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目的分析一起疑似脊灰疫苗变异株病毒循环调查处置过程。方法进行病例核实诊断和个案调查,开展医院AFP病例主动搜索,评价AFP病例监测系统运转情况,调查密切接触者儿童粪便带毒率及脊灰疫苗接种率。结果在3例病例粪便标本中同时分离到Ⅲ型脊灰病毒,该病毒VP1区与Sabin疫苗株病毒相比,分别有0.44%、0.55%和0.44%的核苷酸变异。3例病例发病地点相距较远,均接种口服脊灰减毒活疫苗(OPV),密切接触者粪便标本未分离到脊灰病毒,当地儿童常规免疫接种率均处较高水平。结论脊灰疫苗变异株病毒未在当地发生循环。提高AFP监测系统敏感性、脊灰疫苗接种率和疫情应急能力,是有效阻止脊灰疫苗病毒变异株循环和脊灰野病毒输入的有效措施。
Objective To analyze the process of investigation and disposal of virus circulating suspected of poliovirus variant. Methods Case verification and case investigation were carried out. The hospital AFP cases were actively searched to evaluate the operation of AFP case surveillance system and to investigate the rate of polio entrapment and polio vaccination in close contacts. Results The poliovirus type Ⅲ was also isolated from the stool specimens of three cases. The VP1 region of the virus showed 0.44%, 0.55% and 0.44% nucleotide variation compared with the Sabin vaccine strain, respectively. Three cases were far away from each other. All of them were vaccinated with oral live attenuated poliovirus (OPV), and poliovirus was not isolated from the stool specimens of close contacts. The routine immunization rates of local children were higher. Conclusion The poliovirus mutant virus did not circulate locally. Increasing the sensitivity of the AFP surveillance system, the vaccination rate of poliovirus and the emergency response capability are effective measures to prevent the mutation of poliovirus and the input of poliovirus.