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目的对北京市1例庞贝氏症携带脊髓灰质炎(脊灰)疫苗高变异株(Vaccine High-mutant Poliovirus,VHMPV)患儿进行流行病学调查分析。方法开展病例的个案调查、消毒隔离、排毒监测、病毒传播风险评估,召开急性弛缓性麻痹(AFP)病例分类诊断专家会对病例进行最终分类诊断。结果 2015年7月报告1例AFP病例,麻痹后采集2份合格粪便标本,经国家脊灰实验室核苷酸序列测定为VHMPVⅢ。患儿2月龄接种1剂脊灰灭活疫苗,3、4月龄分别口服1剂脊灰减毒活疫苗;排毒监测患儿及其密切接触者粪便标本中脊灰病毒分离均为阴性;患儿所在居委会接种率普查发现1例脊灰疫苗零剂次免疫儿童;昌平区所有街乡学龄前儿童脊灰疫苗查漏补种发现漏种率0.18%,补种率100%;医院AFP主动搜索发现1例AFP漏报病例;病例采取消化道隔离措施直至疫情结束。病例分类诊断为脊灰排除病例,临床诊断为庞贝氏症。结论患儿的弛缓性麻痹症状为其原发病庞贝氏症所致,是一名VHMPVⅢ携带者。病例所在区应进一步加强AFP病例监测,夯实常规免疫和查漏补种工作。
Objective To investigate the epidemiological investigation of 1 case of Pneumococcal Vaccine High-mutant Poliovirus (VHMPV) in Beijing. Methods To carry out the case investigation, disinfection and isolation, detoxification monitoring, risk assessment of virus transmission, acute flaccid paralysis (AFP) case diagnosis experts will diagnose the final classification of cases. Results One case of AFP was reported in July 2015, and two qualified stool specimens were collected after paralysis. The stool samples were determined to be VHMPV Ⅲ by the national polio laboratory nucleotide sequence. Children with 2-month-old inoculation of a polio inactivated vaccine, 3, 4 months of age were oral administration of a live attenuated poliomyelitis vaccine; detoxification monitoring of children and their close contacts were polio samples stool specimens were negative; Surveys of children’s neighborhood committees vaccination rate survey found that 1 polio vaccine zero-dose immunization of children; Changping District, all street-level pre-school children polio vaccine leak detection replant found 0.18% leakage rate, 100% seed replantation rate; hospital AFP initiative Search found 1 case of AFP omission cases; cases of digestive tract isolation measures until the end of the epidemic. Case classification diagnosis of cases of polio exclusion, clinical diagnosis of Pompe disease. Conclusion The flaccid paralysis symptom in children is caused by its primary disease of Pompe disease and is a VHMPV Ⅲ carrier. The district where the case is located should further strengthen the surveillance of AFP cases, consolidate routine immunization and leak detection and replanting work.