泉州市2002—2007年急性弛缓性麻痹病例的监测

目的了解泉州市2000—2007急性弛缓性麻痹（AFP）病例的发病情况、分布特征及AFP监测系统运转情况,为我市继续保持无脊髓灰质炎（脊灰）决策提供依据。方法采用回顾性调查方法,分析泉州市2002—2007年AFP病例个案调查表、随访表和实验室病毒学检测结果等资料。结果泉州市2002—2007年AFP病例监测系统共报告AFP病例183例,15岁以下儿童非脊灰AFP病例报告发病率为1．7／10万。AFP病例男女比为2．6：1,以5岁小年龄组居多,全年各月分布无差异。报告AFP病例未完成OPV基础免疫及免疫史不详的病例分别占9．8％（18／183）和6．0％（11／183）,其中181例为脊灰排除病例,2例为脊灰临床符合病例。AFP病例合格粪便标本采集率为96．2％（176／183）,脊灰病毒分离率为4．0（7／176）,其中6例为脊灰疫苗株,1例为脊灰疫苗高变异株。75d内随访及时率为99．4％（180／181）。结论2002—2007年泉州市无脊灰野病毒确诊病例,AFP病例监测系统各项指标均达到《全国急性弛缓性麻痹（AFP）病例监测方案》的要求,但适龄儿童的基础免疫工作仍需加强,还应加强临床医生的培训,提高AFP病例监测系统的工作质量。     

Acute onset flaccid quadriparesis in pediatric non‐Hodgkin lymphoma: Vincristine induced or Guillain–Barré syndrome?

Immunological involvement of peripheral nervous system in non‐Hodgkin lymphoma (NHL) is very rare and it may be difficult to differentiate it from vincristine‐induced neuropathy. We report clinical and electrophysiological findings of an 8‐year‐old male with NHL who developed acute onset fulminant motor sensory autonomic neuropathy during induction chemotherapy which included vincristine. Characteristic clinical picture and nerve conduction studies favored Guillain–Barré syndrome. The patient improved rapidly with intravenous immunoglobulin and supportive care. It is possible that an immune mechanism damaged the peripheral nervous system in the patient without ruling out the adverse effects of vinca alkaloids. Pediatr Blood Cancer. 2010;55:1234–1235. © 2010 Wiley‐Liss, Inc.     

Poliomyelitis eradication programme: acute flaccid paralysis surveillance in mardin and five other provinces around Mardin, Turkey 1998

After the successful eradication of small pox, the eradication of poliomyelitis was planned. In the poliomyelitis eradication programme, conducted since 1989, routine vaccination, supplemental immunisation activities and acute flaccid paralysis (AFP) surveillance were the main strategies. In 1997, in Mardin provinces six poliomyelitis cases were reported. Therefore it was planned to strengthen the eradication programme in this province and those around it. In 1998 in Mardin and five neighboring provinces, a study was conducted that included monthly visits, educational activities, etc. At the result of this study, 64 AFP cases (22 of them poliomyelitis) were reported. Non-poliomyelitis AFP rate had increased from 0.9 in 1997 to 2.8 in 1998. An adequate two specimen ratio was 72%. We recognised that more poliomyelitis cases were reported in hot seasons when compared with non-poliomyelitis cases reported throughout the year. This difference was statistically significant (P<0.001). Most AFP cases were aged under 35 months. At the 60th day follow-up visits of the patients, we found 90.9% of the poliomyelitis cases but only 19.0% of the non-poliomyelitis case had residual paralysis. Presence of prodromal fever was another finding that distinguished poliomyelitis cases from non-poliomyelitis AFP cases. 90.9% of the poliomyelitis cases but only 64.3% of the non-poliomyelitis cases had fever at onset. This finding was also statistically significant (P<0.05).     

贵州省1999～2002年残留麻痹的急性弛缓性麻痹病例发病情况分析

目的　为做好急性弛缓性麻痹 (AFP)病例监测 ,巩固无脊髓灰质炎 (脊灰 )成果。方法　对贵州省 1 999～2 0 0 2年 40 3例残留麻痹的AFP病例的流行病学特征、免疫状况和疾病谱进行了分析。结果　 64 3%的病例为 <5岁儿童 ,6～ 8月发病较多 ,未服苗和服苗 <3次的占 34 0 %。引起残留麻痹的疾病 ,格林 巴利综合征占 52 1 % ,6 2 %的病例为临床符合脊灰和诊断不详病例 ,其中 7例怀疑为接触者疫苗相关麻痹型脊灰。结论　为维持无脊灰状态 ,应加强AFP病例监测 ,提高合格粪便标本的采集率和口服脊灰疫苗常规免疫覆盖率     

江西省2003年保持无脊髓灰质炎状态工作分析

目的　评价江西省2 0 0 3年急性弛缓性麻痹(AFP)病例监测系统的运转情况。方法　对报告的AFP病例进行描述流行病学分析。结果　江西省2 0 0 3年AFP病例监测系统共报告2 38例非脊髓灰质炎(脊灰)AFP病例,1例临床符合脊灰,未发现本土或输入性脊灰野病毒病例。<15岁儿童非脊灰AFP病例报告发病率为2 . 16 /10万,合格粪便标本采集率为80 . 6 7%。结论　为了继续保持无脊灰状态,应加强对县级及以下医务人员的培训,提高AFP病例的报告发病率和合格粪便标本的采集率。同时加强对薄弱地区的主动搜索和常规免疫接种管理,保持口服脊灰疫苗高免疫接种率。     

