由疫苗重组脊髓灰质炎病毒引起的聚集性急性弛缓性麻痹病例分析  

An Analysis of AFP Cases Induced by Vaccine-Recombinant Polioviruses

作　　者：张礼璧[1] 侯晓辉[1] 陈立[1] 秦明晖[2] 祝双利[1] 

机构地区：[1]中国疾病预防控制中心病毒病预防控制所,北京100050 [2]四川省疾病预防控制中心,成都610031

出　　处：《中国计划免疫》2003年第4期189-192,共4页Chinese Journal of Vaccines and Immunization

摘　　要：20 0 2年 6月中旬 ,在四川省攀枝花市和泸州市 ,从 3例急性弛缓性麻痹 (AFP)病例及其 3名密切接触者中 ,共分离到 6株脊髓灰质炎 (脊灰 )病毒。这 6人中有 5人是口服脊灰疫苗“零”剂次免疫 ,1名免疫史不详。用逆转录 聚合酶链反应 (RT PCR)分析病毒的VP1和 3D基因编码区发现 ,所有病毒均为疫苗重组脊灰病毒 (VRPV) ,其中 2株为Ⅱ型和Ⅰ型的重组 ,其余为Ⅱ型和Ⅲ型的重组。经序列分析发现 ,从AFP病例中分离到的毒株 ,在VP1编码区与标准参考株SabinⅡ型有 3个同样的核苷酸发生了变异 ,而从密切接触者中分离到的毒株有 4个核苷酸发生了变异。 6株病毒来源相同 ,并已在免疫覆盖率低的地方引起儿童患病及播散。There are more and more vaccine-recombinant polioviruses(VRPVs) identified from poliomyelitis cases in China.In the middle of June of 2002,a total of six VRPVs were isolated from acute flaccid paralysis(AFP)cases and their contacts in Panzhihua and Luzhou cities of Sichuan Province.Five of the children had zero OPV history and one was unknown.After the PCR-RFLP assay in the VP1 and 3D fragments of the VRPV,two viruses were identified as recombinants of polio type 2 and type 1 and the other four were of polio type 2 and type 3.All the poliovirus isolates were serotype 2 with discordant RFLP [1] results from their reference strain,Sabin 2,in the VP1 fragment.The sequencing data showed that there were three and four nucleotide changes in VP1 fragment of AFP cases and their contacts respectively.The homology of VP1 fragment (99.67% in AFP cases and 99.56% in contacts)was more than 99% which is the recommendatory class for vaccine-derived poliovirus(VDPV). One of the viruses showed a discordant ELISA result with a Double Reactive Virus(DRV).

关 键 词：疫苗 重组脊髓灰质炎病毒 聚集性急性弛缓性麻痹 病例分析 

分 类 号：R373.22[医药卫生—病原生物学]