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目的调查1例疫苗衍生脊髓灰质炎病毒病例是否与服用脊髓灰质炎疫苗有关,确定是否为预防接种异常反应病例,并分析处置方法的得失。方法对病例开展个案调查,采集病例及其密切接触者和健康儿童粪便标本进行病毒分离,对脊灰病毒阳性分离物进行血清型、型内鉴定以及核苷酸序列分析;并收集病历相关资料。由专家诊断小组进行诊断。结果该病例有脊髓灰质炎减毒活疫苗免疫史,早期临床表现有发热、右下肢无力等,诊断为急性弛缓性麻痹,粪便标本分别检出Ⅰ型疫苗衍生脊灰病毒、Ⅱ型脊灰疫苗病毒株。此病例不属于预防接种异常反应。结论该疫苗衍生脊髓灰质炎病毒病例为单独病例;某市级医学会先后处置该病例伤残鉴定和异常反应鉴定的程序不当;为保持无脊髓灰质炎状态,应落实各项工作责任和防控措施;加强AFP病例监测和搜索工作;严格按照国家有关法规和工作规范处置预防接种异常反应病例的鉴定工作。
Objective To investigate whether one case of vaccine-derived poliovirus (IVPV) was associated with taking a polio vaccine and determine if there was an abnormal response to vaccination and analyze the pros and cons of the treatment. Methods To carry out a case-by-case survey, collecting cases and their close contacts and healthy children stool samples for virus isolation, serotypes, in-type identification and nucleotide sequence analysis of positive for poliovirus isolates; and collection of medical records related information. Diagnosed by expert diagnostic team. Results The cases of live attenuated poliomyelitis vaccine history, early clinical manifestations of fever, weakness of the right lower limb, acute flaccid paralysis diagnosed, stool specimens were detected Type I vaccine-derived poliovirus, poliovirus type II Virus strains. This case does not belong to the vaccination abnormal reaction. Conclusions The case of vaccine-derived poliovirus is a single case; a municipal medical association has successively handled the procedures of disability identification and abnormal reaction identification of the case; in order to maintain polio-free status, all the work responsibilities and prevention and control should be implemented Measures; strengthen AFP case surveillance and search work; in strict accordance with relevant state laws and regulations and work norms to deal with the identification of cases of abnormal response to vaccination.