德州市1989～2003年消灭脊髓灰质炎监测与控制分析

目的了解德州市脊髓灰质炎(脊灰)监测与控制系统的运转状况。方法收集1989-2003年脊灰监测数据,进行分析和评价。对AFP病例采集双份粪便标本,对部分AFP病例的接触者及健康人群采集粪便标本进行肠道病毒检测,并对2432份健康人群血清标本进行脊灰中和抗体检测。结果1991年建立急性弛缓性麻痹(AFP)监测系统以来,全市共报告AFP病例477例,1994年来非脊灰AFP报告发病率达到了WHO提出的1/10万指标,1995年以来AFP病例及时报告率、及时调查率、双份标本合格采集率、标本及时送检率和随访率均在90%以上,达到了卫生部80%的指标。脊灰疫苗(TOPV)接种率维持在90%以上,0～4岁儿童强化免疫接种率达到95%以上,1990年10月以来未发生脊灰野病毒病例。抗体检测表明,三型脊灰抗体阳性率维持在95%以上,AFP病例标本和接触者标本及健康人群肠道病毒检测,未检出脊灰病毒。结论德州市AFP监测系统运转良好,由于形成了较为牢固的脊灰人群免疫屏障,便得脊灰流行的可能性降为最低。

Analysis on Monitoring and Control of Elimination of Poliomyelitis from 1989 to 2003 in Dezhou City

Objective This analysis was designed to learn about the operation of monitoring and control system for poliomyelitis (PM) in Dezhou. Methods Data from 1989 to 2003 were collected for analysis and evaluation. For AFP cases, double samples of feces were collected; for part of AFP contactors and healthy population, feces samples were gathered for enterovirus determination and 2 432 serum samples of healthy people were administered PM neutralization antibody testing. Results Since the establishment of monitoring system for acute flaccid paralysis (AFP) in 1991, 477 cases had been reported in the entire city. Since 1994, the onset rate of non-PM reported had been in accord with the index of 1/lakh proposed by WHO. Since 1995, the timely reporting rate, in-time investigation rate, rate of double specimens collection, rate of timely submission for determination and follow-up rate had all been over 90%, which attained the index of 80% stipulated by the Minister of Health. The vaccination rate of Trivalent Oral Polio Vaccine (TOPV) maintained over 90%, within which children aged between 0 and 4 years old had a vaccination rate of reinforced immunization over 95%. Since October of 1990, no wild-type virus cases of PM had occurred. Antibody testing demonstrated that the positive antibody rate of type III PM was kept above 95% and no PM virus were detected from specimens of AFP cases, contactors and healthy population in enterovirus testing. Conclusion The AFP monitoring system works well in Dezhou. Due to the establishment of relatively strong immunization barrier among PM populations, the possibility of PM epidemic is reduced to the lowest.