检出脊灰疫苗急性弛缓性麻痹病例流行病学分析  

Epidemiological Status of Acute Flaccid Paralysis Cases With Isolation of Poliovirus

作　　者：覃志英[1] 方刚[1] 杜飞[1] 刘宇[1] 马晓珍[1] 陈娜[1] 

机构地区：[1]四川省疾病预防控制中心,成都610041

出　　处：《预防医学情报杂志》2014年第2期126-130,共5页Journal of Preventive Medicine Information

摘　　要：目的 了解四川省分离检出脊髓灰质炎（脊灰）疫苗病毒（PV）阳性的急性弛缓性麻痹（AFP）病例流行病学特征,为消灭脊灰后期我国适时调整免疫策略提供依据.方法 利用四川省AFP病例监测系统有关资料,对2006-2012年检出脊灰疫苗病毒48例AFP病例,采用描述流行病学方法进行分析.结果 2006 ～ 2012年四川省报告2492例AFP病例,其中48例标本中检出PV,经鉴定均为脊灰疫苗相关病毒.48例PV阳性的AFP病例分布于15个市（州）的36个县（区）,发病时间无明显的聚集趋势.＜3岁儿童72.92％（35/48）；未免疫和未全程免疫（包括免疫史不详）60.42％（29/48）.48例PV型别差异明显,以脊灰Ⅱ型占优势（24例,占50.00％）,残留麻痹病例中,以Ⅱ型居多,占51.85％ （14/27）.疫苗相关麻痹型脊灰病例（VAPP）发生率平均为0.14/100万；服苗者与接触者VAPP发生率分别为0.08/100万和0.06/100万；首次服苗VAPP发生率为0.45/100万.2012年1月在阿坝县发生1例脊灰疫苗衍生病毒（VDPV）病例.结论 四川省VAPP发生率很低,提示接种口服脊灰减毒活疫苗（OPV）安全有效.鉴于OPV的生物学特性,有极罕见出现VAPP的可能,在维持无脊灰时代,应尽快研究灭活脊灰疫苗（IPV）的免疫策略.Objective To analyze epidemiological characteristics of acute flaccid paralysis （AFP） cases with isolation of poliovirus during 2006 -2012 in Sichuan province and provide evidence for adjusting endgame strategies of polio eradication. Methods Descriptive epidemiologieal methods were used for AFP surveillance data analyzing. Results A total of 2492 AFP cases were reported during 2006 -2012 in Sichuan. Polioviruses were detected from stool samples of 48 AFP cases and all were identified as vaccine -related polioviruses, distr/buting in 36 counties （districts） of 15 cities （prefectures） and with no temporal clustering trend in paralysis onset. Cases under 3 years old accounted for 72.92% （35/48） ; unimmunized and incomplete immunized cases （including those with uncertain immunization history ） accounted for 60.42% （29/48）. Poliovirus type Ⅱ was predominant （50. 00% ） in all poliovirus types, accounting for 51.85% （14/27） poliovirus that caused residual paralysis in AFP case Average vaccine - associated paralytic poliomyelitis （VAPP） incidence rate was 0. 14/10^6, and VAPP incidence rates in oral polio vaccine （OPV） recipients and contacts were 0. 08/0 ^6 and 0. 06/0^6, respectively. In first - dose OPV recipients, VAPP incidence rate was 0.45/10^6.One vaccine derived poliovirus （VDPV） case was found in Aba county in January, 2012. Conclusion VAPP incidence rate stays very low in Sichuan province, indicating OPV immunization is safe and effective. Due to OPV biological characterization, AVPP still has a rare chance to appear and thus inactivated polio vaccine （IPV） immunization strategies should be formulated.

关 键 词：急性弛缓性麻痹 脊髓灰质炎疫苗株病毒 流行病学分析 

分 类 号：R512.3[医药卫生—内科学]