关键词： 急性弛缓性麻痹   疫苗衍生脊髓灰质炎病毒   脊髓灰质炎病毒   核苷酸  

摘要： 目的分析河北省2009-2011年急性弛缓性麻痹(AFP)病例及其密切接触者中脊髓灰质炎(脊灰)病毒分离株VP1编码区基因核苷酸变异情况,及时发现可能出现的疫苗衍生脊灰病毒(Vaccine-derived poliovrus,VDPV)及其引起的VDPV循环(Circulating VDPV,cVDPVs),为河北省维持无脊灰状态提供依据。方法按照《世界卫生组织(WHO)脊灰实验室手册》的要求,对全省2009-2011年997例AFP病例及90例的接触者的粪便标本进行病毒分离与鉴定,分离的脊灰病毒送中国疾病预防控制中心(CDC)病毒病预防控制所国家脊灰实验室进行VP1编码区基因核苷酸序列测定与分析。结果河北省2009-2011年,从24例AFP病例和7例AFP病例的密切接触者粪便标本中分离到脊灰病毒,将混合株进行单型分离,得到38株脊灰病毒,经国家脊灰实验室对脊灰病毒VP1编码区基因核苷酸序列测定,其中,36株发生突变,变异率均<1.0%,最多变异个数为5个。脊灰病毒阳性AFP病例男性明显高于女性,主要集中在小年龄组。结论2009-2011年分离到的脊灰病毒均为疫苗株,局部地区出现高变异株,未发现VDPV,河北省继续保持无脊灰状态。

关键词： 手足口病   急性弛缓性瘫痪   肠道病毒71型   非脊髓灰质炎肠道病毒  

摘要： 目的分析手足口病(HFMD)并发急性弛缓性瘫痪(AFP)患儿的临床特点。方法观察8例HFMD并发AFP患儿的临床特点,在起病1～3周内进行神经电生理、MRI检查,并进行早期药物治疗及康复锻炼,随访3～12个月。结果 8例手足口病并发AFP病例中,3例四肢瘫痪,2例单侧上肢瘫痪,2例双下肢瘫痪,1例单侧下肢瘫痪。7例神经电生理结果提示脊髓前角细胞病变,4例MRI显示颈2～7或胸12～腰1脊髓前角区长T1长T2信号。其中有1例四肢瘫痪MRI示延髓长T1长T2信号,胸3～7中央管扩张。单侧下肢瘫痪者功能恢复较快,上肢及四肢瘫痪患儿恢复相对缓慢。1例四肢瘫患儿随访至6个月时出现后遗症,随访至12个月时其患肢功能障碍仍存在。8例手足口病合并AFP中,EV71阳性5例。其中1例双下肢瘫痪患儿粪便EV71排毒时间长达70 d。结论手足口病并发AFP患儿其神经电生理、MRI显示病变越重,相应患肢功能障碍越明显,恢复时间亦相对漫长,预后较差。神经电生理、MRI检查对于早期诊断、评估病情及预后有重要的参考价值。EV71感染后粪便排毒周期长,需强化综合预防控制措施。

关键词： Adaptation   Biology   Evolutionary biology   Evolutionary genetics   Evolutionary processes   Evolutionary selection   Evolutionary systematics   Genetic drift   Genomic evolution   Microbiology   Mutation   Natural selection   Phylogenetics   Research Article   Viral evolution   Viral vaccines   Virology  