山东省2003年急性弛缓性麻痹病例监测分析

目的评价山东省2003年急性弛缓性麻痹(AFP)病例监测系统敏感性、及时性、完整性。方法采用描述流行病学分析方法。结果山东省2003年AFP病例监测系统共报告非脊髓灰质炎AFP病例439例,发病率2.32/10万,接到报告后48h内调查率94.04%,合格粪便标本采集率91.34%,标本7d内送达率97.04%,实验室7d内进行病毒培养率94.43%,28d内完成病毒分离鉴定率92.58%,麻痹75d内随访表送达率92.03%。结论山东省2003年AFP病例监测系统运转良好。     

高州市保持无脊髓灰质炎情况分析

目的 分析高州市保持无脊髓灰质炎的监测情况，以巩固无脊灰成果。方法 对急性驰缓性麻痹（AFP）病例监测系统和口服脊灰疫苗（OPV）免疫资料进行描述性分析。结果 2000-2004年全市共报告AFP病例22例，确诊为非脊灰AFP病例21例，〈15岁儿童非脊灰AFP病例报告发病率大于1/10万，其它监测指标均达到卫生部和世界卫生组织的标准。五年来OPV常规免疫报告接种率均大于99％，强化免疫接种率均大于96．5％。结论 高州市AFP病例监测运行高效，OPV继续保持高水平免疫接种率，全市继续保持无脊灰状态。     

聊城市2003～2005年急性弛缓性麻痹病例资料分析

[目的]评价维持无脊髓灰质炎（脊灰）工作。[方法]对聊城市2003-2005年急性弛缓性麻痹（AFP）病例资料进行分析。[结果]2003～2005年合计报告非脊灰AFP病例78例，〈15岁儿童报告发病率3年分别为2．59／10万、2．14／10万和1．81／10万。聊城市所辖8个县（市、区）均有病例报告，其中东昌府区、冠县、茌平县、高唐县占全市病例总数的70．51％。接到报告后48h内调查率为96．15％，合格粪便标本采集率为89．74％，标本7d内送达率为94．87％。[结论]AFP病例各项监测指标均达到卫生部规定要求。     

Polio eradication--the validity of surveillance indicators

A major pre-requisite for polio-free certification by the World Health Organization is that the local surveillance system successfully detects one case of non-polio acute flaccid paralysis (AFP) per 100,000 children below 15 years of age per annum and that no cases of polio occur for three consecutive years. Mpumalanga, a rural province in the northeast of South Africa, implemented an enhanced surveillance system, which consisted of training hospital ICNs to rapidly report and correctly respond to nine infectious disease syndromes, including AFP. Weekly zero reporting is a component of the system. The non-polio AFP reporting rate per 100,000 children below the age of 15 years increased from 0.56 in 1997 to 0.91 in 1998 after introduction of the enhanced surveillance system, with more than 80% of the units reporting weekly. All units reported weekly from April 1999 to December 2001. Although non-polio AFP reporting rates were 0.27 (1999), 1.18 (2000) and 0.87 (2001), the 95% binomial exact confidence intervals for all years included 1 per 100,000. A review of paediatric admissions from January 1998 to December 2001 at all hospitals revealed that only five AFP cases had been missed by the enhanced surveillance system. The low international AFP reference rate and attendant variation expected due to chance, particularly in areas with relatively small populations, is an important factor that deserves more attention as we approach global polio eradication.     

1997 1998年5个省急性弛缓性麻痹病例的追踪调查分析

1997、1998年对云南省、山西省、贵州省、广西壮族自治区、新疆维吾尔自治区报告的187例急性弛缓性麻痹（AFP）病例进行了神经学诊断方面的追踪调查,同时对监测工作的质量予以评价．诊察结果为;临床脊髓灰质炎（脊灰）的24例,其余为其它麻痹性疾病。麻痹性疾病的发病率存在着地理性差异,在中国南方地区非脊灰脊髓炎（脊髓炎）病例很多,而西北地区脊髓炎较少,则以格林-巴利综合征（GBS）为多．在追踪临床诊断为脊灰的24例中,仅有3例接脊灰病例报告;在当地诊断为脊灰23例中,追踪诊断为脊灰的仅3例。本次追踪调查在AFP病例监测方面发现以下问题：①对有无后遗症的判定不正确;②由于在家中采集粪便标本,使得粪便标本不能妥善保存;③发病日期的记录不正确等。另外,通过从这些AFP病例中分离出的脊灰病毒均为疫苗株可以判定,存在着在采集粪便标本前给患者服用脊灰疫苗（OPV）的情况。建议省专家诊断小组在对病例进行最终诊断时,有必要慎重地研究临床经过。特别是对高危病例应亲自诊察。对病例的调查不能仅由县级人员进行,应争取地区级和省级神经学专家的协助。在判定临床经过时,不能仅依赖个案调查表,也应查阅医院的病案记录．另外,为防止因主观因素影响到采集粪便标本质量,造成实验室误诊