浙江省1例AFP病例检出脊髓灰质炎疫苗高变异株病毒的流行病学调查  

An epidemiological investigation on vaccine-hypervariable poliovirus in a case with acute flaccid paralysis in Zhejiang Province

作　　者：唐学雯[1] 龚黎明[2] 周洋[1] 严睿[1] 邓璇[1] 朱瑶 何寒青[1] TANG Xuewen;GONG Liming;ZHOU Yang;YAN Rui;DENG Xuan;ZHU Yao;HE Hanqing(Department of Immunization Program,Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou,Zhejiang 310051,China;Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou,Zhejiang 310051,China)

机构地区：[1]浙江省疾病预防控制中心免疫规划所,浙江杭州310051 [2]浙江省疾病预防控制中心,浙江杭州310051

出　　处：《预防医学》2023年第1期65-67,共3页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：浙江省医药卫生科技计划项目(2021KY118)。

摘　　要：2021年6月,浙江省1例6月龄急性弛缓性麻痹(AFP)监测病例检出Ⅲ型脊髓灰质炎(脊灰)疫苗高变异株病毒(VHPV),分离培养的病毒与Sabin疫苗株相比在VP1区有6个核苷酸变异。病例有3剂次脊灰疫苗免疫史,发病时左上肢肌力Ⅱ级,临床诊断为肩蜂窝织炎(左侧),经治疗后恢复正常,神经系统检查无异常,痊愈出院。病例后续采集的标本中未再分离到VHPV,密切接触者中未检出VHPV,病例所在县区医疗机构主动搜索及社区人群搜索未发现类似病例。由于病例未出现VHPV所致脊灰的类似临床症状,经专家组讨论排除脊灰。本例VHPV发现及时,并采取有效措施,未造成病毒进一步传播,提示需继续保持AFP病例监测系统的敏感性,提高适龄儿童脊灰疫苗接种率,遏制脊灰病毒传播和流行。Vaccine-hypervariable poliovirus typeⅢwas detected in an acute flaccid paralysis infant at age of 6months in Zhejiang Province in June,2021,and the isolated and incubated virus had six nucleotide variations in the VP1 region as compared to the poliovirus Sabin vaccine strain.The infant had a history of three-dose poliovirus vaccination,and grade 2 muscle strength of the left upper limb upon onset.He was clinically diagnosed with cellulitis of the left shoulder,and recovered to normal following treatment.No abnormality was detected in the nervous system,and the infant was cured and discharged from hospital.No vaccine-hypervariable poliovirus was detected in subsequent infant’clinical samples or in close contacts,and no similar cases were identified during the active case detection by county/district medical institutions and among community populations.Since the infant did not present poliomyelitis-related clinical symptoms caused by vaccine-hypervariable poliovirus,poliomyelitis was excluded.The vaccine-hypervariable poliovirus was not spread because of timely identification and effective responses,suggesting the urgent need to maintain the sensitivity of the acute flaccid paralysis surveillance system and improve the coverage of poliovirus vaccination,so as to inhibit the transmission of poliovirus.

关 键 词：脊髓灰质炎 脊髓灰质炎疫苗高变异株病毒 急性弛缓性麻痹 

分 类 号：R512.4[医药卫生—内科学]