摘要： Partial sequences of 110 type 2 poliovirus strains isolated from sewage in Slovakia in 2003-2005, and most probably originating from a single dose of oral poliovirus vaccine, were subjected to a detailed genetic analysis. Evolutionary patterns of these vaccine derived poliovirus strains (SVK-aVDPV2) were compared to those of type 1 and type 3 wild poliovirus (WPV) lineages considered to have a single seed strain origin, respectively. The 102 unique SVK-aVDPV VP1 sequences were monophyletic differing from that of the most likely parental poliovirus type 2/Sabin (PV2 Sabin) by 12.5-15.6%. Judging from this difference and from the rate of accumulation of synonymous transversions during the 22 month observation period, the relevant oral poliovirus vaccine dose had been administered to an unknown recipient more than 12 years earlier. The patterns of nucleotide substitution during the observation period differed from those found in the studied lineages of WPV1 or 3, including a lower transition/transversion (Ts/Tv) bias and strikingly lower Ts/Tv rate ratios at the 2nd codon position for both purines and pyrimidines. A relatively low preference of transitions at the 2nd codon position was also found in the large set of VP1 sequences of Nigerian circulating (c)VDPV2, as well as in the smaller sets from the Hispaniola cVDPV1 and Egypt cVDPV2 outbreaks, and among aVDPV1 and aVDPV2 strains recently isolated from sewage in Finland. Codon-wise analysis of synonymous versus non-synonymous substitution rates in the VP1 sequences suggested that in five codons, those coding for amino acids at sites 24, 144, 147, 221 and 222, there may have been positive selection during the observation period. We conclude that pattern of poliovirus VP1 evolution in prolonged infection may differ from that found in WPV epidemics. Further studies on sufficiently large independent datasets are needed to confirm this suggestion and to reveal its potential significance.

关键词： Fever   Pneumococcal conjugate vaccine   Hexavalent vaccine   Paracetamol   Prophylaxis  

摘要： Background: In two clinical trials, low-grade fever was observed more frequently after coadministration than after separate administration of two recommended routine pediatric vaccines. Since fever is an important issue with vaccine tolerability, we performed this open-label study on the efficacy and safety of prophylactic use of paracetamol (acetaminophen, Benuron (R)) in children administered routine 7-valent pneumococcal conjugate vaccine (PCV-7) coadministered with hexavalent vaccine (diphtheria-tetanus-acellular pertussis-hepatitis B, poliovirus, Haemophilus influenzae type b vaccine [DTPa-HBV-IPV/Hib]) in Germany. Methods: Healthy infants (N = 301) who received a 3-dose infant series of PCV-7 and DTPa-HBV-IPV/Hib plus a toddler dose were randomly assigned 1:1 to prophylactic paracetamol (125 mg or 250 mg suppositories, based on body weight) at vaccination, and at 6-8 hour intervals thereafter, or a control group that received no paracetamol. Rectal temperature and local and other systemic reactions were measured for 4 days post vaccination;adverse events were collected throughout the study. Results: In the intent-to-treat population, paracetamol reduced the incidence of fever >= 38 degrees C, but this reduction was only significant for the infant series, with computed efficacy of 43.0% (95% confidence interval [CI]: 17.4, 61.2), and not significant after the toddler dose (efficacy 15.9%;95% CI: -19.9, 41.3);results were similar in the per protocol (PP) population. Fever >39 degrees C was rare during the infant series, such that there were too few cases for assessment. After the toddler dose, paracetamol effectively reduced fever >39 degrees C, reaching statistical significance in the PP population only (efficacy 79%;95% CI: 3.9, 97.7). Paracetamol also reduced reactogenicity, but there were few significant differences between groups after any dose. No vaccine-related serious adverse events were reported. Conclusions: Paracetamol effectively prevented fever and

关键词： ISOELECTRIC focusing   POLIOVIRUS   POLIOMYELITIS vaccine   BIOSAFETY   CAPILLARY electrophoresis  

摘要： Using a capillary isoelectric focusing whole column imaging detection (CIEF-WCID) method, the isoelectric points (pI) of complete intact polioviruses were determined. The polioviruses that were analyzed are the commonly used viruses for the production of inactivated polio vaccines (IPV)-Mahoney (type 1), MEF (type 2), and Saukett (type 3)-as well as for attenuated oral polio vaccines (OPV) and Sabin types 1, 2, and 3. A method for analyzing biological hazardous components (biological safety level 2) was set up for the CIEF-WCID analyzer used. This method is based on closed circuits. The determined pI's were 6.2 for Mahoney, 6.7 for MEF-1, and 5.8 for Saukett. The pI's of Sabin types 1, 2, and 3 viruses were 7.4, 7.2, and 6.3, respectively. Resolution of the virus peaks was shown to be reproducible. Using this adjusted CIEF-WCID technique, the pI of biologically hazardous components like toxins or viruses can be determined, which is,beneficial for the development of vaccine production methods among others.

