河南省2004～2015年疫苗相关麻痹型脊髓灰质炎病例分析  

Epidemiological Analysis of Vaccine-associated Paralytic Poliomyelitis in Henan Province,2004-2015

作　　者：张肖肖[1] 史鲁斌 王燕[1] 肖占沛[1] 王长双[1] 路明霞[1] 马雅婷[1] 张延炀[1] 

机构地区：[1]河南省疾病预防控制中心,河南郑州450016

出　　处：《中国疫苗和免疫》2016年第5期511-514,共4页Chinese Journal of Vaccines and Immunization

基　　金：2015年度河南省医学科技攻关计划项目(201504049);河南省疾控中心科研基金资助项目

摘　　要：目的分析河南省口服脊髓灰质炎（脊灰）减毒活疫苗（OPV）接种后疫苗相关麻痹型脊灰（Vaccine-associated Paralytic Poliomyelitis,VAPP）病例发生规律,为其防控措施制定提供科学依据。方法采用描述性分析方法对河南省2004-2015年VAPP病例进行分析。结果 2004-2015年河南省共报告VAPP病例26例,发生率为0.16/100万剂次;其中首剂OPV接种后VAPP 20例（73.08%）,发生率为1.11/100万剂次。发生数男女性比为5.5∶1。23例（88.46%）为2-6月龄儿童。接种至麻痹平均时间间隔为23天。病例麻痹部位主要为双下肢、单下肢。麻痹60天后随访均有残留麻痹。14例（53.85%）病例合并其他疾病,其中9例合并肛周脓肿。在13例脊灰疫苗病毒分离阳性的VAPP病例中,Ⅱ型占61.54%。结论 VAPP病例以低月龄、首剂OPV接种儿童为主。应密切关注脊灰疫苗免疫策略调整后VAPP发生情况。Objective To determine the incidence of vaccine-associated paralytic poliomyelitis（ VAPP）following administration of oral poliovirus vaccine（ OPV） in Henan,and for developing measures for VAPP prevention. Methods Data from VAPP cases in Henan during 2004-2015 were analyzed descriptively. Results Twenty-six VAPP cases were reported in 2004-2015 in Henan,for an incidence rate of0. 16 per 1 000 000 doses administered; 20（ 73. 08%） cases were first-dose recipients,for an incidence rate of 0. 11 per 1 000 000 doses. The male to female ratio was 5. 5∶ 1; 23（ 88. 46%） cases were in 2-6month old children. The average interval from immunization to onset was 23 days. Paralysis usually involved one or both lower limbs. All cases remained paralyzed 60 days after onset. Fourteen（ 53. 85%）cases were accompanied by other diseases; 9 had perianal abscess. Type II poliovirus cases accounted for61. 54% of 13 VAPP cases from which vaccine virus had been isolated. Conclusions VAPP mainly occurred in young infants and first-dose recipients. We should pay close attention to the incidences of VAPP after adjustment of the polio immunization strategy.

关 键 词：口服脊髓灰质炎减毒活疫苗 疫苗相关麻痹型脊髓灰质炎 

分 类 号：R186[医药卫生—流行病学]