江苏省消灭脊髓灰质炎工作的回顾及策略

Review of the Works for Poliomyelitis Eradication and Its Strategies in Jiangsu Province

江苏省历史上是脊髓灰质炎 (脊灰 )的高发省份之一。消灭脊灰工作经历了 :(1)使用口服脊灰疫苗 (OPV)前(195 6～ 196 0年 ) ,(2 )开始使用OPV(196 1～ 196 9年 ) ,(3)广泛使用OPV(1970～ 1978年 ) ,(4 )实施计划免疫 (1979～ 1989年 ) ,(5 )消灭脊灰 (1990～ 1999年 )五个时期。回顾消灭脊灰工作的进程和所采取的策略 ,应该强调两点 :(1)不断提高OPV免疫覆盖率。江苏省在开展计划免疫后 ,加强冷链和规范化接种门诊建设 ,提高和保证服苗质量 ;开展消灭脊灰工作后 ,在做好常规免疫的基础上开展强化免疫活动 ,形成了有效的免疫屏障。 (2 )加强病例报告和监测。江苏省于 1991年建立了急性弛缓性麻痹 (AFP)病例监测系统 ,实行报病奖励制度 ,定期进行主动搜索 ,不断加强AFP病例报告和监测 ,如今各项监测指标已达到无脊灰证实的要求。自 1993年以来未发现脊灰野病毒病例。总结评价所采取的策略 ,对巩固消灭脊灰工作的成果 。

Jinagsu Province is one of the provinces with high incidence of poliomyelitis historically. Eradication of poliomyelitis in the province had experienced five stages as follows: (1) Stage before administration of oral polio vaccines (OPV) (1956～1960); (2) Beginning of OPV administration (1961～1969); (3) Extensive administration of OPV (1970～1978); (4) Implementation of expanded program on immunization (EPI) (1979～1989) and (5)Eradication of poliomyelitis (1990～1999). While reviewing the adopted strategies in the process of polio eradication, two points should be emphasized: (1) To raise the OPV immunization coverage rate unceasingly. After carrying out in Jiangsu Province the EPI, we have taken steps to strengthen the construction of cold chain and to standardize the vaccination in clinics, thus to ensure the vaccination quatity. Based on routine polio vaccination, still we carried out supplementary vaccination to establish an effective immune barrier among the population; (2) To strengthen the AFP surveillance. The AFP surveillance system had been established in 1991 in Jiangsu Province, the various surveillance indexes now has reached every requirements for proving no polio virus exists. In the course of surveillance, we pursued a case reporting encouragement system and an active AFP searching at regular intervals to strengthen AFP case reporting and surveillance. Since 1993, there was no wild type polio virus found. To summarize and evaluate the strategies for poliomyelitis eradication not only can consolidate the achievements of the work but also can provide reference in controlling other viral diseases.