口服脊髓灰质炎疫苗与相关病例发生危险性的流行病学分析

Epidemic analysis of danger between oral polio vaccine and vaccine associated paralytic poliomyelitis

[目的]为探讨口服脊髓灰质炎活疫苗(OPV)与脊髓灰质炎疫苗相关病例(VAPP)的关系。[方法]对1991～1999年日照市报告的6例VAPP进行了分析。[结果]首次服苗者发生率为24.05/100万,0～4岁服苗总发生率为1.90/100万。发病者男、女性别之比为5:1;发病年龄在4～10月龄,均为第一次服苗后发病。服苗至发病平均潜伏期为20 d,60d后随访残留麻痹;有4名患者在发病前30 d内有肌肉注射史,其中3例口服OPV时与吸附百白破混合制剂(DPT)进行了联合免疫。病毒分型:Ⅰ型2株,Ⅱ型4株,Ⅲ型4株。[结论]VAPP主要发生在OPV的首次免疫;OPV首次免疫与DPT联合免疫VAPP发生率高于非联合免疫;VAPP发生以Ⅱ型、Ⅲ型病毒为主。

[Objective] To discuss the association of oral polio vaccine (OPV) and vaccine associated paralytic poliomyelitis (VAPP) . [Methods] We analyzed the six VAPP cases reported froml991 to 1999. [Results] Morbidity among the people who had taken the first dose of OPV was 24.05/million, and the morbidity aged 0-4 were 1.90/million. Among the cases. , ratio between male and female was 5:1. The patients, aged between 4-10 months, were attacked after taking the first dose. Average incubation - period was 20 days, and some patients still had paralysis when visited 60 days later. There were 4 patients who had the history of muscle injection 30 days before getting ill, and 3 patients who had been injected DPT joint immunization. Virus types: 2 type Ⅰ, 4 type Ⅱ, 4 type Ⅲ. [Conclusion] VAPP happens mainly among the people who take the first OPV; Morbidity of joint immunization of OPV immunization and DPT is higher than non - joint immunization; Among the VAPP cases, virus Ⅱ, Ⅲ are dominant.