肇庆市健康儿童脊髓灰质炎抗体水平检测结果分析

目的了解肇庆市健康儿童脊髓灰质炎抗体水平。方法2005和2006年对肇庆市辖下3个县3～15岁儿童共465人进行脊髓灰质炎中和抗体测定;检测方法用微量组织培养法。结果465名儿童脊灰Ⅰ、Ⅱ、Ⅲ型抗体阳性率分别为98.7%、99.8%、97.6%,几何平均滴度(GMT)分别为1:145、1:104、1:40。3县间脊灰Ⅰ、Ⅱ、Ⅲ型抗体阳性率和GMT比较差异无统计学意义;三个年龄组间脊灰Ⅰ、Ⅱ、Ⅲ型抗体阳性率比较差异无统计学意义,GMT差异有统计学意义;男、女性别差异无统计学意义。结论肇庆市通过OPV常规免疫和强化免疫,已形成对脊灰病毒有效的免疫屏障,年龄较大的儿童脊灰抗体水平偏低。     

2004年全国计划免疫审评不同免疫覆盖率县的儿童脊髓灰质炎中和抗体水平调查

目的了解2004年全国计划免疫审评不同免疫覆盖率县的儿童脊髓灰质炎(脊灰)中和抗体水平。方法根据2004年全国计划免疫审评县四种疫苗[卡介苗、口服脊灰减毒活疫苗(OPV)、百白破联合疫苗、麻疹减毒活疫苗]免疫覆盖率不同分为3层,每层随机抽取2个县,每个县随机调查10个村,每个村随机调查1992~2003年出生儿童42名;检测方法用微量组织培养法。结果①被调查儿童建卡率和建证率分别为66.5%和75.3%。②脊灰Ⅰ、Ⅱ、Ⅲ型中和抗体阳性率分别为96.9%、98.6%、93.7%;几何平均滴度(GMT)分别为1∶113.2、1∶83.7、1∶40.5。③各型抗体GMT均随年龄增长呈明显下降的趋势。④不同免疫覆盖率儿童与脊灰中和抗体阳性率无相关性。结论本次调查地区儿童脊灰中和抗体阳性率、GMT总体保持在较高水平,但是个别地区的个别年龄组儿童较低。儿童OPV的接种率不能客观反映儿童脊灰的抗体水平。     

2019年四川省凉山州Ⅱ型疫苗衍生脊髓灰质炎病毒循环相关儿童脊髓灰质炎病毒中和抗体水平调查北大核心CSCD

目的评价2019年6月四川省凉山州Ⅱ型疫苗衍生脊髓灰质炎(脊灰)病毒循环(Circulating vaccine-derived poliovirus type II,cVDPV2)相关儿童脊灰病毒(Poliovirus,PV)中和抗体水平。方法在发生cVDPV2的雷波县田坝村选取所有1-5岁儿童,在雷波县其他地区和凉山州其他6个县采用便利抽样法抽取1-5岁儿童,采集血清标本,应用微量中和试验检测PVⅠ、PVⅡ、PVⅢ和/或cVDPV2中和抗体,分析抗体阳性率和几何平均滴度(Geometric mean titer,GMT)。结果在凉山州7个县(不包括田坝村)697名儿童中,PVⅠ、PVⅡ、PVⅢ中和抗体阳性率分别为90.8%、78.5%、85.5%,GMT分别为1∶85.1、1∶25.2、1∶37.1;各型PV抗体水平均随年龄增长而先下降再上升,且在7个县之间具有显著性差异。在雷波县田坝村52名儿童中,PVⅠ、PVⅡ、PVⅢ、cVDPV2中和抗体阳性率分别为44.2%、34.6%、38.5%、84.6%,GMT分别为1∶9.5、1∶5.1、1∶8.2、1∶89.9;在雷波县其他地区100名儿童中,相应中和抗体阳性率为分别为88.0%、75.0%、80.0%、79.0%,GMT分别为1∶69.4、1∶12.3、1∶32.5、1∶18.0。结论本起cVDPV2发生地区的儿童存在脊灰免疫空白,cVDPV2循环时间较久且传播广泛,凉山州1-5岁儿童脊灰免疫水平较低,需加强儿童脊灰预防接种工作。     

