云南省2003—2007年分离到脊髓灰质炎病毒的急性弛缓性麻痹病例特征分析

Characteristics of 57 acute flaccid paralysis cases with polio-virus isolated from stool specimens, in Yunnan province, from 2003 to 2007

目的了解云南省脊髓灰质炎（脊灰）病毒（PV）流行情况。方法对云南省2003—2007年急性弛缓性麻痹（AFP）病例粪便标本分离到PV的AFP病例进行描述性分析。结果2003-2007年云南省报告1171例AFP病例，1138例采集到粪便标本，57例分离到PV，PV分离率5．0％。159例分离到NPEV（非脊灰肠道病毒），NPEV分离率14．0％，922例分离结果阴性。PV型别以PVⅡ型居多，单型合计占总数的31．6％。57例PV阳性AFP病例分布在37个县，占全省总县数的28．7％（37／129），病例主要集中在2岁以下儿童共43例，占75．4％，口服脊灰疫苗≥3次29人，全程口服脊灰疫苗者占50．9％。麻痹前有发热的41例，占71．9％；麻痹部位以单下肢为主共28例，占49．1％。60d后随访有26例残留麻痹，占45．6％；经统计学检验，未全程免疫者残留麻痹率大于全程免疫者，差异有统计学意义。结论继续开展高质量的口服脊灰疫苗常规免疫和强化免疫活动，消除免疫空白地区和空白人群。

Objective Study on the epidemiological characteristics of poliomyelitis virus in Yunnan, from 2003 to 2007. Methods Surveillance data of acute flaccid paralysis （AFP） cases from year 2003 to 2007 was gathered. All the stool specimens were identified to contain polio virus. Results 1171 AFP cases were reported. Out of the total number of 1138 stool specimens from 2003 to 2007, 57 cases showed polio virus （5.0%）, 159 showed NPEV （14.0%）, 922 cases showed virus negative. In those virus, polio typeⅡ took the lead （31.6%）. 57 AFP cases appeared in 37 （28.7%） counties in Yunnan. Most of the cases were under 2 years of age. 29 cases had taken more than 30PV （oral poliovaccine） dosages and 41 cases had fever before paralysis occurred. Most of the cases appeared paralysis on single lower limb, but 26 cases leaving deformity. Significant difference was found between the two groups： having received vaccination more than 30PV dosages or less than 3 dosages. Conclusion High quality AFP epidemiological and laboratory surveillance program, together with OPV routine and supplemental immunization strategy to cover the poorly immunized area/population appeared to be most effective.