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目的对济南市环境污水中监测到Ⅱ型(Type 2)疫苗高变异脊髓灰质炎(脊灰)病毒(Vaccine Hypervariable Poliovirus,VHPVⅡ)/疫苗衍生脊灰病毒(Vaccine-derived Poliovirus,VDPVⅡ)后,进行流行病学调查和处置,为维持无脊灰提供参考。方法对济南市口服脊灰减毒活疫苗(Oral Poliomyelitis Attenuated Live Vaccine,OPV)常规免疫和补充免疫活动进行评估,开展0~47月龄儿童OPV接种率调查,对急性弛缓性麻痹(Acute Flaccid Paralysis,AFP)病例监测情况进行评价,继续采集污水标本开展脊灰病毒监测。结果济南市适龄儿童OPV各剂次接种率均>99%,2010~2012年全市<15岁儿童非脊灰AFP病例报告发病率均>1/10万,合格粪便标本采集率均>90%,AFP病例监测系统灵敏,能够及时发现病例,后续采集的污水中未检测到VHPV/VDPV。结论VHPV/VDPV在当地引起传播的风险较小,但污水采集点辐射范围内流动人口较多,应进一步加强AFP病例监测和OPV接种,防止VHPV/VDPV在人群中循环。
Objective To detect the type 2 vaccine of Vaccine Hypervariable Poliovirus (Vaccine-derived Poliovirus) and VDPVⅡ in environmental wastewater of Jinan City Epidemiological investigation and disposal, to provide reference for maintaining polio. Methods The routine immunization and supplementary immunization activities of Oral Poliomyelitis Attenuated Live Vaccine (OPV) in Jinan were evaluated. The OPV inoculation rate in children aged 0-47 months was investigated. Acute Flaccid Paralysis , AFP) case surveillance to assess the situation, continue to collect sewage samples for poliovirus surveillance. Results The inoculation rates of OPV in each school-age children in Ji’nan city were> 99%. The incidence of non-polio AFP cases in children <15 years old from 2010 to 2012 was> 1/10, and that of qualified stool specimens> 90% AFP case monitoring system is sensitive, timely detection of cases, the subsequent collection of sewage did not detect VHPV / VDPV. Conclusions VHPV / VDPV is less likely to spread locally. However, there are more floating population in the radiation area of sewage collection sites. Monitoring of AFP and OPV vaccination should be further strengthened to prevent VHPV / VDPV from circulating in the population.