安徽省Ⅲ型脊髓灰质炎减毒活疫苗病毒衍生株病例调查分析

Report of Paralytic Cases caused by Type 3 Vaccine-derived Poliovirus in Anhui Province

目的 了解发生在安徽省 2 0 0 2年 3例Ⅲ型脊髓灰质炎减毒活疫苗病毒衍生株 (VDPV)引起的病例的流行病学特征和临床表现。方法 病例个案调查。结果 3例分布在相距较远的农村地区 ,为 <2岁男孩 ,均发病于春夏季 ,有 2次或 3次脊髓灰质炎减毒活疫苗 (OPV)服苗史 ,其中 1例在服苗后 2 5d发病 ;病例有发热、非对称性麻痹、腱反射减弱、巴彬斯基征阴性和留有后遗症等临床表现 ,其中 2例临床症状严重。结论 首例Ⅲ型VDPV病例发生在安徽省 ,病例有增多的趋势 ;其流行学特征和临床表现与野病毒引起的病例相似 ;2例患儿因感染在环境中循环的Ⅲ型VDPV而发病 ;尚未发现该疾病的传播流行 ;

Objective To find out epidemiological and clinical feature of paralytic cases caused by type 3 vaccine-derived poliovirus(VDPV) in Anhui province in 2002.Methods Case investigatigation. Results Three cases distributed in different rural areas. These cases aged <2 years old and were all boys. They had onset of paralysis in spring and summer, received 2～3 doses of oral polio vaccine (OPV). One of them was taken bad after received one doses OPV at 25 days. The clinical characteristics of these case manifested by fever, asymmetrical flaccid paralysis, weakness of reflexes of tendon, the absence of Babinski sign and residue paralysis. Of them, symptom of 2 cases was serious.Conclusions First paralytic case was caused by type 3 vaccine-derived poliovirus in Anhui province and the cases had trend to increase. The epidemiological and clinical features of the cases were similar to poliomyelitis. 2 cases were caused by circulating vaccine-derived poliovirus. The transmission of the disease was not discovered at present. Full immunizing or no full immunizing infants could become the case.