重庆市2008-2011年急性驰缓性麻痹病例监测结果

Analysis on virological surveillance of acute flaccid paralysis in Chongqing (2008-2011)

目的评价重庆市2008-2011年急性驰缓性麻痹(AFP)病例监测运转情况。方法按照《脊灰病毒检验手册》操作规程进行病毒分离与鉴定,由国家脊灰实验室用PCR-RFLP法和ELISA法对分离到的脊灰病毒株进行型内鉴定。结果从307例AFP病例粪便标本中分离到脊灰病毒(PV)10株,分离率为3.26%,其中脊灰Ⅱ型5株,Ⅲ型3株,PV混合2株,Ⅱ型为我市的主要型别占50.00%,其次是Ⅲ型、PV混合型分别占30.00%、20.00%。所有PV经国家脊灰实验室进行型内鉴定,有9株为疫苗相关株,另外有1株Ⅱ型有6个核苷酸序列变异,鉴定为疫苗高变异株。分离非脊灰肠道病毒(NPEV)26株,分离率为8.47%。结论重庆市2008-2011年急性驰缓性麻痹病例中未发现脊灰野病毒,维持了无脊灰状态。在实现无脊灰目标后,仍应加强AFP病例的病毒学监测工作,以确保最终实现全球消灭脊灰的目标。

Objective To evaluate the surveillance system of the acute flaccid paralysis （AFP）eases in Chongqing from 2008 to 2011. Methods Viruses were isolated and identified according to the Polio Laboratory Manual, and the results were conducted intratypie differentiation at the National Poliomyelitis Laboratory by PCR-RFLP and ELISA methods. Results 10 strains of poliomyelitis virus（PV） were isolated from human fecal samples of 307 AFP cases ,The isolating rate was 3.26% , which included 5 strains of the type II poliovirus ,3 strains of the type III poliovirus and 2 strains of the mixed poliovirus. The principle prevalent type was II, accounted for 50.00%, followed by type III and PV hybrid, accounted for 30. 00% and 20. 00% respectively. All the PVs were sent to the National Poliomyelitis Laboratory for further intratypic differentiation and identification. The results indicated that 9 strains were vaccine-related. Meanwhile, 6 nucleotide sequence variations were found in 1 strain of the type II poliovirus, which was confirmed as the pre-vaccine-derived poliovirus （ pre- VDPV）. 26 strains of non-polio enterovirus were also isolated. , The isolating rate was 8.47%. Conclusions From 2008 to 2011 in Chongqing, no wild polio virus was isolated from the acute flaccid paralysis cases, which meant Chongqing remain polio-free area. However, the surveillance of AFP cases should be continued to ensure reaching the target of polio- myelitis eradication all over the world.