2000-2013年玉林市检出脊髓灰质炎疫苗病毒的急性驰缓性麻痹病例流行病学分析  

Epidemiological analysis on acute flaccid paralysis cases of vaccine virus of Polio in Yulin, 2000-2013

作　　者：陈明文 李文 陆沛超 卢然 

机构地区：[1]广西玉林市疾病控制中心,广西玉林537000

出　　处：《现代预防医学》2015年第9期1547-1549,共3页Modern Preventive Medicine

摘　　要：目的分析脊髓灰质炎(脊灰)病毒(PV)的急性驰缓性麻痹(AFP)病例流行病学特征,为维持无脊髓灰质炎状态提供科学依据。方法采用描述性流行病学方法对玉林市2000-2013年检出的PV阳性AFP病例进行流行病学分析。结果玉林市2000-2013年共检测了451例急性驰缓性麻痹病例的粪便标本,检出PV13株,检出率2.88%,型内特征鉴定有1株为疫苗变异PV,经VP1基因核苷酸序列测定达到VDPV的分类标准。分离到的PV以Ⅱ型为主,AFP病例散在发生,无聚集性。未全程免疫儿童>全程免疫儿童,年龄以≤1岁儿童为主(92.31%)。服苗1月内出现麻痹占46.15%(6/13),麻痹伴发热占61.54%,60 d后随访仍残留麻痹病例高达23.08%,以Ⅱ型疫苗株为主。结论玉林市2000-2013年未发现由脊灰野病毒引起的病例。在无脊灰证实阶段,存在着疫苗衍生病毒(VDPV)和发生VDPV循环(c VDPVs)的可能,保持AFP病例监测的敏感性,加强对脊灰疫苗衍生病毒的监测及研究,具有重要的现实意义。Objective To analyze epidemiological characteristics of poliomyelitis （polio） virus （PV） of acute flaccid paralysis （AFP） cases, and provide a scientific basis for maintaining polio-free status. Methods Descriptive epidemiological method was adopted to analyze PV-positive AFP cases in Yulin between 2000 and 2013. Results There were 451 fecal samples tested during that period, which contained PV 13 strains, including a variation PV which achieved vaccine-derived virus （VDPV） classification criteria by the VP1 gene nucleotide sequence determination. The PV was mainly type 2, and AFP cases were sporadic without aggregation. Among children less than 1 year old, there were more non-fully immunized than full immunization. Emerging paralysis after taking drugs during 1 month accounted for 46.15% （6/13）, and paralysis accompanied by fever accounted for 61.54%. Paralysis still remained after 60 days follow-up were up to 23.08%, and type 2 vaccine strains still played a dominant role. Conclusion Cases, owing to the wild poliovirus, are not found during 2000-2013 in Yulin. In the stage of the lack of confirming poho, it is possible that VDPV exists and cycle. It is important to maintain the sensitivity of AFP surveillance and strengthen the monitoring and study the vaccine-derived polio virus.

关 键 词：急性驰缓性麻痹 脊髓灰质炎疫苗病毒 疫苗衍生脊灰病毒 

分 类 号：R181.8[医药卫生—流行病学]