论文部分内容阅读
目的对北京市首例Ⅰ型(Type1)疫苗高变异脊髓灰质炎(脊灰)病毒[Vaccine High-mutant Poliovirus(PV),VHMPV_Ⅰ]病例进行流行病学调查分析。方法开展VHMPV病例个案调查、排毒监测、病毒传播风险评估、消毒隔离。结果患儿为北京市户籍,患有肛门周围脓肿,有1剂口服脊灰减毒活疫苗(Oral Poliomyelitis Attenuated Live Vaccine,OPV)接种史,麻痹前随母亲到河北省大厂回族自治县暂住,发病后采集3份合格粪便标本,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核苷酸序列测定为VHMPV_Ⅰ病例。间隔14天采集患儿粪便标本4份,密切接触者采集单份粪便标本7份,PV分离和逆转录-聚合酶链反应检测均为阴性;病例居住地所在乡OPV接种率调查、相邻乡和流动人口聚居乡OPV接种率快速评估均未发现OPV零剂次免疫儿童;医院和社区急性弛缓性麻痹性病例主动搜索未发现漏报病例;病例采取消化道隔离方式直至疫情结束。结论 VHMPV_Ⅰ病例可能为低免疫水平儿童,由外环境感染导致发病;应进一步开展VHMPV_Ⅰ基因突变与神经毒力关系研究。
Objective To investigate the epidemiological investigation of the first case of Type 1 vaccine in Beijing with Vaccine High-mutant Poliovirus (PV), VHMPV_Ⅰ. Methods To carry out case investigation of VHMPV cases, detoxification monitoring, risk assessment of virus transmission, disinfection and isolation. Results The children were resident in Beijing. They had an abscess around the anus. They had a history of vaccination with Oral Poliomyelitis Attenuated Live Vaccine (OPV). Before their paralysis, their mother went to Dachang Hui Autonomous County temporarily for medical residency, After the onset of the acquisition of three qualified stool specimens by the Chinese Center for Disease Control and Prevention virus prevention and control of the national polio laboratory nucleotide sequence determination of VHMPV_Ⅰ cases. Four fecal specimens were collected at intervals of 14 days. Seven close-stool specimens were collected from close contacts. PV isolation and reverse transcription-polymerase chain reaction (PCR) tests were negative. Infection survey of OPV in the township where the cases were located, And the rapid assessment of the OPV inoculation rate in migrant population in townships did not find OPV zero-dose immunization of children; no cases of omission were found in the active search of acute flaccid paralysis cases in hospitals and communities; the cases were separated by digestive tract until the epidemic was over. Conclusion VHMPV Ⅰ may be a low immunocompromised children and lead to morbidity caused by external environment infection. The relationship between VHMPV Ⅰ mutation and neurotoxicity should be further studied.