宁波市鄞州区首例疫苗相关Ⅰ型麻痹型脊髓灰质炎病例的调查分析  

Epidemiological study on the first case of type-I vaccine-associated paralytic poliomyelitis in Yinzhou District,Ningbo City

作　　者：孙烨祥 徐来荣[2] 舒先定 平建明[2] 李珊燕 

机构地区：[1]浙江大学公共卫生学院,浙江杭州310023 [2]宁波市鄞州区疾病预防控制中心 [3]宁波市鄞州区邱隘镇中心卫生院

出　　处：《实用预防医学》2015年第11期1396-1398,共3页Practical Preventive Medicine

摘　　要：目的分析宁波市鄞州区首例疫苗相关Ⅰ型麻痹型脊髓灰质炎病例的流行病学情况。方法对患儿的发病及诊治经过,流行病学调查和处置,实验室检测结果,伤残残留及等级鉴定,补偿政策落实进行调查分析。结果实验室分离与定型为Ⅰ型,浙江省预防接种异常反应调查诊断专家组诊断为脊灰疫苗相关麻痹型脊灰(VAPP)病例;调查显示鄞州区儿童脊灰疫苗接种率为99.71%,脊灰灭活疫苗(IPV)替代接种率为0.87%;主动搜索未发现急性弛缓性麻痹(AFP)病例;接种门诊接种实施规范。结论该病人感染系口服脊灰疫苗株病毒所致;鄞州区IPV接种服务有待提高;预防接种单位对接种脊灰疫苗尤其是首次接种者需行肛周脓肿检查,以筛查特殊人群;卫生部门应当主动应对VAPP病例的发生,确保常规免疫工作正常开展。Objective To analyze the epidemiology of the first case of type I vaccine- associated paralytic poliomyelitis （VAPP） in Yinzhou District, Ningbo City. Methods We studied the onset of the disease, diagnosis and treatment, epidemi- ologieal investigation and disposal, laboratory test results, disability residue and rank appraisal and implementation of compensati- on policy in the child patient. Results The case which was diagnosed by the expert group of immunization adverse reaction survey and diagnosis in Zhejiang Province was confirmed as type- I VAPP based on the result of the laboratory test. The survey showed that children＇ s polio vaccination rate was 99.71% and the rate that inactivated poliovirus vaccine （IPV） replaced the oral poliomyditis attenuated live vaccine （OPV） was 0.87 % in Yinzhou District. No acute flaccid paralysis （AFP） case was found in the active search. The operation of the vaccination clinic conformed to the specifications. Conclusions The patient is infected by the oral polio vaccine virus. The immunization services of IPV in Yinzhou District should be improved. Vaccination clinics should check the perianal abscess before inoculating polio vaccine in children especially for the first vaccination. The health departments should take initiatives to deal with the VAPP case so as to ensure the normal implementation of routine immunization.

关 键 词：Ⅰ型 疫苗相关麻痹型脊髓灰质炎 口服脊灰疫苗株病毒 

分 类 号：R186[医药卫生—流行病学]