内蒙古自治区首次疫苗衍生脊髓灰质炎Ⅰ型病毒健康携带者的调查及处理  

Investigation and Response of a First Healthy Carrier with Vaccine-derived Poliovirus Type Ⅰ in Inner Mongolia Autonomous Region

作　　者：闫绍宏[1] 闫真[1] 张双一[2] 徐冬冬[1] 郭忠梅 

机构地区：[1]内蒙古自治区疾病预防控制中心,内蒙古呼和浩特010031 [2]鄂尔多斯市疾病预防控制中心,内蒙古东胜区017000 [3]乌审旗疾病预防控制中心,内蒙古嘎鲁图017300

出　　处：《中国疫苗和免疫》2015年第5期539-542,共4页Chinese Journal of Vaccines and Immunization

基　　金：2013年内蒙古自治区卫生和计划生育委员会科研立项:内蒙古自治区环境污水中脊髓灰质炎;EV71等重要肠道病毒分离和应用技术研究基金(项目号:201303028)

摘　　要：目的了解内蒙古自治区乌审旗首次疫苗衍生脊髓灰质炎病毒(VDPV)健康携带者的发生及处理情况,评价处理效果。方法对发生的VDPV健康携带者进行个案调查,采集粪便标本分离病毒;对个案所在地及医院进行急性弛缓性麻痹(AFP)病例主动搜索;对个案所在地及相邻地开展儿童常规接种率快速评价;对密切接触者和周围健康儿童进行粪便标本带毒率调查。结果经过自治区专家诊断组诊断,该个案为VDPV健康携带者,从该健康携带者分离到脊灰Ⅰ型病毒株,VP1区发生10个碱基变异,与Sabin疫苗株脊灰病毒相比核苷酸变异率为1.1%。结论当地脊髓灰质炎病毒学监测和流行病学监测系统的敏感性、及时性、完整性和准确性等指标良好,各级疾病预防控制机构在乌审旗采取了包括AFP病例主动搜索、口服脊髓灰质炎减毒活疫苗补充免疫等多项措施,有效地阻断了VDPV的循环。Objective To investigate and response to a first healthy carrier with vaccine-derived poliovirus（ VDPV） type I in Wushen County of Inner Mongolia Autonomous Region,and to evaluate the effect of taken measures. Methods Case investigation was conducted when the VDPV carrier occurred. Stool specimens were collected for enterovirus isolation. Active search for acute flaccid paralysis（ AFP） cases in local areas and hospitals were conducted. Routine immunization coverage rates of children in local and adjacent areas were evaluated rapidly. A survey for enterovirus carrying rate in stool specimens of close contacts and healthy children were carried out. Results One case was diagnosed as a healthy carrier of VDPV by the regional expert group. Poliovirus type I was isolated from this carrier. 10 nucleotides in VP1 of the isolated strain had variation; there was more than 1. 1% of nucleotide variation,compared with Sabin vaccine strain of poliovirus. Conclusion The sensitivity,timeliness,completeness and accuracy of the local polio surveillance and epidemiological surveillance systems were good. After taking measures such as the active search for AFP cases and supplementary immunization activities in Wushen County,the circulation of VDPV was effectively blocked.

关 键 词：疫苗衍生脊髓灰质炎病毒 急性弛缓性麻痹 

分 类 号：R511[医药卫生—内科学]