浙江省脊髓灰质炎野病毒输入与传播的风险评估工具研究及其应用

目的 通过建立脊髓灰质炎(脊灰)野病毒输入传播风险评估工具,确定浙江省2014年各市、县的风险等级,为科学制定相应防控措施提供依据。方法 成立专家组,采用头脑风暴法,在中国疾病预防控制中心研究的脊灰野病毒输入传播风险评估工具的基础上,根据浙江省实际进行调整,并开展应用。结果 本次风险评估工具从人群免疫状况、急性弛缓性麻痹(AFP)病例监测情况和输入风险3个一级指标开展评估,每个一级指标包括多个二级指标。浙江省人群免疫屏障良好,AFP监测敏感性较高,输入风险相对较低,然而仍存在薄弱环节。其中,湖州南浔区应加强2月龄至4岁儿童的脊灰疫苗查漏补种工作,台州椒江区应加强AFP监测工作,提高重视度,加强日常管理和疫情应对能力,杭州西湖区和金华义乌市应时刻警惕输入风险。结论 浙江省存在随时发生脊灰野病毒输入病例的可能,但由输入病例导致本地脊灰野病毒传播流行的风险较低。同时,由于维持无脊灰形式是动态变化的,因此脊髓灰质炎野病毒输入与传播风险评估工具指标应不断改进。

Study and application of assessment tool for wild poliovirus importation and transmission risk in Zhejiang

Objective To establish applicable assessment tool to determine the wild poliovirus(WPV) importation and transmission risk in Zhejiang province in 2014,and provide evidence for the prevention of wild poliovirus spread.Methods Brainstorming method was used. On the basis of risk assessment tool established by China CDC, our expert team made adjustments according to the actual situation in Zhejiang province.Results By using the assessment tool, the herd immunity, acute flaccid paralysis(AFP) surveillance performance and WPV importation risk(three level Ⅰ indicators) were assessed. Each level Ⅰ indicator included several level Ⅱ indicators. Overall, the risk of WPV importation was low in Zhejiang province. However, weakness still existed. In Nanxun district of Huzhou it is necessary to strengthen supplemental immunization activity of polio vaccine in children aged 2 months-4 years. In Jiaojiang district of Taizhou it is necessary to improve the sensitivity of AFP surveillance and emergency response capability. In Xihu district of Hangzhou, Jinhua and Yiwu it is necessary to strengthen the monitoring of WPV importation risk.Conclusion The risk of importation of WPV cases exists in Zhejiang, but the risk of secondary transmission is low. Due to the changeable polio free status, it is necessary to make improvement on the risk assessment tool.