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目的对广西大化县疫苗相关的脊髓灰质炎病例(VAPP)进行病例个案调查,对疫苗衍生脊髓灰质炎病毒(VDPV)进行跟踪监测,并对儿童人群进行免疫力评价。方法粪便标本用RDa和L20B细胞进行脊髓灰质炎病毒分离和中和试验鉴定分型,然后进行VP1区序列测定。儿童血清分别用ELISA及中和试验检测脊髓灰质炎病毒抗体。结果从10050病例分离到Ⅰ型VDPV,VP1区变异率为1.4%;从周围6名健康儿童分离到6株VDPVs,VP1区变异率为1.6%～2.2%。周围儿童血清脊髓灰质炎病毒IgG阳性率为77.4%,Ⅱ型脊髓灰质炎病毒中和抗体活性显著高于Ⅰ、Ⅲ型。结论VDPV发生在脊髓灰质炎疫苗免疫缺失儿童,VDPVs发生了短暂的循环。当地儿童Ⅰ、Ⅲ型脊髓灰质炎病毒血清中和抗体活性较低,应提高儿童OPV免疫覆盖率以防止VDPVs的潜在危害。
Objective To investigate case-by-case case reports on vaccine-associated poliomyelitis (VAPP) in Dahua County of Guangxi Province, and to monitor and monitor the vaccine-derived poliovirus (VDPV) and to evaluate the immunity of children. Methods Stool samples were isolated from poliovirus strains of RDa and L20B and neutralized. The VP1 region was sequenced. Serum of children were tested by ELISA and neutralization test for poliovirus antibodies. Results The type Ⅰ VDPV was isolated from 10050 cases and the mutation rate of VP1 was 1.4%. Six VDPVs were isolated from 6 healthy children. The mutation rate of VP1 was 1.6% -2.2%. Serum poliovirus IgG positive rate of children around 77.4%, type II poliovirus neutralizing antibody activity was significantly higher than Ⅰ, Ⅲ type. Conclusion VDPV occurs in polio immunocompromised children, and VDPVs have a short cycle. Local children with type I and type III poliovirus serum neutralizing antibody activity is low, children should be increased OPV immunization coverage to prevent the potential harm of VDPVs.