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目的通过对中国(未包括香港、澳门特别行政区和台湾地区,下同)2006年脊髓灰质炎(脊灰)实验室网络监测结果进行分析,评估其运转情况,提供中国继续维持无脊灰状态的实验室依据。方法分析31个省(自治区、直辖市,下同)急性弛缓性麻痹(AFP)病例个案调查表数据库和中国疾病预防控制中心(CDC)病毒病预防控制所国家脊灰实验室监测数据库,总结脊灰实验室网络运转中的培训和质量控制,评价实验室网络运转的各项指标。结果2006年全国脊灰实验室网络收集了5 299例AFP病例的10 537份粪便标本,按《世界卫生组织(WHO)脊灰实验室手册》的要求进行病毒分离和鉴定。28d内完成病毒血清型定型的及时率为88.7%,AFP病例中分离到脊灰病毒(PV)的280例,分离率为5.3%;分离到非脊灰肠道病毒的551例,分离率为10.4%。国家脊灰实验室对2006年全国脊灰实验室网络分离到的359株PV进行了聚合酶链反应-限制性酶切片段长度多态性分析(PCR-RFLP)型内鉴定,对462份单血清型PV进行了酶联免疫吸附试验(ELISA)型内鉴定。并对PCR-RFLP及ELISA型内鉴定有异常的毒株或分离于零剂次服苗的AFP病例的毒株及部分Ⅲ型毒株,共180株进行VP1基因核苷酸序列测定和分析,未发现脊灰野病毒。但在广西壮族自治区的1例AFP病例和7名接触者中,分离到8株Ⅰ型疫苗衍生脊灰病毒(VDPVs),在上海市1名健康儿童中分离到1株Ⅲ型VDPV。在培训和质量控制方面,2006年举办了两期全国脊灰实验室新人手把手培训班,12个省CDC脊灰实验室16人参加了培训。2006年,国家脊灰实验室以优异的成绩通过WHO的2006年度能力验证和现场认证;31个省CDC脊灰实验室通过了2006年度盲样标本能力验证;内蒙古、江苏、福建、云南、湖南、四川、新疆、安徽8个省CDC脊灰实验室通过了WHO的实验室现场认证。结论中国2006年脊灰实验室网络运转良好,已建立的科学化、系统化、规范化的质量控制体系取得良好的实效和发挥了应有的作用。中国2006年继续保持无脊灰状态,脊灰实验室网络运转正常,监测系统敏感,为维持无脊灰提供了实验室依据。
Objective To analyze the monitoring results of the poliovirus (polio) laboratory network in China (excluding the Hong Kong SAR, Macao Special Administrative Region and Taiwan, the same below) in 2006 to assess their operation status and provide evidence that China continues to maintain its polio-free status Laboratory basis. Methods A case-control questionnaire database of acute flaccid paralysis (AFP) cases in 31 provinces (autonomous regions and municipalities directly under the Central Government) and the national polio laboratory monitoring database of CDC virus disease prevention and control were analyzed, and polio Laboratory network operation training and quality control, evaluation of laboratory network operation of the indicators. Results A total of 10 537 stool specimens from 5 299 AFP cases were collected from the National Polio Laboratory Network in 2006. The virus was isolated and identified according to the “WHO Polio Laboratory Manual”. 28.8 days to complete the final serotype of the virus serotype rate of 88.7%, AFP cases isolated poliovirus (PV) in 280 cases, the isolation rate was 5.3%; isolated 551 cases of non-polio enterovirus, the isolation rate was 10.4%. The National Polio Laboratory carried out the PCR-RFLP in-vitro identification of 359 PV isolated from the National Polio Laboratory Network in 2006, and identified 462 single Serum PV was subjected to enzyme-linked immunosorbent assay (ELISA) type identification. A total of 180 strains of AFP cases and some type Ⅲ strains isolated from PCR-RFLP and ELISA were sequenced and their VP1 gene nucleotide sequences were determined and analyzed. No wild polio virus was found. However, in the 1 case of AFP and 7 contacts in Guangxi Zhuang Autonomous Region, 8 type I vaccine-derived poliovirus (VDPVs) were isolated and one type III VDPV was isolated from one healthy child in Shanghai. In terms of training and quality control, two training sessions were held in 2006 for new recruits to the National Poliomyelitis Laboratory, and 16 participants from 12 CDC polio laboratories in 12 provinces participated in the training. In 2006, the National Polio Laboratory passed the 2006 WHO Proficiency Test and Field Certification with outstanding achievements. The CDC Polio Laboratory in 31 provinces passed the 2006 capacity verification of blind samples; Inner Mongolia, Jiangsu, Fujian, Yunnan and Hunan CDC polio laboratories in eight provinces of Sichuan, Xinjiang and Anhui have passed the WHO laboratory site certification. Conclusion The Chinese polio laboratory network operated well in 2006, and the established scientific, systematic and standardized quality control system has achieved good results and played its due role. China continued its polio-free status in 2006, the polio laboratory network was functioning normally and its monitoring system was sensitive, providing a laboratory basis for maintaining polio-free status.