福建省脊髓灰质炎疫苗转换前后脊髓灰质炎抗体水平监测

目的评价福建省2016年脊髓灰质炎(脊灰)疫苗转换前全人群和转换前后目标儿童脊灰抗体水平。方法采用分层随机抽样方法,在疫苗转换前抽取0-82岁人群且在疫苗转换18个月后抽取5岁儿童,采集血标本,检测脊灰中和抗体,比较转换前后儿童抗体阳性率和几何平均滴度(GMT)。结果疫苗转换前0-82岁人群脊灰病毒Ⅰ、Ⅱ、Ⅲ型抗体阳性率分别为96.29%、95.53%、92.21%,GMT(1:)分别为78.59、55.83、32.89。脊灰疫苗转换前后3岁儿童脊灰病毒Ⅰ型、Ⅲ型抗体阳性率分别为99.19%vs 99.11%(x2=0.006,P=0.94)、97.52%vs98.20%(x2=0.16,P=0.69),GMT(1:)分别为215.57 vs 325.88(t=-2.37, P=0.018)、128.74 vs 199.42(t=-2.30,P=0.02)。脊灰疫苗转换前后3-4岁儿童脊灰Ⅰ型、Ⅲ型抗体阳性率分别为98.73%vs 98.86%(x2=0.008,P=0.93)、95.60%vs97.70%(x2=0.71,P=0.40),GMT(1:)分别为171.74vs 155.86(t=0.51,P=0.61)、53.29vs 72.70(t=-1.46,P=0.15)。结论脊灰疫苗转换前福建省全人群已建立良好的脊灰免疫屏障,疫苗转换后未影响目标儿童脊灰抗体水平。     

上海市消灭脊髓灰质炎的监测工作和预防策略及措施

上海市从 196 3年起使用口服脊髓灰质炎 (脊灰 )疫苗 (OPV) ,1987年报告最后 1例脊灰野病毒病例 ,1990年发现最后 1例外地来沪脊灰野病毒病例 ,1989年起检测健康儿童粪便标本未发现脊灰野病毒 ,可以认为 1987～1989年上海市已阻断脊灰野病毒的传播。 1972～ 1978年对 110名 2～ 12月龄婴儿做前瞻性调查 ,全程免疫后 4年的脊灰中和抗体Ⅰ型、Ⅱ型、Ⅲ型阳性率分别为 10 0 0 %、92 6 %、92 6 % ,几何平均滴度 (GMT)分别为 1∶12 1 0、1∶33 0、1∶2 2 0 ,显示OPV 3次免疫后效果很好。 1983年起建立接种门诊进行常规免疫 ,使免疫程序得以及时实施。对 18月龄～ 2岁儿童进行加强免疫后 ,脊灰中和抗体 3个型抗体阳性率均为 10 0 0 % ,GMT显著增长。从 1986年起 ,全市免疫程序为 2、3、4月龄 3次全程免疫 ;18月龄、4岁加强免疫 ;外来人口 (儿童和大学新生 )补服。 1984～2 0 0 1年全程免疫接种率为 97%～ 99% ,1986～ 2 0 0 1年加强免疫接种率为 95 %～ 99%。 1986～ 1997年 6月龄～ 2 9岁健康人群脊灰中和抗体Ⅰ、Ⅱ、Ⅲ型均阳性率为 92 5～ 96 0 %。全市消灭脊灰的预防策略和措施是以提高人群免疫力为主导 ,辅以对疑似脊灰病例和急性弛缓性麻痹病例的监测管理。     

