菏泽地区1998年急性弛缓性麻痹监测分析

[目的]对荷泽地区1998年急性弛缓性麻痹（AFP）监测情况进行分析。初步评价该区消灭脊髓炎质炎（脊灰）工作进展，为消柬2灰工作及其验证提供科学依据。[方法]根据菏泽地区脊灰监测中心提供的疫情资料，流行病学个案调查资料，临床诊断和实验室病毒分离结果进行分析。[结果]荷泽地区1998年共报告AFP42例，无脊灰确诊病例，有1例脊灰监床符合病例，有5例临床脊灰（高度怀疑疫苗相关病例）；42例AFP分布于全区的9县市，呈散发，15岁以下儿童非脊灰AFP报告发病率为1．42／10万；AFP病例48h内调查率为94．7％，14d内合格粪便标本采集率为82．3％；从AFP病例及接触者粪便标本中从未分离出脊灰野病毒，而分离出脊灰疫苗病毒和COX（柯萨奇）病毒，ECHO（人肠道细胞病变孤儿病毒）等其他肠道病毒，AFP标本脊灰疫苗病毒和其他肠道病毒阳性率均为15．79％，引起AFP靳原因是多种的。[结论]该区AFP监测及消灭脊灰工作取得了很大进展，但仍有不足之处，加就诊48h内及时报告完成率等仍较低。建议仍应强加AFP监测和诊断，消灭脊灰工作仍需努力。

Analysis on Acute Flaccid Paralysis(AFP) Occurred in HeZe Area in 1998

[Objective] To analyze the supervision on AFP occurred in He Ze in 1998. To give a primitive evaluation on the working development in this area against poliomyelitis and to provide a scientific basis for the elimination of poliomyelitis. [Method] Analysis was made based on the epidemic information, investigation information of epidemic disease and clinical and experimental virus isolation result provide by Supervision Center of Poliomyelitis in He Ze. [Result] Among the 42 reported AFP cases, , one was clinically diagnosed coincident polio , five were clinically diagnosed {very probably diagnosed vaccine - associated), but no confirmed diagnosis was made. Those reported AFP cased were dotted in 9 counties and towns. The rate of reported non - polio AFP cases (among children under 15)was 1.542/100,000 . 94.7% of the total amount of AFP were found within 48hs after reported. 82.3% of AFP cases had the unqualified two stool specimens collected within 0 - 14days after paralysis. No wild - type polio virus was isolated from the stool specimens of AFP and the contacts; But other enterovirus like COX virus and ECHO virus were isolated. The positive isolation rate of polio vaccine virus of AFP specimens was 15.79 % . Causes of AFP are various. [Conclusion] Great improvement has been made in supervising and eliminating AFP in Ze He area. But report with 48 hs are still to be hastened. Therefore much more effort should be made .