小月龄儿疑似脊髓灰质炎疫苗相关麻痹2例流行病学调查

目的：分析2007年及2008年杭州市二例小月龄儿脊髓灰质炎疫苗相关麻痹病例的传播及其影响因素。方法：对报告的2例急性弛缓性麻痹（AFP）患儿进行流行病学调查。结果：1例脊灰病毒分离与定型为Ⅱ＋Ⅲ型，诊断小组认定为脊灰疫苗相关麻痹型脊灰（VAPP）病例。1例实验室检测为阴性，专家诊断小组诊断为可能是VAPP病例，建议按VAPP病例有关规定处理。结论：在实现无脊灰目标后，将面临苗相关麻痹型脊灰病例的发生等问题。应采取的措施主要是：保持高水平的免疫接种率和高质量的急性弛缓性麻痹病例监测工作。

An epidemiological study on two small-month infants suspected of vaccine-associated paralytic poliomyelitis

Objective To analyze the transmission and influencing factors of two suspected cases of small--month infants with vaccine- associated paralytic poliomyelitis （VAPP） in Hangzhou from 2007 to 2008. Methods An epidemiological investigation was made on two reported cases of children with acute flaccid paralysis （AFP）. Results One case was diagnosed as VAPP based on the result of the isolate being typed as polioviruse Ⅱ＋Ⅲ. Meanwhile,the other case was diagnosed as suspected paralytic poliomyelitis because of the negative result and was suggested to treat according to related regulations of VAPP. Conclusion Since the goal of poliomyelitis eradication has been realized,the problems about VAPP will appear. Specific measures should be taken to keep high vaccination rate and the effective monitoring for acute flaccid paralysis cases.