珠江三角洲地区外来儿童与本地儿童脊髓灰质炎抗体水平比较分析

目的了解珠江三角洲的广州、深圳、东莞、佛山4个市流动儿童口服脊髓灰质炎(脊灰)减毒活疫苗(OPV)预防接种现状及影响因素,为制定流动儿童免疫策略提供科学依据。方法对这4个市本地和外来儿童进行了脊灰抗体水平检测,应用Foxpro 5.0建立数据库,SPSS软件进行统计分析。结果共检测1 180名0~6岁儿童的血标本,其中本地儿童595名,脊灰Ⅰ、Ⅱ、Ⅲ型抗体阳性率分别为99.50%、99.16%、98.15%,几何平均滴度(GMT)Ⅰ、Ⅱ、Ⅲ型分别为1∶217、1∶214、1∶73;外来儿童585名,脊灰Ⅰ、Ⅱ、Ⅲ型抗体阳性率分别为94.53%、98.12%、94.53%,GMTⅠ、Ⅱ、Ⅲ型分别为1∶145、1∶193、1∶58。显示外来儿童和本地儿童的脊灰抗体阳性率和GMT均在较高水平。结论广东省通过OPV常规免疫和强化免疫,已形成对脊灰病毒有效的免疫屏障。但外来儿童的脊灰抗体阳性率和GMT均低于本地儿童,因此应加强对流动人口儿童的免疫规划管理。     

湛江市健康儿童脊髓灰质炎中和抗体水平分析

目的 了解湛江市健康儿童脊髓灰质炎(脊炎)中和抗体水平,评价湛江市近年来口服脊髓灰质炎疫苗免疫效果。方法 于2002年8月至2003年10月对雷州市、昊川市、徐闻县的健康儿童进行脊灰中和抗体水平调查,选择2～4、6～8、13～15岁3个年龄组儿童进行随机抽样,共抽取323名进行血清中和抗体检测。结果 3县(市)健康儿童脊灰Ⅰ、Ⅱ、Ⅲ型中和抗体阳性率、几何平均滴度(CMT)分别为99．38％、98．76％、98．45％,和1：87．36、1：81．56、1：45．30;Ⅰ、Ⅱ型脊灰中和抗体GMT以2～4岁组最高,6～8岁组次之,13～15岁组最低,各年龄组之间差异有显著性,Ⅲ型中和抗体GMT各年龄组之闻差异则无显著性;雷州市脊灰各型中和抗体GMT明显高于徐闻县。结论 湛江市健康儿童有较高的脊灰免疫水平,并已形成有效的免疫保护屏障。     

上栗县健康儿童脊髓灰质炎抗体水平与肠道病毒携带状况分析

目的:了解上栗县0～15岁健康儿童脊髓灰质炎(脊灰)抗体水平及肠道病毒携带状况,为制定脊灰疫苗免疫策略和防治措施提供科学依据。方法:在上栗县按东南西北中调查5个乡镇健康儿童180名,用微量细胞中和试验测定血清脊灰中和抗体,调查其中2个乡镇健康儿童100名,分别于7月、11月采集粪便标本进行肠道病毒检测。结果:脊灰中和抗体Ⅰ、Ⅱ、Ⅲ型阳性率分别为96.67%,98.89%,92.22%;抗体几何平均滴度分别为1∶65.28、1∶89.92、1∶27.91。粪便标本肠道病毒阳性率分别为25.00%、26.00%。结论:上栗县健康儿童已形成有效的脊灰免疫屏障。     

