccid paralysis (AFP) cases. Methods To carry out early epidemiological investigation and evaluation of high-risk AFP cases and to conduct targeted intensified immunization of poliovirus vaccine. The results showed that high-risk AFP16 cases, the age of onset of 0 to 3 years old, 1 year old accounted for 5 625%; 2 cases of aggregation; 13 cases of poliovirus detected, of which 4 cases of type II vaccine recombinant strains, close contacts Three isolates of poliovirus type Ⅱ were detected, 13 cases were residual paralysis, 14 cases of primary immunization were “0”, and the average polio vaccination rate of local township in 15 cases was 72 18% and less than 85%, respectively, and the number of migrant children and migrant children was significantly lower than that of resident and child-bearing children. The poliovirus vaccine immunization intensified in all districts and counties, all of which reached over 95%. Conclusion There was a local circulation of poliovirus type Ⅱ vaccine mutation in nature in Sichuan Province. The emergency immunization with poliovirus could effectively block the mutation virus. Enhance the sensitivity of AFP monitoring, early detection and timely investigation and treatment of high-risk AFP cases, help to improve sensitive detection, a strong blockade of the overall ability of transmission of poliovirus transmission cycle.