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目的了解1992-2011年昭通市急性迟缓性麻痹病例中检出脊髓灰质炎疫苗株病毒病例的流行病学特征,为维持无脊灰提供科学依据。方法根据脊灰实验室监测结果,对检出脊灰疫苗株病毒病例进行流行病学分析。结果 581例病例合格标本脊灰疫苗株病毒检出61例,检出率为10.50%;检出疫苗株病毒病例集中在2岁以内儿童,男多于女;未进行疫苗全程免疫的病例多于全程免疫病例,“0”剂次儿童所占比例较大,最多服苗剂次儿童服苗12剂次;麻痹病例中检出Ⅱ、Ⅲ型病毒较多;15岁以下儿童VAPP的发生率为0.62/100万,服苗者VAPP的发生率为0.49/100万。2010年检出1株疫苗变异株病例,变异株为新出现的VDPV病毒。环境脊灰监测从污水与河流中检出疫苗株病毒,检出率为25%。结论脊灰疫苗基础免疫工作存在薄弱环节。必须保持高水平的疫苗接种率,严防VDPV病例产生和VDPV循环引起脊灰暴发或流行。服苗儿童VAPP发生率高于国内文献报道的西安、福建和杭州,低于甘肃、深圳。加强污水的消毒处理严防接触者VAPP的发生。
Objective To understand the epidemiological characteristics of poliovirus strains detected in acute delayed paralysis cases in Zhaotong City from 1992 to 2011 and to provide a scientific basis for maintaining poliomyelitis. Methods According to the results of polio laboratory monitoring, the epidemiological analysis of poliovirus strains was carried out. Results 61 out of 581 cases of poliovirus were detected, the detection rate was 10.50%. The cases of vaccine strains were found in children less than 2 years old, more than males and females. More cases than those without vaccine were more than In the whole immunization case, the proportion of children in the “0” group was higher than that in the group of children with up to 12 doses of vaccine. In the cases of paralysis, there were more type Ⅱ and Ⅲ viruses; and the incidence of VAPP in children under 15 years The rate was 0.62 / 1 million, the incidence of VAPP was 0.49 / 100 million. In 2010, one vaccine mutant strain was detected, and the mutant strain was newly emerged VDPV virus. Environmental polio monitoring Vaccine strains were detected in sewage and rivers, with a detection rate of 25%. Conclusion There is a weak link in the basic immunization of polio vaccine. High levels of vaccination must be maintained to prevent polio outbreaks or epidemics from occurring in VDPV cases and VDPV circulation. The incidence of VAPP in service-taking children was higher than that of Xi’an, Fujian and Hangzhou reported in domestic literature, lower than those in Gansu and Shenzhen. Strengthen the disinfection of sewage to prevent contact with the occurrence of VAPP.