1995-2004年南充市急性驰缓性麻痹病例监测分析

目的 促进急性驰缓性麻痹(Acute flaccid paralysis AFP)病例监测工作,保证消灭脊灰措施落实.方法 对1995-2004年南充市AFP病例监测系统资料用Epinfo和Excel软件进行统计分析.结果 1995-2004年全市共报告AFP病例223例,未发现脊灰野病毒引起的病例;病例分布在全市9县(市、区);发病以5岁以下儿童为主,占57.40%(128/223);男性发病多于女性(146∶ 77);223均为排除脊灰病例,临床诊断以格林巴利综合征最多(96/223)占43.05%,自1995年起,15岁以下儿童非脊灰AFP病例连续12年报告发病大于1/10万;1998年以后各项主要监测指标均达到卫生部规定的要求.结论 全市AFP病例监测系统各项监测指标维持在较高水平,乡村医生AFP病例报告意识尚须加强.     

昆明市2004年～2008年急性驰缓性麻痹病例监测结果分析

[目的]了解昆明市急性弛缓性麻痹(AFP)病例发病及监测系统运转情况,巩固和维持无脊髓灰质炎(脊灰)状态,及时发现输入病例,指导消灭脊灰工作。[方法]对昆明市2004年～2008年AFP监测结果进行分析。[结果]昆明市2004年～2008年共报告15岁以下AFP病例188例,年报告发病率为1.85∕10万～2.57∕10万,病例大部分为0岁～5岁儿童,占总发病数的61.70%;发病时间和地区无明显的聚集趋势;有16.49%儿童未全程免疫或免疫史不详,甚至出现零剂次。[结论]AFP发病趋于小年龄组,易感人群依然存在;5年出现无病例报告10县次,初次就诊报告率低(57.45%),提示须加强监测系统的管理,加强基层计划免疫工作,提高免疫接种率。     

1997—2006年广西永福县急性驰缓性麻痹病例监测

目的 了解永福县1997-2006年报告的急性驰缓性麻痹(AFP)病例流行病学特征及监测系统运转情况,找出薄弱环节,指导消灭和继续维持无脊灰工作. 方法 分析AFP监测系统报告的17例病例的流行病学特征及AFP监测指标. 结果 1997-2006年监测系统报告17例AFP病例,男性10例女性7例,发病时间无季节性,发病年龄最大为12岁,最小为1岁,免疫次数≥3次64.71%,免疫2次及免疫史不详35.29%;15岁以下儿童非脊灰AFP病例报告发病率为1.89/10万,双份合格粪便标本采集率100%,均未分离出脊灰病毒.AFP监测系统报告病例调查及时性和粪便标本采集及时性、随访及时性均达100%. 结论 1997-2006年永福县无脊灰病例发生,AFP病例监测系统各项监测指标均达到要求,监测系统运转正常,但在脊灰免疫管理存在漏洞,应加强管理.     

2013年福建省急性弛缓性麻痹病例流行病学及监测系统运转情况

目的了解福建省急性弛缓性麻痹（AFP）流行病学情况和AFP监测系统运转情况。方法用Excel 2003软件对全省2013年AFP监测信息报告管理系统的个案调查表、随访表和实验室病毒学监测结果等资料进行分析。结果2013年AFP病例监测系统报告了161例AFP病例,〈15岁儿童非脊灰AFP病例报告发病率为2.70/10万。每个月均有病例发生,男女性别比1.82∶1;AFP发病者中以5岁以下为主,占72.05%;95.65%的病例脊灰疫苗免疫史≥3次;脊灰病毒分离率为3.11%;14d内双份合格标本采集率为91.30%、7d内标本送达率为98.14%、75d随访表送达率为94.41%。结论 2013年福建省AFP病例监测系统各项指标以省为单位均达标,但各设区市监测工作发展不平衡。     

1991～2001年宁波市急性弛缓性麻痹病例监测系统评价

目的：评价急性弛缓性麻痹(AFP)病例监测系统运转情况。方法：对199l--2001年宁波市AFP病例监测系统资料用SPSS软件进行统计分析。结果：199l--2001年全市共报告AFP病例17l例，未发现脊灰野病毒引起的病例。病例分布在全市11个县(市、区)；发病以5岁以下儿童为主，占80．1％；男性发病多于女性；免疫史＜3次者占8．2％(主要为流动儿童)；17l例均为排除脊灰病例，最终诊断以格林巴利综合征最多，占21．6％；自1995年起，l5岁以下儿童非脊灰AFP病例连续7年报告发病率＞l／10万，1997年起其余各项主要监测指标均达到了80％的要求。结论：为维持无脊灰状态，仍需加强流动儿童管理，保持AFP监浏系统的敏感性、及时性、完整性。     

