中国2014年脊髓灰质炎实验室网络的运转与评价

Running status and evaluation of the China Polio Laboratory Network in 2014

目的评价中国(未包括香港、澳门特别行政区和台湾地区,下同)2014年脊髓灰质炎(脊灰)实验室网络(Polio Laboratory Network,PLN)运转情况,为中国维持无脊灰状态提供病毒学依据。方法对中国急性弛缓性麻痹(Acute flaccid paralysis,AFP)病例监测信息报告管理系统中31个省份报告的AFP病例和国家脊灰实验室(National Polio Laboratory,NPL)的监测数据进行分析,对PLN的各项运转指标进行评价。结果 2014年中国PLN共报告5 751例AFP病例,收到5 688例AFP病例的11 363份粪便标本;14天内双份粪便标本的采集率为92.16%,合格粪便标本采集率为91.65%,病毒分离结果 18天内反馈率为97.62%。从5 688例粪便标本中132例(2.32%)分离到脊灰病毒(Poliovirus,PV);590例(10.37%)分离到非脊灰肠道病毒(NPEV)。2014年NPL收到省级脊灰实验室送检的分离自AFP病例及其接触者、非AFP病例、健康人的292株L20 B细胞阳性分离物,262株为PV,21株为NPEV,9株为非肠道病毒(Non-enterovirus,NEV)。262株PV中,7株为疫苗衍生脊灰病毒(Vaccine-derived poliovirus,VDPV),来自内蒙古、山西、河北和湖南;未发现脊灰野病毒(Wild poliovirus,WPV)。从脊灰病毒外环境监测采集的污水标本中分离到4株VDPV。2014年NPL和31个省级CDC脊灰实验室都通过了世界卫生组织(WHO)粪便标本肠道病毒的新检测流程的能力验证标本考核。NPL和8个省级CDC脊灰实验室接受并通过了WHO现场评估认证,其他省级实验室接受了信函认证。结论中国PLN 2014年运转正常,未发现WPV,为维持中国无脊灰状态、早期发现VDPV或VDPV病例、早期采取应对措施阻断其传播提供了重要的病毒学依据。

Objective To provide virology evidence for maintaining polio-free status in China（excluding Hong Kong and Macao Special Administrative Region and Taiwan）.Methods Data from the Polio Laboratory Network（PLN） reported in 2014 were analyzed.Acute flaccid paralysis（AFP） surveillance data from all 31 provinces reported to the AFP Surveillance Information Reporting and Management System（AFPSIRMS） and virology surveillance data from the National Polio Laboratory（NPL） of the Institute of Viral Disease Control and Prevention（IVDCP） were analyzed.Performance indicators of the Chinese PLN were analyzed.Results There were5 751 AFP cases reported to the Chinese PLN in2014;11 363 stool samples were received from5 688 AFP registered cases.Among these,92.16% had 2 stool specimens collected within 14 days;the adequate stool sample rate was91.65%.Additionally,97.62% of cases＇ viral isolation results were reported within 18 days.Finally,132（2.32 %） poliovirus（PV） and 590（10.37 %） non-polio enteroviruses（NPEV）were isolated from 5 688 cases＇ stool specimens in 2014.In total,292 L20 B positive isolates were sent to NPL that had been isolated from AFP cases,contacts,non-AFP cases,or healthy children.Among these,262 were PV,21 were NPEV,and 9 were non-enteroviruses（NEV）.No wild PVs（WPV） were found,while 7 vaccine-derived PVs（VDPVs） were detected in 2014;they were isolated from Inner Mongolia,Shanxi,Hebei,and Hunan.There were 4 VDPVs isolated from environmental surveillance.The NPL and all 31 provincial polio laboratories passed the 2014 proficiency test using a new algorithm.The NPL and 8 provincial polio laboratories received accreditation following on-site reviews conducted by the World Health Organization（WHO）,while other provincial polio laboratories received accreditation by letter authentication.Conclusions The Chinese PLN was working well;no WPVs were detected.The results provided important virology evidence for improving the work of maintaining polio-free status,early detection of VDPV or VDPV cases,and prompt interruption of VDPV circulation.