江西省首例免疫缺陷疫苗衍生脊灰病毒病例的调查  

Investigation of the first case of immunodeficiency Vaccine- derived Poliovirus( iVDPV),Jiangxi Province

作　　者：郭世成[1] 胡志勇[2] 刘莉红[3] 涂秋凤[1] 赵红平[1] 程慧健[1] 

机构地区：[1]江西省疾病预防控制中心,江西南昌330029 [2]新余市疾病预防控制中心,江西新余338000 [3]宜春市疾病预防控制中心,江西宜春336000

出　　处：《现代预防医学》2016年第5期922-924,930,共4页Modern Preventive Medicine

摘　　要：目的对江西省首例免疫缺陷疫苗衍生脊灰病毒(immunodeficiency Vaccine-derived Poliovirus,i VDPV)病例进行调查和处置,为制定江西省应急预案提供参考。方法对i VDPV病例进行医学治疗的同时开展现场调查工作。对其进行医学检查及采样检测,并召开专家诊断会议对其进行最终诊断。对该地区i VDPV传播的风险进行评估,并通过健康教育宣传,及对患儿家庭的卫生指导,避免病毒的传播。结果病例最终分类诊断为免疫缺陷疫苗衍生脊灰病毒病例,属江西省首例。通过15次连续采样检测显示病毒变异程度逐渐增加。通过接种率调查发现当地儿童的常规免疫接种率为98.7%,加强免疫接种率为73.7%;病例接触者标本分离结果仅分离到非脊灰肠道病毒,未发现脊灰病毒,风险评估认为i VDPV传播的风险较小。结论通过有力的处置,该病毒未在当地造成流行。保持高水平的OPV接种率和AFP监测系统的敏感性,是及时发现并阻断脊灰野病毒或VDPV输入及传播的最有效措施。病例所在地的OPV疫苗加强免疫接种率应加强,同时如何阻断i VDPV病例的持续排毒值得研究。Objective To investigate and dispose the first case of the immunodeficiency Vaccine- derived Poliovirus（ i VDPV）,and to provide the basis for the development of an emergency plan in our province. Methods Investigation and treatment of the i VDPV case were made at the same time. Medical examination and sampling inspection were implemented in the case,and the diagnostic expert meeting was held for its final diagnosis. The risk of i VDPV transmission in the region was assessed,and to avoid the i VDPV transmission through promoting health education and making health guide to the family of the case. Results This case was finally classified as i VDPV,which was the first case in Jiangxi Province. The degree of virus variation gradually increased through 15 successive sampling detections. The investigation of the coverage showed that the routine immunization of local children was 98. 7% and the intensifying immunization rate was 73. 7%. Only the Non- polio Enterovirus（ NPEV） was founded in the sample of the case. The risk assessment showed that the risk of i VDPV transmission was small. Conclusion The virus did not cause the epidemic in the local area due to the strong disposal. Therefore,keeping a high level of OPV vaccination rate and the sensitivity of the AFP monitoring system is the most effective measures to timely detect and block the transmission of the polio virus or VDPV. The intensifying immunization coverage of the OPV in the location of the case should be strengthened,and it is worth to study how to block the sustained detoxification of i VDPV.

关 键 词：免疫缺陷疫苗衍生脊灰病毒病例 调查 处置 

分 类 号：R186[医药卫生—流行病学]