中国疫苗衍生脊髓灰质炎病毒循环事件的流行病学调查  

Firstly Detecting and Conducting of Circulating Type Vaccine-derived Poliovirus in China

作　　者：温宁[1] 左树岩[1] 殷大鹏[1] 夏伟[1] 邹建[2] 喻浩[2] 

机构地区：[1]中国疾病预防控制中心免疫规划中心,北京100050 [2]贵州省疾病预防控制中心,贵阳550004

出　　处：《中国计划免疫》2005年第4期248-251,共4页Chinese Journal of Vaccines and Immunization

摘　　要：目的了解中国首次发生的疫苗衍生脊髓灰质炎(脊灰)病毒(VDPV)循环事件中,病例的临床检查及流行病学调查情况。方法急性弛缓性麻痹(AFP)病例按个案调查表进行,临床符合脊灰病例由国家和省级AFP病例分类专家诊断小组会诊并做出最后分类。结果2004年8月6日,中国疾病预防控制中心(CDC)病毒病预防控制所国家脊灰实验室经序列分析发现,贵州省CDC送检的1例AFP病例脊灰病毒分离物为Ⅰ型VDPV,病毒株VP1区与Sabin疫苗株脊灰病毒相比有≥1%核苷酸变异。在此后开展的一系列调查和实验室检测中,又发现1例VDPV病例,此2例的3名接触者中分离到VDPV,并在1例高危AFP病例的密切接触者粪便标本中分离到1株VDPV,证实贞丰县发生了VDPV循环。经调查发现,本次疫情发生于口服脊灰减毒活疫苗(OPV)覆盖率较低、人口密度较大、流动人口相对较多、卫生条件较差的山区。结论经过AFP病例主动搜索、OPV强化免疫活动的开展等多项控制措施,阻断了VDPV的循环。Objective To introduce the epidemiology investigation and clinical test of the circulating type Ⅰ vaccine-derived poliovirus （VDPV） cases. Method AFP cases were investigated according to the AFP investigation form issued by MOH.The clinical polio cases diagnosed by national and provincial clinical experts. Results In August 2004, type Ⅰvaccine-derived poliovirus （VDPV） was isolated from 2 AFP cases and 3 conductors in Yaoshang Village, Zhenfeng County, Qianxinan Prefecture, Guizhou Province. The first case was a 3-year old boy with 0-dose of OPV and paralysis onset 13 June 2004.The second case was a 1-year old boy with 0-dose of OPV with paralysis onset 11 July 2004.Type Ⅰ VDPV was also isolated from two of 21 conductors. By sequence analysis, the virus isolated from the cases and the conductors differed by 9-11 nucleotides （1.0-1.2%） compared to the reference Sabin Ⅰ strain. Conclusion Immunization coverage investigation, active search for AFP cases and Supplementary Immunization Activities （SIA） in Guizhou Province to control AFP, similar strains have not been isolated in other parts of Guizhou or China.

关 键 词：急性弛缓性麻痹(AFP) 疫苗衍生脊髓灰质炎病毒 高危AFP病例 

分 类 号：R512.4[医药卫生—内科学]