关键词： 脊髓灰质炎病毒   离出   埃及   污水标本   基因序列   巴基斯坦   野病毒   麻痹型  

摘要： 埃及于2012年12月2日和6日在开罗地区2个区域采集的污水标本中分离出Ⅰ型（TypeⅠ）脊髓灰质炎（脊灰）野病毒（Wild Poliovirus,WPVⅠ）。但仅在污水标本中检出病毒,未报告麻痹型脊灰病例。基因序列显示,该病毒株与巴基斯坦信德省北部传播的病毒密切相关。

关键词： 预防接种   疫苗相关麻痹性脊髓灰质炎  

摘要： 2011年,杭州市拱墅区发生1例疫苗相关麻痹型脊髓灰质炎（脊灰）（Vaccine-assocaited Paralytic Poliomyetitis VAPP）,现报告如下。1基本情况患儿,男,2011年1月2日出生,散居流动儿童,户籍四川省,病前与父母暂住杭州市某村。其父亲为某网络公司员工,母亲在家。

关键词： 脊髓灰质炎疫苗   生产人员   病毒株   保护   州立大学   疫苗生产   免疫反应  

摘要： 纽约州立大学石溪分校的研究小组已开发出新型脊髓灰质炎病毒株以保护脊髓灰质炎疫苗的生产人员。这些新毒株激发免疫反应的能力与目前疫苗生产用活病毒相同，但即使这些毒株逃逸也没有引发脊髓灰质炎的危险。

关键词： 脊髓灰质炎   灭活疫苗   Sabin株   野毒株   序贯免疫   中和抗体  

摘要： 目的评价Sabin株脊髓灰质炎灭活疫苗(Sabin strain inactivated poliovirus vaccine,sIPV)和野毒株脊髓灰质炎灭活疫苗(Wild strain inactivated poliovirus vaccine,wIPV)在恒河猴体内不同免疫方案的免疫原性。方法将25只恒河猴随机分为5组:sIPV组(免疫3剂sIPV)、sIPV/口服脊髓灰质炎减毒活疫苗(oral attenuated poliovirus vaccine,OPV)组(免疫2剂sIPV后,再免疫2剂OPV)、wIPV组(免疫3剂wIPV)、wIPV/OPV组(免疫2剂wIPV后,再免疫2剂OPV)和对照组(免疫3次稀释液M199),每组5只。OPV口服接种,IPV和M199经上臂三角肌处肌肉注射,2剂间免疫间隔时间为1个月。首次免疫前和每剂免疫后1个月采血,分离血清,采用微量中和试验法测定血清中抗脊髓灰质炎病毒Ⅰ、Ⅱ、Ⅲ型中和抗体效价。结果除对照组外的4个试验组全程免疫结束后,恒河猴血清中均可检出较高水平的中和抗体,且所有恒河猴血清中Ⅰ、Ⅱ、Ⅲ型中和抗体全部阳转。Ⅰ型和Ⅲ型抗体免疫应答中,接种sIPV的2个试验组中和抗体水平高于接种wIPV的2个试验组(P<0.05);Ⅱ型免疫应答中,接种wIPV的2个试验组中和抗体水平高于接种sIPV的2个试验组(P<0.05)。采用wIPV/OPV序贯免疫,Ⅰ、Ⅱ、Ⅲ型抗体免疫应答均可获得与单独接种wIPV同样的效果;而采用sIPV/OPV序贯免疫,Ⅰ型抗体免疫应答效果低于单独接种sIPV,Ⅱ型抗体水平差异无统计学意义(P>0.05),Ⅲ型抗体第4剂免疫后水平也有所上升。结论 sIPV和wIPV在恒河猴体内均可诱导良好的免疫应答,初步证实了IPV/OPV序贯免疫的可行性,为今后免疫策略的制定提供了一定的实验依据。

关键词： wild poliovirus   outbreak   importation   viruses   Central African Republic   vaccine   vaccination   polio   immunization   poliovirus   OPV   oral poliovirus vaccine   AFP   acute flaccid paralysis  

摘要： This article discusses a study which investigated the importation of wild poliovirus (WPV) into Central African Republic during successive events in 2008, 2009 and 2011. Researchers collected fecal samples from patients who had acute flaccid paralysis (AFP) during the period. The samples were analyzed for virus isolation, typing and intratypic differentiation. The researchers learned that the importation of wild poliovirus strains appeared to follow three different routes.