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目的分析湖南省首例患原发性免疫缺陷的疫苗衍生脊髓灰质炎(脊灰)病毒(Immunodeficiency-associated Vaccine-derived Poliovirus,i VDPV)病例,探讨控制策略。方法对该i VDPV病例进行流行病学调查,检测脊灰抗体,测定免疫功能,并定期采集粪便标本分离病毒,对病例所在地及医院进行急性弛缓性麻痹病例主动搜索,对病例所在地进行接种率调查和人群抗体水平检测,开展风险评估。结果病例最终分类诊断为i VDPV病例,当地适龄儿童常规免疫接种率较高,人群具有较高的脊灰抗体水平,粪便标本未分离到疫苗衍生脊灰病毒(VDPV)。在病例所在地及相邻地区开展脊灰疫苗查漏补种。结论病毒未在当地造成循环,高水平的免疫屏障、高效率的监测系统、及时有效的应急处置是防范野病毒输入和VDPV传播的保障。但随着全球消灭脊灰的进展,应对患免疫缺陷的儿童采取针对性的策略和研究。
Objective To analyze the first case of immunodeficiency-associated Vaccine-derived Poliovirus (iVDPV) in Hunan province and to explore the control strategy. Methods The epidemiological investigation of i VDPV cases was carried out. Antibody of poliovirus was detected, immune function was measured, and stool samples were collected regularly to separate the virus. The case was located and the hospital was actively searched for cases of acute flaccid paralysis, and the vaccination rate was investigated And human antibody levels to carry out risk assessment. Results The final classification of cases was diagnosed as i VDPV. The routine immunization rate of local school-age children was higher, the population had higher level of anti-polio antibody, and the vaccine-derived poliovirus (VDPV) was not isolated from the stool samples. Polio vaccination should be conducted at the site of the case and in the neighboring areas. Conclusion The virus does not cause circulation in the local, high-level immune barrier, high-efficiency monitoring system, timely and effective emergency response is to prevent wild-type virus input and VDPV transmission protection. However, with the progress of eradicating polio in the world, targeted strategies and research should be carried out for children with immunodeficiency.