广东省1995年急性弛缓性麻痹病例流行病学分析及监测系统评价

EPIDEMIOLOGICAL ANALYSIS OF THE ACUTE FLACCID PARALYSIS (AFP)CASES IN GUANGDONG PROWNCE IN 1995 AND THE EVALUATION ON ITS SURVEILLANCE SYSTEM

广东省１９９５年脊髓灰质炎（脊灰）专报系统报告１５岁以下儿童急性弛缓性麻痹（ＡＦＰ）病例３２１例，发病率为１．７４／１０万；９０．０８％（１０９／１２１）的县（市、区，下同）报告了ＡＦＰ病例，≥５０万人口的县均有病例报告，５～８月份发病数占５２．０２％（１６７／３２１）。５岁以下病例占７６．９５％（２４７／３２１），未服苗者占５．６１％（１８／３２１）。ＡＦＰ病例及其接触者粪便标本的病毒分离阳性率为１６．７６％（１２０／７１６），其中脊灰疫苗株病毒占２０．００％（２４／１２０），非脊灰肠道病毒（ＮＰＥＶ）占７８．３３％（９４／１２０），待定１．６７％（２／１２０），未分离到脊灰野病毒。卫生防疫站接到ＡＦＰ病例报告后４８小时内调查率９８．６％，ＡＦＰ病例出现麻痹后１４天内间隔２４～４８小时采集２份粪便标本冷藏送省卫生防疫站脊灰实验室且状态良好者达８９．７％；省卫生防疫站脊灰实验室收到粪便标本后７天内分离培养率为８７．０％；ＡＦＰ病例麻痹６０天后随访并将随访表７５天内送省卫生防疫站达８１．０％。但ＡＦＴＰ病例粪便标本７天内送省卫生防疫站脊灰实验室占７０．１％，省卫生防疫站脊灰实验室收到粪便标本３０天内分离培养结?

n 1 995 in Guangdong Province, 321 AFP cases under 1 5 years old children were reportedspeclally by the surveillance system,the disease inciedence was 1.74 /100,000.This tuwse report wasfrom 1 09 counties(Distrcit City,the same below)that aanunted for 90.08%of the total counties(109 /121)of Guangdong Province,of which involvai all coreunties having a population of ≥fivehundred thousands,The AFP Q1ses reported in May to August of the year accounted for 52.02%(167/321).The cases under 5 years old accounted for 76.95%(247/321) and the unvaccinated the5.61 %(18/321).Virus positive isolation rdte from feal speclmens of AFP patients and their contactswds 1 6.76%(1 20/716 ),among them polio vaccine strains were 24/1 20(20.0%) non-polioentemviruses were 94/120(78.33%)the unidentified strdins were2/1 20(1.67%) The wild-typepolio virus was not isolated. The investigating rdte within 48 hours after receiving AFP case reportwds 98.60%,two stool specimens colleded rdte within 1 4 days after oppearance of pardlysis ofAFP cases reached 89.70%, and the specimens were sent under a cold condition, the vinis isolationrate was 87.00%, culturing and isolation was carried out by Provincial Epidemic Prevention Stationwithin 7 dayd after rasiving fecal samples,the follow-up visiting rdte of AFP cases 60 days later andthe visiting forms be sent to Provincial Epidemic Prevention Station within 75 days was 8 1.00%.Nomatter how hard we have worked,still there are rooms to be improved.In 1995,the AFP fecal speci-men delivery rate within 7 days to Provincial Epidemic Prevention Station was 70.1 0%,the virus isolation feed back rate by Provincial Epidemic Prevention Station within 30 davs was 73.00%,thedelivering rate of virus isolates to National Poliomyelitis Laboratory within 30 days was 53.90%,Soa better scientific management of the Surveillance system must be emphasizal in order to rdise itsworking quality.