广东省部分地区儿童免疫状况调查评价

目的了解近年广东省计划免疫实施情况以及儿童免疫状况。方法按全省地理位置抽花都、乳源、潮阳、麻章、徐闻和郁南6个县(区),每县(区)随机抽取1个乡镇,每个乡镇随机抽取1个自然村。结果共调查1997年1月1日至2000年7月1日出生的儿童178名,儿童建卡率为86.0%,建证率为81.5%,卡介苗、脊灰、百白破、麻疹和乙肝疫苗接种率分别为81.5%、79.2%、79.2%7、8.7%和62.4%。6个调查点之间的建卡率,建证率,卡介苗、脊灰、百白破、麻疹和乙肝疫苗接种率比较差异均有统计学意义(均P<0.01)。脊髓灰质炎3个型别抗体阳性率均为100%,麻疹抗体、乙肝表面抗体和乙肝表面抗原阳性率分别为87.1%、56.3%和4.4%。6个调查点之间麻疹抗体、乙肝表面抗体和乙肝表面抗原阳性率比较差异均有统计学意义(均P<0.01)。60.6%的家长能回答出脊灰疫苗强化免疫日时间;25.3%的家长能回答儿童1岁内需接种哪些计划免疫疫苗;26.4%的家长知道乙肝疫苗可预防乙肝,他们获得乙肝疫苗预防乙肝的信息途径主要是从医生处获得(49.8%)。76.4%的儿童是在乡镇卫生院级及以上接种门诊实施预防接种,36.5%的儿童是由防疫员或村医上门接种。儿童预防接种通知主要依靠乡村医生发放。结论儿童脊灰抗体水平达到了较高水平,部分地区儿童的麻疹抗体水平偏低,应重点加强贫困地区和活动人群聚集地麻疹免疫工作。     

流动人口与常住人口中5岁以下儿童脊髓灰质炎免疫状况及抗体水平比较分析

对郑州市金水区内１～５岁的流动儿童及同龄常住儿童的脊髓灰质炎（脊灰）免疫状况及抗体水平,进行随机抽查并分别做了分析评价．流动儿童中达到＞３次服苗的占８０％,常住儿童占９８％。采用脊灰中和抗体测定法测定流动儿童脊灰中和抗体,脊灰Ⅰ、Ⅱ、Ⅲ型抗体阳性率分别为９６％、９８％、９４％;３个型抗体几何平均滴度（ＧＭＴ）分别为Ⅰ型１：１１０,Ⅱ型１：２０２,Ⅲ型１：的常住儿脊灰中和抗体阳性率Ⅰ、Ⅱ、Ⅲ型均为１００％,３个型抗体ＧＭＴ分别为Ⅰ型１：２９８、Ⅱ型１：３７７、Ⅲ型１：２２９．结果提示两组儿童的抗体水平有差别。如何提高流动儿童的免疫接种率,是当今计划免疫工作所面临的一大难题．通过本次调查分析,为今后加强流动儿童的计划免疫管理提供了一定的依据。     

从重点监测地区看在广东省消灭脊髓灰质炎的前景

调查材料表明,通过大规模的服食糖丸疫苗,脊灰炎流行已在广东得到控制。其流行病学表现亦有恨大改变;在计划免疫好地区的儿童粪便及污水检材中均未能检出脊灰炎病毒;82.1%~96.8%的人有I~Ⅱ型脊灰炎抗体;97.7%及90%的产妇及脐血三个型脊灰炎抗体阳性;说明这些地区人群内的传播链已濒中断。但野毒株仍可在预防接种不良地区检出,并存在着免疫裂隙,故爆发的危险依然存在,必须进一步加强服苗工作。     

内蒙古自治区部分地区脊髓灰质炎麻痹后遗症调查报告

本文在163 013名12岁以下儿童中进行了跛行调查,确诊脊髓灰质炎(简称脊灰)麻痹后遗症312例,现患率为1.91‰。结果分析表明脊灰疫苗计划免疫以来,脊灰发病明显减少,但漏报严重;93%以上的脊灰患者未服苗;脊灰的好发年龄为4岁以下。     

Poliomyelitis surveillance in England and Wales, 1969-1975.

