广东省2015-2017年急性弛缓性麻痹病例病原学特征

Pathogen surveillance among acute flaccid paralysis cases in Guangdong province during 2015-2017

目的分析广东省急性弛缓性麻痹(Acute flaccid paralysis,AFP)病例病原学特征。方法对广东省2015-2017年0-14岁儿童AFP病例粪便标本进行脊髓灰质炎(脊灰)病毒(Poliovirus,PV)和非脊灰肠道病毒(Non-polio enterovirus,NPEV)分离和血清型鉴定,对PV株进行VP1编码区核苷酸序列测定,分析肠道病毒病原谱。结果在2015-2017年1156例AFP病例中,PV、NPEV总阳性率分别为1.90%(22例)、5.97%(69例)。0-4岁儿童病例PV、NPEV阳性率分别为21.10%(22例)、13.29%(59例)。5-7月份病例PV、NPEV阳性率分别为1.86%(6例)、16.15%(52例)。在PV阳性病例中,PV1、PV2、PV3、混合型分别为5例、4例、7例、6例;疫苗类似株、疫苗衍生脊灰病毒分别为21例、1例。结论广东省2015-2017年AFP病例未发现脊灰野病毒;NPEV感染以0-4岁儿童为主且呈夏秋季高峰。

Objective To identify enterovirus pathogens among acute flaccid paralysis(AFP) cases in Guangdong province.Methods We determined the AFP surveillance enterovirus spectrum by isolating polioviruses(PV) and non-polio enteroviruses(NPEV) from stool specimens from 0-14-year-old AFP cases during 2015-2017, identifying PV and NPEV serotypes, and conducting nucleotide sequencing of the VP1 region of isolated PVs.Results Of 1 156 AFP cases reported during 2015-2017, PV and NPEV positivity rates were 1.90%(22 cases) and 5.97%(69 cases), respectively;among 0-4 year-olds, rates were 21.10%(22 cases) and 13.29%(59 cases);between May and July, rates were 1.86%(6 cases) and 16.15%(52 cases). Among PV isolates, five, four, seven, and six were PV1, PV2, PV3, and mixed serotypes. Vaccine strains were identified in 21 cases and a vaccine-derived PV was identified in one case.Conclusions No wild PVs were found in AFP cases from 2015 to 2017 in Guangdong. NPEV infections occurred most commonly among 0-4 year-old children and had a summer-autumn seasonal peak incidence.