2004-2011年四川省急性弛缓性麻痹监测系统中残留麻痹病例流行病学特征分析

Epidemiological Analysis of Acute Flaccid Paralysis Cases With Residual Paralysis in Sichuan,2004-2011

目的了解四川省2004-2011年间急性弛缓性麻痹(acute flaccid paralysis,AFP)病例监测中残留麻痹病例的流行病学和病原学特征。方法对残留麻痹病例的脊灰减毒活疫苗(OPV)免疫史、年龄、发生的时间和粪便标本病毒学分离结果进行流行病学分析。结果 2004-2011年四川省共报告2 761例AFP病例,麻痹后60 d随访时351例病例仍有残留麻痹症状,占报告病例的12.71%,主要人群为6岁以下儿童(63.82%),男女性别比为1.74∶1;残留麻痹并采集到双份合格粪便标病例本中,脊髓灰质炎(脊灰)病毒(poliovirus,PV)阳性为11.73%,非脊灰肠道病毒(non-polio enterovirus,NPEV)阳性率为10.85%,PV阳性中以PVⅡ型最多。结论 2004-2011年四川省未发现脊灰野病毒引起的残留麻痹病例,在现阶段应进一步加强对NPEV的病原学和流行病学研究,找出儿童致残的主要病因。

Objective To analyze the epidemiological characteristics of the acute flaccid paralysis（ AFP） cases with residual paralysis in Sichuan province from 2004 to 2011. Methods Epidemiological analysis was adopted to study the residual paralysis cases with regards to immunization history,age,time of onset and virus isolations from stool specimens. Results A total of 2761 AFP cases were reported in Sichuan province during 2004-2011. There were 351 cases,accounting for 12. 71% of all AFP cases,remained residual paralysis in the follow-up 60 days after onset of paralysis. Children under 6 years,with the sex ratio of 1. 74： 1,were the main population and accounted for 63. 82 % of all residual paralysis cases. Of adequate double stool specimens collected from residual paralysis cases,PV and non-polio enterovirus（ NPEV） positive rates were 11. 73% and10. 85%,respectively,and PV type Ⅱwas predominant among PV types. Conclusion The case with residual paralysis caused by wild poliovirus is not found from 2004 to 2011 in Sichuan. It is necessary to strengthen the research in etiology and epidemiology of NPEVs at the present stage,so as to identify the main reason for children disability.