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为及时发现和阻断疫苗衍生脊髓灰质炎(脊灰)病毒(vaccine-derived polioviruses,VDPVs)循环、脊灰野病毒的输入和能够引起临床脊灰的其它脊灰疫苗相关病毒,做好贵州省无脊灰状态下脊灰病毒学监测工作,采用病毒分离、鉴定与核苷酸序列测定和分析方法,对贵州省贞丰县及周围10个县2003~2004年报告的急性弛缓性麻痹(AFP)病例及2004年接触者粪便标本的病毒学监测的结果进行了分析。对收集到的105例AFP病例和47例密切接触者的278份便标本进行了病毒学监测,结果从66例中共分离到肠道病毒(EV)66株,阳性率为43.4%,其中脊灰病毒(PV)29例,分离率为19.1%,非脊灰肠道病毒(NPEV)37例,分离率为24.3%。29例PV经中国疾病预防控制中心病毒病预防控制所国家脊灰实验室鉴定,24例为疫苗相似株,5例为脊灰Ⅰ型VDPVs,这5例均为2004年从贞丰县所分离到。贞丰县及周围县EV阳性检出率(43.4%)高于2003~2004年全省水平(22.9%~24.6%),2004年PV分离率比2003年高达2.6倍,29株PV中单个Ⅰ型占34.5%,明显高于往年(2000~2002年全省平均4.1%)。本研究提示,Ⅰ型VDPVs在贞丰县引起了循环(cVDPVs),通过口服脊灰疫苗强化免疫已经阻断cVDPVs的传播。人群中PV和NPEV带毒率明显增高,非VDPVs引起的临床符合脊灰病例不容忽视;应加强脊灰病毒学监测数据的分析和早期疫情预警工作。
In order to timely detect and block the vaccine-derived polioviruses (VDPVs) circulation, the input of poliovirus and other poliovirus associated with poliovirus, Poliovirus virulence monitoring in poliovirus was performed. AFP cases reported from 2003 to 2004 in Zhenfeng County and surrounding counties in Guizhou Province were detected by virus isolation, identification and nucleotide sequence determination and analysis. And the results of virological surveillance of stool specimens from contacts in 2004 were analyzed. A total of 278 samples of AFP (collected from 105 cases) and 47 (47 cases) from the close contact were enrolled in the study. Virological tests were performed on 66 collected samples of 66 enteric viruses (EVs), with a positive rate of 43.4% 29 cases of virus (PV), isolation rate was 19.1%, non-polio enterovirus (NPEV) 37 cases, the isolation rate was 24.3%. 29 cases of PV by the Chinese Center for Disease Control and Prevention virus prevention and control by the National Polio Laboratory identification, 24 cases of vaccine-like strains, 5 cases of poliovirus type VDPVs, these 5 cases were isolated in 2004 from Zhenfeng County . EV positive detection rate (43.4%) was higher in Zhenfeng County and its surrounding counties than that in 2003-2004 (22.9% -24.6%). In 2004, the PV isolation rate was 2.6 times higher than that of 2003, Accounting for 34.5%, significantly higher than in previous years (from 2000 to 2002, the province’s average of 4.1%). This study suggests that type V VVVVs cause circulating cVDPVs in Zhenfeng County and that the enhanced immunization with oral polio vaccine has blocked the spread of cVDPVs. People with PV and NPEV poisoning rate was significantly increased, non-VDPVs caused by clinical cases of polio can not be ignored; poliovirus monitoring data should be strengthened and early warning of the epidemic should be strengthened.