2001～2005年衡阳市急性弛缓性麻痹病例流行病学分析及监测质量评价

目的掌握衡阳市急性弛缓性麻痹(AFP)病例流行病学特征及对监测质量进行评价,及时发现问题,提高监测质量。方法对2001~2005年全市报告的AFP病例进行个案调查和标本采集,对调查资料及实验室检验结果进行统计分析。结果2001~2005年衡阳市无脊灰野病毒病例发生,15岁以下儿童AFP病例共报告125例,7岁以下儿童病例,占91.2%。4例病例标本中分离出非脊灰肠道病毒,5例分离出脊灰疫苗株Ⅱ、Ⅲ型病毒,未分离出脊灰野病毒。发病无明显季节性。结论衡阳市AFP监测系统敏感性强,各项监测指标均达到世界卫生组织(WHO)的标准,AFP监测系统运转正常。     

临沂市2003~2006年急性弛缓性麻痹病例监测系统评价

目的评价全国保持无脊髓灰质炎状态行动计划出台以来临沂市急性弛缓性麻痹(AFP)病例监测系统运转情况。方法对2003~2006年临沂市AFP病例监测系统资料用EpiData软件进行统计分析。结果2003~2006年全市共报告AFP病例202例,未发现脊灰野病毒引起的病例。病例分布在全市12个县(区):发病以0到5岁儿童为主,占83.2%;男性发病多于女性,男女比例1.93:1;所有监测病例经山东省专家诊断组均为排除脊灰病例,格林巴利综合征最多,占19.9%,监测并鉴定了3例疫苗相关病例(VAPP)。自2003年起,15岁以下儿童非脊灰AFP病例报告发病率均大于1/10万,各项主要监测指标均达到了卫生部规定的80%的要求。结论临沂市AFP监测系统保持高度敏感性,有能力及时发现各类监测病例。     

潍坊市2001—2012年急性弛缓性麻痹病例流行病学分析及监测系统运行情况评价

目的分析潍坊市2001-2012年急性弛缓性麻痹(Acute Flaccid Parelysis,AFP)病例流行病学特征,评价监测系统运行情况。方法采用描述流行病学方法,分析潍坊市AFP病例流行病学特征;按照世界卫生组织(WHO)和卫生部规定的各项监测指标,评价监测系统运行情况。结果潍坊市2001-2012年共报告AFP病例314例。根据病毒学诊断标准,314例均为非脊髓灰质炎(脊灰)(Non-Polio,NP)AFP(NPAFP)病例。AFP病例报告发病率在1.52/10万~2.40/10万之间,年平均报告发病率2.09/10万。AFP发病者中以5岁以下儿童为主,占76.11%。病例中服苗史≥3剂次285例,占90.76%。合格粪便样本采集率为93.63%。从37例AFP病例粪便样本中分离到非脊灰肠道病毒(Non-Polio Enterovirus,NPEV),分离率11.78%。结论潍坊市2001-2012年AFP病例监测系统各项指标以市为单位,均达到WHO和卫生部要求。为保持无脊灰状态,应保持高水平脊灰疫苗免疫接种率,提高AFP病例监测系统质量。     

2005年广东省急性弛缓性麻痹病例监测结果分析

目的分析广东省2005年急性弛缓性麻痹(AFP)病例监测结果,为广东省继续保持无脊髓灰质炎(脊灰)决策提供依据。方法分析全省2005年AFP病例监测系统的个案调查表、随访表和实验室病毒学监测结果等资料。结果广东省2005年AFP病例监测系统共报告AFP病例312例,15岁以下儿童非脊灰AFP病例报告发病率为1.7/10万,其中3例诊断为临床符合脊灰病例。AFP病例合格粪便标本采集率为95.2%(297/312),脊灰病毒分离率为9.0%(28/311),均为脊灰疫苗株;非脊灰肠道病毒分离率为13.5%(42/311)。未完成OPV基础免疫及免疫史不详的病例分别占16.3%、5.8%。结论广东省AFP病例监测系统各项监测指标均达到世界卫生组织和卫生部的相关要求。但流动儿童的基础免疫工作仍需要加强,还应加强临床医生的培训,提高AFP病例监测系统的工作质量。     