Poliomyelitis continued to be a rare disease in England and Wales in the period 1969-75. Only 31 paralytic and 44 cases of possible non-paralytic poliomyelitis were recorded during the 7 years. Of the 31 paralytic cases approximately one third were vaccine-associated; 3 were patients who had recently received oral poliovaccine and 7 had been in contact with a vaccinated person. Five of these 7 patients were parents of recently vaccinated children. The rate of vaccine-associated poliomyelitis was estimated in recipients to be 0.2 and in contacts 0.4 per million doses of vaccine given. Marker test results were reported on 555 strains of poliomyelitis virus isolated during 1969-75, using the reproductive capacity temperature test. Forty-eight (8.6%) resembled wild virus in this property, 15 strains being type 1, 8 type 2 and 25 type 3. Most of these isolations of apparently wild virus were from excreters with no symptoms of poliomyelitis, although 3 of the 15 type 1 strains were from patients with paralytic poliomyelitis and 3 from possible cases of non-paralytic poliomyelitis. None of the 8 apparently wild type 2 viruses was from a case of paralytic illness and only 1 of the 39 type 3 strains. Eleven of the 31 paralytic cases were in patients in whom the infection was likely to have been acquired abroad.     

Poliomyelitis surveillance in England and Wales, 1969-1975

Poliomyelitis continued to be a rare disease in England and Wales in the period 1969-75. Only 31 paralytic and 44 cases of possible non-paralytic poliomyelitis were recorded during the 7 years. Of the 31 paralytic cases approximately one third were vaccine-associated; 3 were patients who had recently received oral poliovaccine and 7 had been in contact with a vaccinated person. Five of these 7 patients were parents of recently vaccinated children. The rate of vaccine-associated poliomyelitis was estimated in recipients to be 0.2 and in contacts 0.4 per million doses of vaccine given. Marker test results were reported on 555 strains of poliomyelitis virus isolated during 1969-75, using the reproductive capacity temperature test. Forty-eight (8.6%) resembled wild virus in this property, 15 strains being type 1, 8 type 2 and 25 type 3. Most of these isolations of apparently wild virus were from excreters with no symptoms of poliomyelitis, although 3 of the 15 type 1 strains were from patients with paralytic poliomyelitis and 3 from possible cases of non-paralytic poliomyelitis. None of the 8 apparently wild type 2 viruses was from a case of paralytic illness and only 1 of the 39 type 3 strains. Eleven of the 31 paralytic cases were in patients in whom the infection was likely to have been acquired abroad.     

Paralytic poliomyelitis in children under 6 years in Pondicherry: a community survey.

STUDY OBJECTIVES--To assess the amount of poliomyelitis and its epidemiological features including risk factors. DESIGN--This was a retrospective study of cases of paralytic poliomyelitis among children 0-6 years of age. SETTING--Pondicherry, India, 1983-89. SUBJECTS--A total of 47,960 children aged less than 6 years. MEASUREMENTS AND MAIN RESULTS--In 1989, 469 field workers undertook a door to door survey of children 0-6 years old to identify those with limb paralysis. This was followed by clinical examination to establish the cause, supplemented by case notes held by the Child Development Services. Altogether 203 cases of limb paralysis were identified, 188 of which were judged a result of paralytic poliomyelitis. The prevalence of poliomyelitis in 1989 was 3.9/1000 among children below 6 years of age. There was a male preponderance with a male:female ratio of 1.4:1. The prevalence was least in infants (1/1000) and highest in children aged 2 to 3 years (6.4/1000). The age at onset was less than 12 months in 42% of cases and less than 3 years in 98%. The median age at onset was 13.4 months. Time series analysis showed a high occurrence of cases from May to September between 1983 and 1989. The legs were affected in 97%. About 41% of children had received three doses of oral polio vaccine. There was a history of intramuscular injection, possibly provoking a paralytic attack, in 54% of cases. CONCLUSION--This retrospective community study involving the staff of the Integrated Child Development Services provided valid data about poliomyelitis with little additional cost and minimum training. Because the study covered a whole population of children under 6 years, rather than a sample, the data will help in monitoring and surveillance of poliomyelitis and also in planning strategies for effective control.     

