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目的分析宁波市鄞州区首例疫苗相关Ⅰ型麻痹型脊髓灰质炎病例的流行病学情况。方法对患儿的发病及诊治经过,流行病学调查和处置,实验室检测结果,伤残残留及等级鉴定,补偿政策落实进行调查分析。结果实验室分离与定型为Ⅰ型,浙江省预防接种异常反应调查诊断专家组诊断为脊灰疫苗相关麻痹型脊灰(VAPP)病例;调查显示鄞州区儿童脊灰疫苗接种率为99.71%,脊灰灭活疫苗(IPV)替代接种率为0.87%;主动搜索未发现急性弛缓性麻痹(AFP)病例;接种门诊接种实施规范。结论该病人感染系口服脊灰疫苗株病毒所致;鄞州区IPV接种服务有待提高;预防接种单位对接种脊灰疫苗尤其是首次接种者需行肛周脓肿检查,以筛查特殊人群;卫生部门应当主动应对VAPP病例的发生,确保常规免疫工作正常开展。
Objective To analyze the epidemiology of the first vaccine-associated paralytic type 1 poliomyelitis in Yinzhou District of Ningbo City. Methods The incidence and diagnosis and treatment of children, epidemiological investigation and disposal, laboratory test results, residual disability and grade identification, compensation policy implementation survey. Results The laboratory isolated and stereotyped as type Ⅰ, Zhejiang Province vaccination anomalous response survey diagnostic expert group diagnosed as poliovirus-associated paralytic poliovirus (VAPP) cases; survey showed Yinzhou District polio vaccination rate of children was 99.71%, ridges Vaccination rate of gray inactivated vaccine (IPV) was 0.87%; no case of acute flaccid paralysis (AFP) was found on active search; norms of vaccination on vaccination were implemented. Conclusions This patient was infected with oral poliovirus due to oral administration of poliovirus. Yinchuan IPV vaccination service needs to be improved. Vaccination unit should check perianal abscess against polio vaccine, especially for the first time, to screen for special population. Should take the initiative to respond to the occurrence of VAPP cases, to ensure the normal immunization work normally.