一例急性弛缓性麻痹病例的流行病学调查与分析

目的通过对1例急性弛缓性麻痹病例的调查分析,了解当地AFP监测现状。方法运用现场流行病学调查方法,根据脊髓灰质炎疫情应急处理预案(试行)要求,对该例AFP病例的发病过程、治疗情况、脊灰疫苗免疫史等情况进行调查,同时开展脊灰疫苗接种率调查和对病例住所周围及县人民医院AFP病例进行主动搜索。结果2004年6月,固始县段集乡发生了1例急性弛缓性麻痹病例。该病例为“零剂次”免疫儿童,于6月20日出现双侧下肢麻痹,经国家和省AFP病例分类专家诊断小组诊断为Ⅱ型脊灰疫苗变异株病例。在调查中发现,该病例周围5岁以下儿童OPV3次以上接种率仅为32.26%,OPV“零剂次”儿童占16.13%。结论计免工作存在管理混乱、疾病监测系统不敏感、存在免疫空白区等问题。提高OPV接种率是保护儿童免受脊灰野病毒、疫苗变异株病毒侵袭的有效措施。

An Epidemiological Investigation of A Case of Acute flaccid paralysis

Objective This investigation was conducted to better understand the status quo of acute flaccid paralysis surveillance throngh analysis of a case of the disease Methods Acocrding to the requirements laid down in the Emergency Management Plan for Poliomyelitis，field epidemiological investi gation was conducted into the hislory of poliomyeitis vaccination，pathogenic process，treatment and other aspects of the AFP case And the inoculation rate of polio vaccine and AFP cases near the residence of the case and the AFP cases managed in the county hospitals were surveyed Results A case of acute flaccid paralysis in Duanji township of Gusi county was reported in June it turned out that the child was of zero immunization The child，who manifested total paralysis of lower limbs，was given a diagnosis of type II poliomyelitis vaccine variant by the National aid provincial expert panels of diagnosis for AFP classification it was found that the rate of over-3-times OPV inoculation among the children under 5 yeas of age around this case was only 32.26％. Children having zero prior OPV doses accounted for 16.13％。Conclusion it is seen that there exist problems to be urgently solved such as chaotic manage ment of scheduled immmunizations，insensitive disease surveillance system，presence of non-immunized population Increasing the rate of OPV immunization is an effective measure to protect children from wild poliomyeitis virus and vaccine variants