2000～2006年山东省急性弛缓性麻痹病例病毒学监测分析

[目的]分析山东省自2000年实现无脊髓灰质炎(脊灰)目标后急性弛缓性麻痹(AFP)病例病毒学监测结果.[方法]按照WHO规定的方法,对山东省2000～2006年所有AFP病例粪便标本均采用L20B、RD和Hep-2三种细胞进行病毒分离鉴定.[结果]山东省2000～2006年AFP病例病毒学监测指标达到国家要求.在2 893例AFP病例中,共分离出脊灰病毒(PV)254株、非脊灰肠道病毒(NPEV)341株,分离率分别为8.78%、11.79%.NPEV中以艾柯(Echo)病毒为主(占50.15%);全年均分离到,且以夏秋季为主;发病以5岁以下儿童最高,各年龄组儿童感染率存在差异.OPV免疫次数越多,PV阳性的AFP病例残留麻痹比例越低.[结论]在实现无脊灰目标后,仍应加强AFP病例的病毒学监测工作,以确保最终实现全球消灭脊灰的目标.     

Screening of cases of acute flaccid paralysis for poliomyelitis eradication: ways to improve specificity.

The Pan American Health Organization in 1985 adopted an initiative to eradicate poliomyelitis from the Western Hemisphere. In 1990, over 2000 cases of acute flaccid paralysis (AFP) were reported in this region, of which < 1% were determined to be caused by wild poliovirus. At present, the eradication programme uses AFP as the criterion for surveillance of children aged < 15 years; this is 100% sensitive, but not specific. To minimize unnecessary diagnostic investigations, we studied all 4333 cases of AFP reported to the programme during 1989 and 1990 in order to develop more efficient operational screening criteria for cases of AFP. Among children with AFP, the use of criteria such as age < 6 years and either presence of fever at the onset of paralysis or a < 4-day period for complete development of paralysis resulted in a sensitivity of 96% (95% C.I. 90-103%) and specificity of 49% (C.I. 47-52%). With criteria of age < 6 years and fever present at the onset of paralysis the sensitivity was 75% (C.I. 61-89%) and specificity was 73% (C.I. 71-75%). These results suggest that by screening young children with AFP who either had fever at the onset or showed a rapid progression of paralysis, the number of cases of AFP requiring investigation can be reduced by one half, with minimal compromise in the sensitivity of confirmed poliomyelitis case detection.     

中国2012年急性弛缓性麻痹病例监测系统运转情况

目的评价中国（未包括香港、澳门特别行政区和台湾地区,下同）2012年急性弛缓性麻痹（AcuteFlaccidParalysis,AFP）病例监测系统的运转情况。方法分析31个省、自治区、直辖市通过AFP病例监测信息报告管理系统报告的AFP病例数据。结果中国2012年AFP病例监测系统,除云南省报告1例缅甸输入的疫苗衍生脊髓灰质炎（脊灰）病毒（Vaccine-derivedPoliovirus,VDPV）病例外,共报告本国AFP病例7642例。其中AFP病例6576例,非AFP病例1066例。AFP病例中,≥15岁404例,〈15岁6172例。404例≥15岁AFP病例均排除脊灰,6172例〈15岁AFP病例中,6168例排除脊灰,2例为临床符合脊灰,2例为VDPV病例。〈15岁儿童非脊灰AFP病例报告发病率为2．76／10万,合格粪便标本采集率为92％。结论中国2012年AFP病例监测系统保持较高的运转质量,各项监测指标均达到卫生部和世界卫生组织的要求。     

中国2006年急性弛缓性麻痹病例监测系统运转情况分析

目的评价中国(未包括香港、澳门特别行政区和台湾地区,下同)2006年急性弛缓性麻痹(AFP)病例监测系统运转情况。方法分析31个省(自治区、直辖市,下同)报告的AFP病例数据库。结果中国2006年AFP病例监测系统共报告6 111例,其中AFP病例5 635例,非AFP病例476例。按病毒学分类标准,5 625例被排除脊灰,10例为临床符合脊灰。<15岁儿童非脊灰AFP病例报告发病率为2.02/10万。2006年报告AFP病例的县(区、市、旗,下同)2 049个,占全国总县数的65.1%。结论中国2006年AFP病例监测系统保持较高的质量,各项监测指标均达到世界卫生组织和卫生部的要求。     

