中国2013年脊髓灰质炎实验室网络的运转状况与评价  

Evaluation of the China Polio Laboratory Network,2013

作　　者：朱晖[1] 祝双利[1] 张勇[1] 王东艳[1] 严冬梅[1] 李晓嫘[1] 安洪秋[1] 许文波[1] 

机构地区：[1]中国疾病预防控制中心病毒病预防控制所,卫生部医学病毒学和病毒病重点实验室,世界卫生组织西太平洋区脊髓灰质炎参比实验室,北京102206

出　　处：《中国疫苗和免疫》2015年第3期263-268,共6页Chinese Journal of Vaccines and Immunization

基　　金：行使世界卫生组织西太平洋区脊髓灰质炎参比实验室职能;2013年国家卫生和计划生育委员会疾病控制专项

摘　　要：目的通过对中国(未包括香港、澳门特别行政区和台湾地区,下同)2013年脊髓灰质炎(脊灰)实验室网络(Polio Laboratory Network,PLN)监测数据和各项监测指标的分析和评估,为维持我国无脊灰状态提供病毒学依据。方法对中国免疫规划监测信息管理系统数据库中,31个省(自治区、直辖市,下同)报告的急性弛缓性麻痹(Acute Flaccid Paralysis,AFP)病例个案调查表和中国疾病预防控制中心(Center for Disease Control and Prevention,CDC)病毒病预防控制所国家脊灰实验室(National Polio Laboratory,NPL)的监测数据库进行统计分析,对PLN的各项运转指标进行评价。结果中国2013年PLN收集到5623例AFP病例的11 126份粪便标本,14天内双份粪便标本采集率为92.78%,合格粪便标本采集率为92.35%,鉴定结果 28天内反馈率为99.10%。2013年从5623例粪便标本中有111例分离到脊灰病毒(Poliovirus,PV),分离率为1.97%;606例粪便标本分离到非脊灰肠道病毒(Non-polio Enterovirus,NPEV),分离率为10.78%。2013年,NPL收到PLN送检的237份PV分离物,按单个血清型定型统计共计304株,其中19株为疫苗衍生(Vaccine-derived)PV(VDPV),1株来源于1例非AFP病例,另18株来源于1例免疫缺陷相关的(Immunodeficiency-associated)VDPV(i VDPV)病例;未发现野生型(Wild)PV(WPV)。2013年,NPL和31个省CDC脊灰实验室都通过了世界卫生组织(World Health Organization)粪便标本PV等EV的新检测流程的盲样标本考核,NPL和其中8个省CDC脊灰实验室接受并通过了WHO现场评估认证,其他省级CDC脊灰实验室通过信函认证表格认证。结论中国PLN 2013年运转正常,未发现WPV或WPV病例,为维持我国无脊灰状态,早期发现VDPV或VDPV病例,早期采取应对措施阻断其传播提供了重要的病毒学依据。Objective To provide virology evidence for maintaining polio-free status in China （excluding Hong Kong and Macao Special Administrative Region and Taiwan sheng）. Methods Data from the Polio Laboratory Network （PLN） that were reported in 2013 were analyzed. Acute flaccid paralysis （AFP）sur- veillance data from all 31 provinces reported to the Immunization Program Information Management Sys- tem, and virology surveillance data from the National Polio Laboratory （NPL） of the Institute of Viral Disease Control and Prevention （IVDCP） were analyzed. The performance indicators of the Chinese PLN were analyzed. Results There were 11,126 stool samples collected from 5,623 AFP cases registered in Chinese PLN in 2013. Among these, 92.78% had 2 stool specimens collected within 14 days; the adequate stool sample rate was 92. 35%. Ad- ditionally, 99.08% of cases＇ viral identification results were reported within 28 days. Finally, 111 polioviruses （PV） and 606 non-polio enterovirus- es （NPEV） were isolated from 5,623 stool speci- mens in 2013. The PV and NPEV isolation rates were 1.97% and 10. 78%, respectively. In to-tal, 237 PV isolated samples （304 strains by a single serotype） were sent to NPL. No wild PV （WPV） was found, while 19 vaccine-derived PV （VDPVs） were detected in 2013. One VDPV was isolated from a non-AFP case and another 18 VDPVs were isolated from one immune deficient-associated VDPV （iVD- PV） case. The NPL and all 31 polio laboratories passed the 2013 proficiency test of the new detection process. The NPL and 8 provincial polio laboratories received accreditation following an on-site review conducted by the World Health Organization （WHO）, while other provincial polio laboratories received accreditation by letter authentication. Conclusion The Chinese PLN was working well; no WPVs were detected. The results provided important scientific evidence for improving the work of maintaining polio- free status, early detection of VDPV, and prompt interruption of VDPV ci

关 键 词：脊髓灰质炎实验室网络 运转状况 脊髓灰质炎病毒 疫苗衍生脊髓灰质炎病毒 

分 类 号：R373.33[医药卫生—病原生物学]