海南省脊髓灰质炎病毒疫苗株分离及相关资料分析

Isolation and Data Analysis of Poliomyelitis Virus Vaccine-Associated Strain in Hainan Province.

目的 了解海南省 1995～ 2 0 0 0年报告的 15岁以下急性弛缓性麻痹 (AFP)病例及密切接触者粪便标本中脊髓灰质炎病毒 (PV)疫苗株的分离情况 ,分析病例流行病学特征、PV型别分布等相关资料。方法 采用试管法分离肠道病毒 ,微量中和试验法鉴定脊灰病毒 ,国家脊灰实验室采用PCR -RFLP法进行型内鉴别。结果 海南省 1995～ 2 0 0 0年报告的 15岁以下急性弛缓性麻痹 (AFP)病例 177例及 6 85名密切接触者的粪便标本中 ,脊髓灰质炎病毒疫苗株的分离率分别为 10 80 %和 2 .48% ,3岁以内的儿童分别占 94 73%、47 10 %。 19例脊灰病毒疫苗株阳性的AFP病例中 ,31.5 8%的儿童无OPV免疫史 ,2 1.0 5 %的儿童有 1～ 2次免疫史 ,仅 47 37%完成了三次OPV全程免疫。其中 9例病例发病后 6 0天残留麻痹。结论 我国已进入“无脊灰状态” ,已无本土脊灰野病毒感染的病例 ,脊灰病毒疫苗株在人群中的循环及其致病性应进一步研究 ,同时 ,继续保持儿童高的OPV免疫覆盖率仍然是十分必要和有效的。

Objective To understand the poliovirus isolation rate in Acute Flaccid Paralysis(AFP),their exposure to poliovirus in 1995～2000 in Hainan province and analyze the epidemiology characteristics and PV type.Methods Using test tubes to isolate enterovirus and neutralization testto identify the type of poliovirus.In the National Polio Laboratory PCR-RFLP method was used to identify intro-type of poliovirus.Results 176 Acute Flaccid Paralysis(AFP)cases were collected stool samples from 1995 to 2000 in Hainan province.685 stool samples of contact of AFPcases were collected too.The positive rate of poliovirus(PV)of AFP and contact was respectively 10.80% and 2.48%,Children under 3 years old occupied 94.73% and 47.10%.In the 19 PV positive AFP cases 31.58% of them had finished full-course immunization of over 3 times of OPV.9 of the 19 AFP cases occurred residual paralysis after onset date.Conclusion Now China had been certified as'Polio Free'and had no poliomyelitis case caused by indigenous wild poliovirus.The circulation of poliovirus vaccine-associated strain and it's pathogenicity should be studied further,Meanwhile,to keep with high immunization rate of OPV was still very necessary and effective.