Poliomyelitis surveillance: the model used in India for polio eradication

Poliomyelitis surveillance in India previously involved the passive reporting of clinically suspected cases. The capacity for detecting the disease was limited because there was no surveillance of acute flaccid paralysis (AFP). In October 1997, 59 specially trained Surveillance Medical Officers were deployed throughout the country to establish active AFP surveillance; 11,533 units were created to report weekly on the occurrence of AFP cases at the district, state and national levels; timely case investigation and the collection of stool specimens from AFP cases was undertaken; linkages were made to support the polio laboratory network; and extensive training of government counterparts of the Surveillance Medical Officers was conducted. Data reported at the national level are analysed and distributed weekly. Annualized rates of non-polio AFP increased from 0.22 per 100,000 children aged under 15 years in 1997 to 1.39 per 100,000 in 1999. The proportion of cases with two adequate stools collected within two weeks of the onset of paralysis increased from 34% in 1997 to 68% in 1999. The number of polio cases associated with the isolation of wild poliovirus decreased from 211 in the first quarter of 1998 to 77 in the first quarter of 1999. Widespread transmission of wild poliovirus types 1 and 3 persists throughout the country; type 2 occurs only in Bihar and Uttar Pradesh. In order to achieve polio eradication in India during 2000, extra national immunization days and house-to-house mopping-up rounds should be organized.     

中国2005年急性弛缓性麻痹病例监测系统运转情况分析

目的评价中国(未包括香港、澳门特别行政区和台湾地区)2005年急性弛缓性麻痹(AFP)病例监测系统运转情况。方法分析31个省(自治区、直辖市)报告的2005年AFP病例数据库。结果2005年AFP病例监测系统共报告病例5 847例,其中AFP病例5 425例,非AFP病例422例。按病毒学分类标准,5 409例被排除脊髓灰质炎(脊灰),16例为临床符合脊灰。<15岁儿童非脊灰AFP病例报告发病率为1.94/10万。2005年AFP病例监测系统发现了中国首例免疫缺陷疫苗衍生脊灰病毒(iVDPV)病例,未发现本土或输入脊灰野病毒病例。AFP病例报告县(区、市、旗,下同)2 060个,占全国总县数的72.0%。结论中国2005年AFP病例监测系统保持较高的质量,各项监测指标均达到世界卫生组织和卫生部的要求。     

江苏省2003年无脊髓灰质炎证实工作评价

江苏省 2 0 0 3年继续开展保持无脊髓灰质炎 (脊灰 )工作 ,2 0 0 3年共报告AFP病例 2 0 3例 ,<1 5岁儿童非脊灰AFP病例报告发病率为 1 5 2 / 1 0万 ,合格粪便标本采集率、AFP病例及时随访率、粪便标本及时送检率、检验结果及时反馈率均 >93 0 %。通过开展主动搜索 ,全省AFP病例漏报率为 3 8%。全省继续开展脊灰病原学监测 ,未分离到脊灰野病毒。同时继续开展口服脊灰疫苗强化免疫活动 ,两轮强化免疫报告服苗率均 >98 0 %。表明江苏省AFP病例监测质量较高 ,消灭脊灰各项措施得到了较好落实 ,全省仍保持无脊灰状态。     

湖北省1995年非脊髓灰质炎急性弛缓性麻痹病例疾病谱监测分析

对湖北省１９９５年非脊髓灰质炎（脊灰）急性弛缓性麻痹（ＡＦＰ）病例疾病谱做了分析，又对ＡＦＰ病例监测系统敏感性进行了评价。结果表明，湖北省１９９５年非脊灰ＡＦＰ病例疾病谱的顺位为：非脊灰肠道病毒（ＮＰＥＶ）感染、格林巴利综合征（ＧＢＳ）、创伤性神经炎、四肢瘫和单瘫、肌病、横断性脊髓炎、神经根炎、短暂性肢体麻痹等。湖北省１９９５年７０％（１２／１７）的地区、市、州、林区１５岁以下儿童非脊灰ＡＦＰ病例报告发病率达到了１／１０万指标。非脊灰ＡＦＰ病例具有发病年龄以０～４岁为主、无明显季节分布、男性多于女性，以及以下肢麻痹为主等一系列特征。     

