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北京市急性弛缓性麻痹 (AFP)病例监测系统 1989～ 2 0 0 2年共诊断疫苗相关麻痹型脊髓灰质炎 (脊灰 )(VAPP) 2 0例 ,其中首次服苗VAPP 18例 ,接触服苗VAPP 2例。所有病例均 <2岁 ,<6月龄病例占 85 %。男女发病之比为 9∶1。每年VAPP发生率无明显季节性高峰和地区差异。VAPP总发生率为 1 2 0 / 10 0万剂口服脊灰减毒活疫苗 (OPV)投放量或 1 5 9/ 10 0万剂OPV接种量 ,首次服苗VAPP发生率为 13 18/ 10 0万剂首次服苗量 ,接触服苗VAPP发生率为 0 16 / 10 0万剂OPV接种量。监测结果表明 ,北京市VAPP发生的危险性高于中国其它省份和其它许多国家与地区 ;免疫缺陷和 /或肛门周围脓肿可能是VAPP重要的危险因素。在中国当前尚未改变脊灰疫苗免疫策略的情况下 ,为减少和避免VAPP的发生 ,必须加强接种前儿童病史询问和体检 ,严格掌握接种禁忌证 ;同时要加强对VAPP的监测工作。
Beijing Acute flaccid paralysis (AFP) case monitoring system 1989 to 2002 were diagnosed vaccine-associated paralytic poliomyelitis (polio) (VAPP) 20 cases, including the first service-taking VAPP 18 cases, contact service VAPP 2 cases. All cases were <2 years old, <6 months old cases accounted for 85%. Male to female incidence ratio of 9: 1. There is no obvious seasonal peak and regional difference in the annual incidence of VAPP. The overall incidence of VAPP was 120,000 doses of live attenuated oral polio vaccine (OPV) or 15,000 doses of OPV inoculum. The incidence of VAPP in the first service was 13 18/10 0 For the first time, the dose of VAPP in the dose of contact vaccine was 0 16/10 million doses of OPV inoculation. Monitoring results show that VAPP in Beijing is more dangerous than other provinces in China and many other countries and regions; immunodeficiency and / or perianal abscess may be VAPP important risk factors. In order to reduce and avoid the occurrence of VAPP, we must strengthen the consultation and medical examination of the history of children before vaccination and strictly control the contraindication for vaccination. In the meantime, we must strengthen the monitoring of VAPP.