Residual paralytic poliomyelitis in a tropical region of Brazil, 1969-1977: prevalence surveys in different age groups as indicators of changing incidence

The magnitude of the problem of paralytic poliomyelitis in recent years in the tropical Federal District of Brazil was estimated in 1980 by determining the prevalence of residual paralytic poliomyelitis in 10,007 schoolchildren born in 1969-1970 and in 10,794 schoolchildren born in 1973-1974. About 98% of these children attended school in the Federal District. The rate of residual paralytic poliomyelitis of 5.4 per 1000 children born in 1969-1970 was 2.3 times higher than the rate of 2.3 per 1000 born in 1973-1974, which may be related to increasing vaccination of children under one year of age. Paralysis appeared before four years of age in 96.5% of these children. These prevalence rates indicate a minimal average annual incidence of acute persisting paralytic poliomyelitis of 187 cases per million total population during the period 1969-1973 and of 80 per million total population during the period 1973-1977 compared with an average annual incidence of 135 reported persisting and non-persisting paralytic cases per million total population in the United States in the prevaccine era and of four persisting cases per 100 million during 1973-1978.     

Susceptibility of itinerants ("travelling people") in Scotland to poliomyelitis

A total of 109 travelling people (people with a nomadic lifestyle), living on 8 separate sites in central and south Scotland, were examined for neutralizing antibodies to poliovirus types 1, 2, and 3. Of those studied, 10% had no detectable antibody to poliovirus type 3 while 7% had no antibody to type 1, the types most commonly associated with outbreaks of paralytic poliomyelitis. Only one subject, a child aged 9 years, had no detectable poliomyelitis antibody; he had no history of poliomyelitis immunization. The best protected groups of travellers were those located on sites with good facilities.     

Poliomyelitis cases in Northern Greece during 1976–1990

During the period 1976-1990 fourteen cases of paralytic poliomyelitis were recorded in Northern Greece, which has a total population of 2.5 million. Twelve wild strains of poliovirus type-1 were isolated from an equal number of children with paralytic disease from 1976 to 1982. Also, three Sabin-like poliovirus vaccine strains were isolated from two infants with paralytic disease. Since 1985 no paralytic cases have been reported in Northern Greece.     

Poliomyelitis vaccination in Ibadan, Nigeria, during 1964 with oral vaccine (Sabin strains): A report

A mass vaccination campaign of children under 3 years old was carried out in Ibadan in late 1964, following a marked increase in the incidence of paralytic poliomyelitis the previous year. Two doses of Sabin-strain attenuated poliomyelitis vaccine were given—the first of type 2 virus and the second of bivalent vaccine containing type 1 and type 3 viruses—with an interval of four weeks between doses. Although serological tests indicated a low antibody response, there was a pronounced and sustained fall in the incidence of the disease.     

Unnecessary injections and paralytic poliomyelitis in India.

The effect of prior injections on the pattern and severity of paralytic poliomyelitis has been examined by a retrospective analysis of case notes from an outpatient pediatric clinic in South India. Of 262 children with acute polio, 176 had received unnecessary injections < 48 h before paralysis and 12 had received diphtheria-pertussis-tetanus or provocative injections. Two children injected in the right arm had paralysis in that limb only. Children with no injections (controls) had an equal chance of paralysis (0.73) in each left and right leg. Children with injections in the right or left gluteus or in both had a 19% greater chance of paralysis in the injected leg(s), whereas uninjected legs had a 31% lower chance of paralysis. Injected leg muscles were weaker than those of control children. Legs of control children were stronger than those with one leg injected and much stronger than those with both injected. More than 96% of the children had at least one leg paralysed. Age and vaccine status did not affect the results of injections. After injections there was greater likelihood of death or lack of recovery of muscle strength. About three-quarters of the children had received unnecessary injections; of these 60% had more severe paralysis and a non-paralytic attack became paralytic in 40%. If oral medicines for fevers and diarrhoea replaced unnecessary injections, the prevalence and severity of paralytic polio would be reduced.