论文部分内容阅读
目的通过对2例口服脊髓灰质炎疫苗相关病例(VAPP)的报告分析,了解VAPP的发生因素,探讨降低VAPP发生率的有效措施,并为疫苗预防接种异常反应的处置提供参考。方法采集患儿双份大便,由河北省疾病预防控制中心实验室检测,阳性标本送国家疾病预防控制中心脊灰实验室鉴定。结果 2例病例均为2月龄首次口服脊髓灰质炎减毒活疫苗(OPV)而发病,且均为男性;病例1为口服OPV后34d出现急性弛缓性麻痹,鉴定为Ⅲ型脊灰疫苗病毒;病例2为口服OPV后13d出现急性弛缓性麻痹,鉴定为Ⅰ型、Ⅲ型脊灰疫苗病毒;2例病例均属于预防接种异常反应。结论对首次服用OPV的儿童认真做好接种前禁忌症的筛查、询问告知工作,并做好记录;首剂接种建议使用WHO推荐的替代方法:IPV或IPV/OPV序贯免疫程序,减少VAPP发生率;加强AFP监测,及时发现和治疗,减少VAPP并发症。
Objective To understand the causes of VAPP by analyzing the reports of two cases of oral polio vaccine (VAPP) and to find out the effective measures to reduce the incidence of VAPP and to provide reference for the treatment of vaccination abnormalities. Methods Double stool samples were collected from the laboratory of Hebei Provincial Center for Disease Control and Prevention. Positive samples were sent to the National Center for Disease Control and Prevention for identification of poliovirus. Results Both of the 2 cases were all caused by the first oral poliomyelitis attenuated live vaccine (OPV) at 2 months of age and both were male. Case 1 was acute flaccid paralysis 34 days after OPV oral administration and was identified as poliovirus type Ⅲ Case 2 was acute flaccid paralysis on day 13 after oral administration of OPV, which was identified as type I and type III poliovirus. Two cases were all abnormal vaccination vaccination. CONCLUSIONS: Children who first take OPV should be carefully screened for contraindications before vaccination, asked for information and documented. The first inoculation recommended the WHO-recommended alternative: IPV or IPV / OPV sequential immunization programs to reduce VAPP Incidence; strengthen AFP monitoring, timely detection and treatment to reduce VAPP complications.