广东省52例急性弛缓性麻痹病例检出脊髓灰质炎疫苗株病毒分析

广东省１９９４～１９９６年１５岁以下儿童非脊髓灰质炎（脊灰）急性弛缓性麻痹（ＡＦＰ）病例报告发病率，分别为０９２／１０万、１７４／１０万和１３６／１０万。对７４３例粪便标本进行病毒分离，５２例检出脊灰疫苗株病毒，分布在３０个县（市、区），其中Ⅱ型占４６２％（２４／５２）；２８例有残留麻痹，最小年龄３个月，最大６岁。７６９％（４０／５２）病例有免疫史，首次服苗并于服苗后６～４０天出现肢体麻痹者１０例，占１９２％（１０／５２），占服苗总人次数１６７／１００万（５２／３１１３１７３７）。本文分析有５例可诊断为脊灰疫苗相关病例。对检出疫苗株病毒的ＡＦＰ病例进行了流行病学分析。

EPIDEMIOLOGICAL ANALYSIS ON RELATEDNESS OF AFP CASES WITH POLIO VACCINE VIRUS STRAINS

The reporting rates of acute flaccid paralysis(AFP) of children aged under fifteen were 0 92,1 74 and 1 36 per 100,000 respectively in Guangdong Province in 1994,1995 and 1996 Of the 743 AFP cases,52 cases with vaccine related poliovirus isolated mainly were type 2,and of these 52 cases,28 cases had residual paralysis These cases are called acute flaccid paralysis cases associated with vaccine poliovirus,they were from 30 counties/regions,and the range of ages was 3 to 78 month old 76 9%(40/52) of the cases had recived OPV before paralysis,5 cases with onset of paralysis at an interval of 6-40 days following reciept of the first dose of OPV and with presence of residual paralysis were classified as recipent paralytic poliomyelitis associated with vaccine Those who had received more than two doses of OPV,with onset of paralysis at an interal of 6-40 days following reciept of last dose of OPV were suspected paralytic poliomyelitis associated with vaccine 5 AFP cases had zero dose of OPV and there were no mass vaccination at an interval of 6-60 days before onset of paralysis,and these 5 cases with residual paralysis at 60 days after onset of paralysis are considered as propable paralytic poliomyelitis associated with contact with vaccinees