Annual report of the Australian National Poliovirus Reference Laboratory, 2009

The Australian National Poliovirus Reference Laboratory (NPRL) is accredited by the World Health Organization (WHO) for the testing of faecal specimens from acute flaccid paralysis (AFP) cases and operates as a regional poliovirus reference laboratory for the Western Pacific Region. The NPRL, in collaboration with the Australian Paediatric Surveillance Unit, co-ordinates surveillance for cases of AFP in children in Australia, according to criteria recommended by the WHO. Specimens are referred from AFP cases in children and suspected cases of poliomyelitis in persons of any age. The WHO AFP surveillance performance indicator is 1 non-polio AFP case per 100,000 children less than 15 years of age. In 2009, the Polio Expert Committee classified 48 cases as non-polio AFP, a rate of 1.17 cases per 100,000 children less than 15 years of age. An additional WHO AFP surveillance performance indicator is that more than 80% of notified AFP cases have 2 faecal samples collected 24 hours apart and within 14 days of onset of paralysis. Adequate faecal samples were received from 16 (33.3%) of the 48 classified cases. A poliovirus was referred via the Enterovirus Reference Laboratory Network of Australia from a non-AFP case and was determined to be Sabin-like. This case most likely represents an importation event, the source of which was not identified, as Australia ceased using Sabin oral polio vaccine in 2005. The last report of a wild poliovirus importation in Australia was from Pakistan in 2007. In 2009, 1,604 wild poliovirus cases were reported in 23 countries with Afghanistan, India, Nigeria and Pakistan remaining endemic for poliomyelitis.     

中国2000年急性弛缓性麻痹病例监测系统运转情况分析

2000年全国急性弛缓性麻痹(AFP)病例监测系统共报告AFP病例5332例,按病毒学分类标准,5315例为非脊髓灰质炎(脊灰)AFP病例,17例为临床符合脊灰病例,未发现本土及输入的脊灰野病毒病例.5332例AFP病例分布在2111个县(市、区、旗,下同)中,占全国总县数的73.73%(2111/2863).全年报告"零"病例的县数每月均>90%.15岁以下儿童非脊灰AFP病例报告发病率为1.86/10万,合格粪便标本采集率为88.80%,其它各项监测指标也均达到了世界卫生组织(WHO)和卫生部的要求,这一年我国所在的WHO西太平洋区宣布实现了无脊灰目标.为维持我国无脊灰状态,仍需保持高质量敏感的AFP病例监测系统,确保能及时发现、识别、报告任何脊灰野病毒病例.     

Vaccine-associated paralytic poliomyelitis and other diseases with acute flaccid paralysis syndrome in Belarus

According to the WHO global polio eradication initiative acute flaccid paralysis (AFP) surveillance has been conducted in Belarus since 1996. For the period 1996-2002, 295AFP cases were reported. The main indices ofAFP surveillance in Belarus met the WHO criteria. A11 AFP cases, with the exception of one, were virologically examined. Polioviruses (PV) were isolated from 28 (9.5%) of them. Results of intratypic differentiation (a neutralization test with type-specific monoclonal antibodies and a restriction fragment length polymorphism assay) proved vaccine origin of all isolated PV. According to the final classification, 11 AFP cases were classified as vaccine-associated paralytic poliomyelitis (VAPP). Nine VAPP cases were recipient [six of them developed after the first, two--after the third and one--after the fourth oral poliovirus vaccine (OPV) dose] and two cases in non-vaccinated children were classified as contact VAPP cases. PV of all three serotypes were isolated with an equal frequency from the recipient cases and only PV2--from contact ones. Immunological investigations of children with VAPP showed that the majority of them had disorders in B-cell immunity. A risk of one VAPP case per 96,000 first OPV doses and per 745,000 distributed ones was estimated. The other 284 AFP cases were classified as AFP of non-polio etiology (non-polio AFP). Among them Guillain-Barré syndrome (118 cases, 41.5% of all non-polio AFP cases), traumatic neuritis (63 cases, 22.2%), transient monoparesis of limb (35 cases, 12.3%), myelitis (26 cases, 9.2%) were registered most frequently. Vaccine PV were isolated from 19 (6.7%) children with non-polio AFP, 28 (9.9%) children excreted non-polio enteric viruses. In contrast to VAPP, other AFP with PV isolation had no clinical picture typical of poliomyelitis, and had no any residual paralysis 60 days after the onset of paralysis. PV isolation from them seemed to be not related to the etiology of the disease, but was a mere coincidence of paralysis with the recent vaccination. Results of AFP surveillance supported the previous data on the absence of classical poliomyelitis cases caused by wild PV in Belarus for more than 35 years.