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目的了解河北省2011-2015年急性弛缓性麻痹(acute flaccid paralysis,AFP)病例中检出脊髓灰质炎(脊灰)疫苗株病毒阳性病例的流行病学特征。方法采用描述性流行病学方法分析河北省2011-2015年报告的AFP病例资料,主要包括病例的流行病学调查资料和采集标本的实验室检测结果。结果从1 889例AFP病例的标本中检出脊灰病毒52株,检出率为2.75%,其中50株为脊灰疫苗相关株病毒,2株为脊灰疫苗高变异脊灰病毒(vaccine high-mutant poliovirus,VHMPV)。病例散在发生,无聚集性;≤3岁儿童病例占82.69%;61.54%的病例脊灰疫苗接种次数≥3次。诊断疫苗相关脊灰病例(vaccine-associated paralytic poliomyelitis,VAPP)11例,首次服苗VAPP发生率为1.86/100万。结论VAPP、疫苗衍生脊灰病毒(vaccine-derived poliovirus,VDPV)引起的麻痹病例及可能造成的VDPV循环(circulating VDPV,c VDPV)必须引起高度重视,保持高质量的监测水平和脊灰疫苗高接种率是非常必要的,可有利于及时发现并科学处置输入的脊灰野病毒疫情以及由脊灰疫苗引起的相关病例,避免造成传播和流行,保障广大儿童的健康。
Objective To investigate the epidemiological characteristics of positive cases of poliomyelitis (polio) vaccine strains detected in acute flaccid paralysis (AFP) from 2011 to 2015 in Hebei Province. Methods A descriptive epidemiological method was used to analyze the data of AFP cases reported in Hebei Province from 2011 to 2015, including the epidemiological survey data of cases and the laboratory test results of collected samples. Results A total of 528 poliovirus strains were detected from 1 889 cases of AFP, with a detection rate of 2.75%, of which 50 were poliovirus-related strains and 2 were high-polio-poliovirus -mutant poliovirus, VHMPV). Cases occurred scattered, no aggregation; children ≤ 3 years old accounted for 82.69%; 61.54% of cases polio vaccination ≥ 3 times. Eleven patients were diagnosed as vaccine-associated paralytic poliomyelitis (VAPP). The incidence of VAPP in the first dose was 1.86 / 1 million. Conclusions VAPP, paralysis caused by vaccine-derived poliovirus (VDPV) and possible VDPV circulating circulating virus (VDPV) must be given high priority to maintain high quality surveillance and high vaccination of poliovirus The rate is very necessary to facilitate the timely detection and scientific disposal of imported poliovirus outbreaks and the related cases caused by poliovirus vaccine so as to avoid the spread and epidemic and ensure the health of the vast majority of children.