2016年河南省急性弛缓性麻痹病例中脊髓灰质炎病毒监测结果分析

Surveillance of poliovirus isolates from acute flaccid paralysis in Henan Province in 2016

目的鉴定分析河南省15岁以下儿童疑似急性弛缓性麻痹(acute flaccid paralysis,AFP)病例中实验室确诊感染脊髓灰质炎(脊灰)病毒(Poliovirus,PV)的型别,为河南省制定更完善的脊灰防控策略及维持"无脊灰野病毒状态"提供科学依据。方法依据《WHO脊髓灰质炎实验室手册第4版》操作规程,使用RD和L20B两种细胞对河南省2016年AFP标本进行病毒分离,采用荧光定量PCR法及逆转录PCR法进行病毒序列鉴定和分析。结果共检测453例疑似AFP病例,其中有7例(1.55%)病例分离出10株脊灰病毒,其中Ⅰ型、Ⅲ型和Ⅰ+Ⅲ型分别为5株,3株和2株。分离到脊灰毒株与Sabin株相比,核苷酸VP1区发生0、1、2、4和6个变异的数量分别为3、1、3、2和1株。结论 2016年河南省分离出脊灰病毒均为脊灰疫苗株,毒株型别以Ⅰ型为主,VP1区核苷酸以低变异为主,未发现疫苗衍生脊灰病毒(Vaccine-derived poliovirus,VDPV)及脊灰野病毒(Wild poliovirus,WPV)。

Objective To provide the basis for the disease control and prevention and the＂polio free＇status,we identified and analyzed the poliovirus isolated from acute flaccid paralysis （AFP） cases among children under 25 years in Henan Province. Methods L20B and RD cells were used for poliovirus isolation from AFP cases in 2016 according to the 4th edition of WHO polio laboratory manual operating procedures, real-time polymerase chain reaction（rt-PCR）and reverse transcription-polymerase chain reaction（RT-PCR） were used for sequence determination and analysis. Result A total of 453 suspected AFP cases were detected, from 7 cases（ 1.55%）of which 20 poliovirus were isolated. The number of type Ⅰ , type Ⅲ and type Ⅰ ＋Ⅲ were 5,3 and 2. Compared with Sabin strain poliovirus, the number of 0,1,2 and 4 mutation occurred in VP1 region nucleotide is 4,2,2,2 and 2 ,respectively. Conclusion All isolates were vaccine-associated polio strain in Henan Province in 2026,most of which were type I ,and the variation of VP1 region nucleotide were mainly low, no detection of vaccine-derived poliovirus （VDPV）and wild type poliovirus.