中国2003年脊髓灰质炎实验室网络的运转与监测

Surveillance and Running Status of Laboratories Network for Poliomyelitis in 2003 in China

2 0 0 3年 ,中国 31个省 (自治区、直辖市 ,下同 )疾病预防控制中心 (CDC)脊髓灰质炎 (脊灰 )实验室 ,从 5 0 1 4例急性弛缓性麻痹 (AFP)病例中收集了 9987份粪便标本 ,所有粪便标本用L2 0B、RD细胞同时进行肠道病毒分离。从 373例AFP病例粪便标本中分离到脊灰病毒 (PV) ,分离率为 7 4%。然后对所有病毒做了血清定型 ,其中Ⅰ型5 5例 ,Ⅱ型 1 32例 ,Ⅲ型 70例 ,混合型 74例 ,PV与非脊灰肠道病毒 (NPEV)混合 1 6例。从 4 79例AFP病例粪便标本中分离到NPEV ,分离率为 9 6 %。中国CDC病毒病预防控制所国家脊灰实验室共收到送检的 4 75株PV标本 ,其中 373株来源于AFP病例 ,1 0 2株从AFP病例接触者、流动人口、非AFP病例、健康人群等分离到。对送检的 4 75株进行了血清型中和试验复核 ,并使用酶联免疫吸附试验 (ELISA)和聚合酶链反应 限制性内切酶片段长度多态性分析 (PCR RFLP)两种方法进行型内鉴定。血清型中和试验复核和PCR RFLP鉴定结果显示 :4 75株中 ,PVⅠ型疫苗株 80株 ,Ⅱ型疫苗株 1 4 6株 ,Ⅲ型疫苗株 1 0 5株 ,混合型疫苗株 98株 ,PV +NPEV1 7株 ,疫苗Ⅰ、Ⅱ、Ⅲ型变异株分别为 1 0、1 0、9株。将PV混合株进行单型分离后 ,所有单型毒株共 5 96株 ,经ELISA试验鉴定 ,其中疫苗类似株 (SL) 5 73株 。

We analyzed the running status of AFP surveillance system of poliovirus laboratory network in China in 2003. There are 9987 stools which were collected from 5014 AFP cases by all 31 provincial polio laboratory staff, all stool samples were made viral isolation on both L20B cell and RD cell 373 polioviruses were isolated from AFP cases and were done neutralization test,the results are 55 of type 1 poliovirus,132 of type 2 poliovirus, 70 of type 3 poliovirus,74 of mixed poliovirus,16 of mixed with other enteroviruses,also 479 of non-polio enteroviruses (NPEV)were isolated from AFP cases. We retested the serotype of all the polio positive isolates sent by 31 provincial laboratories and did PCR-RFLP intratypic identification tests.Among 475 isolates,80 of type 1 vaccine-like viruses,146 of type 2 vaccine-like viruses,105 of type 3 vaccine-like viruses,98 of mixed viruses,17 of vaccine-like viruses mixed with enteroviruses,29 viruses were identified as mutant viruses, among them 10 of types 1,10 of type 2,9 of type 3 respectively.We also did another intratypic identification test, ELISA test,according to WHO manual,among total 596 single serotype viruses,573 of sabin-like viruses (SL),3 of non-sabin-like viruses(NSL),17 of double reaction viruses(DRV). All results with mutant viruses of PCR test, results with DRV and NSL of ELISA test and part of the polioviruses isolated from patients with 0 dose immunization were selected,total 74 viruses were one VP1 gene sequencing, and no wild polioviruses or VDPVs were found. But 7 VDPVs that isolated between 1999 and 2002 were found by retrospective study,and they were all be contained in laboratory according WHO criterion.We distribute 6 specimens for proficiency test,and due to reported the results lingeringly and missed a NPEV within the report by Tibet polio laboratory,all provincial polio laboratories except Tibet got 100 score and passed the proficiency test, 10 laboratories got accreditation by experts through on-site review.