关键词： 疫苗衍生脊髓灰质炎病毒   脊灰减毒活疫苗   体液免疫力   世界卫生大会   口服接种   脊灰野病毒   消灭脊灰   麻痹型  

摘要： 1988年，世界卫生大会（WHA）通过全球消灭脊髓灰质炎（脊灰）的决议。消灭脊灰所使用的主要工具之一就是口服脊灰减毒活疫苗（Oral Poliomyelitis Attenuated Live Vaccine,OPV）。该疫苗廉价、通过口服接种、易于操作，近期疫苗受种者对脊灰野病毒（wild Poliovirus，WPV）感染具有免疫力，并通过持久的体液免疫力获得对该麻痹型疾病的长期保护。

关键词： 原发性免疫缺陷   疫苗衍生脊髓灰质炎病毒   流行病学调查  

摘要： 目的分析原发性免疫缺陷(PrimaryImm unodeficiency,PID)患者排出疫苗衍生脊髓灰质炎(脊灰)病毒(Vaccine-derived Poliovirus,iVDPV)的流行病学调查和处理情况。方法访谈病例发病前后情况,查阅临床病历,对病例及其密切接触者进行医学观察。对病例进行个案调查和标本检测,测定免疫功能,并定期采集粪便标本分离病毒;对病例所在地及医院进行急性弛缓性麻痹(Acute Flaccid Paralysis,AFP)病例主动搜索;对病例所在地及相邻地进行儿童口服脊灰减毒活疫苗(Oral Poliomyelitis Attenuated Live Vaccine,OPV)接种率调查;采集密切接触者和周围健康儿童的粪便标本,以及病例所在村的污水标本进行病毒分离。结果病例最终分类诊断为Ⅱ型(TypeII)免疫缺陷(Immunodeficiency,ID)VDPV(iVDPVII),核苷酸变异1.8%。病例在麻痹后6个月内定期采集17份粪便标本,未检测到脊灰病毒(Poliovirus,PV)。当地儿童OPV常规免疫接种率100%。采集病例接触者粪便标本50份,除分离到6株非脊灰肠道病毒(Non-polio Enterovirus,NPEV)外,未检出PV。采集病例所在村污水2份,未检出PV。发现iVDPVII后,及时采取了包括隔离治疗、环境消毒、接种率调查、AFP病例主动搜索、在病例所在地及相邻地区开展OPV补充免疫活动等多项措施。结论 iVDPVII未在当地造成循环。iVDPVII的发现,提示有必要对ID人群排出VDPV毒力变异的特点及其对易感人群是否具有致病力进行深入研究。

关键词： 接种率   口服脊髓灰质炎减毒活疫苗   急性弛缓性麻痹   免疫史  

摘要： 目的估算6月龄～3岁儿童口服脊髓灰质炎(脊灰)减毒活疫苗(OralPoliomyelitisAttenuatedLiveVaccine,OPV)接种率,评估新疆维吾尔自治区(新疆)输入脊灰疫情应急免疫活动的OPV实际接种率。方法利用2004年全国计划免疫审评OPV3剂(OPV3)接种率和非脊灰急性弛缓性麻痹(Non-polioAcuteFlaccidParalysis,NPAFP)病例OPV3免疫史,建立6月龄～3岁儿童OPV3估算接种率线性回归方程,估算新疆输入脊灰疫情应急免疫后的OPV3接种率。结果 6月龄～3岁儿童调查OPV3接种率与NPAFP病例OPV3接种率两个变量间具有直线趋势,波松(Pearson)相关系数为0.782,P<0.001;回归方程表达式为Y=41.232+0.578X(F=143.632,P<0.001)。根据回归方程估算6月龄～3岁儿童OPV3接种率,在应急免疫前,全疆接种率<90%,南疆5个地区(州)(包括和田地区、巴音郭楞蒙古自治州、喀什地区、克孜勒苏柯尔克孜自治州和阿克苏地区)估算接种率为73.34%～87.68%;5轮应急免疫后,6月龄～3岁儿童OPV3接种率>95%。西部地区部分省(自治区,下同)6月龄～3岁儿童OPV3估算接种率较低。结论该接种率回归方程模型可以用于估算以省为单位6月龄～3岁儿童OPV3接种率,为风险评估提供重要依据。新疆输入脊灰疫情发生前OPV3接种率较低,通过5轮应急免疫后OPV3接种率达到阻断脊灰野病毒传播的水平。

关键词： 脊髓灰质炎后综合征   下肢无力   双上肢无力   临床资料   左下肢   热诊断   肌萎缩   患者  

摘要： 1临床资料患者女性,63岁,教师,已退休。因＂右下肢无力50余年,加重4年余,左下肢及双上肢无力3年余＂,于2012年4月5日来我院就诊。患者6岁时因右下肢无力、发热诊断为脊髓灰质炎,遗留右下肢无力、肌萎缩,可行走。

关键词： 疫苗衍生脊髓灰质炎病毒   输入   高危急性弛缓性麻痹病例   快速检测  

摘要： 脊髓灰质炎（脊灰）病毒（Poliovirus，PV）快速检测，即运用分子生物学方法将病例粪便标本处理成便悬液后提取核酸，用PV特异性引物进行逆转录一聚合酶链反应（Reverse Transcril *** Chain Reaction，RT-PCR），并将PCR阳性产物送检测序，通过核苷酸比对分析，对脊灰疫苗赛宾类似株（Sabin．1ike，SL）病毒、疫苗衍生脊灰病毒（Vaccine—derived PV，VDPV）及脊灰野病毒（WildPV，WPV）进行鉴别。

关键词： 手消毒剂   聚维酮碘   乙醇氯己定复方   乙醇过氧化氢复方   脊髓灰质炎病毒  

摘要： 目的观察不同种类手消毒剂对脊髓灰质炎病毒的灭活效果。方法采用悬液定量试验法和载体定量试验法进行了实验室观察。结果含有效碘4 500 mg/L的聚维酮碘消毒液在清洁条件下作用10 min,对悬液内脊髓灰质炎病毒灭活对数值>4.00;在有机干扰物存在的条件下作用15 min,对悬液内脊髓灰质炎病毒灭活对数值>4.00。含体积分数70%乙醇与10 g/L过氧化氢的手消毒液在清洁条件下作用15 min,对悬液内脊髓灰质炎病毒灭活对数值>4.00;在有机干扰物存在的条件下作用30 min,对悬液内脊髓灰质炎病毒灭活对数值>4.00。含体积分数70%乙醇与10 g/L氯己定的手消毒凝胶作用3 min,对载体上脊髓灰质炎病毒灭活对数值>4.00。结论乙醇氯己定手消毒凝胶可以快速灭活载体上脊髓灰质炎病毒,聚维酮碘消毒液与乙醇过氧化氢手消毒液有效灭活悬液内脊髓灰质炎病毒需要10 min以上。

关键词： Inactivated polio vaccine   Surface plasmon resonance technology   Monoclonal antibody   Quantification method  

摘要： The inactivated polio vaccine (IPV) contains viral samples that belong to serotypes 1,2 and 3. We report here a surface plasmon resonance (SPR)-based technique that permits the simultaneous assay of the individual viral types in the IPV as well as in different bulk intermediates from the industrial vaccine production process. Monoclonal antibodies specific to each of the 3 viral types along with a negative control antibody are captured via an anti-IgG antibody on the surface of the 4 flow cells of the SPR instrument. The viral samples are then injected over these flow cells and the increase in resonance units as a result of virus binding is measured. The method was calibrated by an analysis of the European Working Standard (EWS) for poliovirus vaccines. We show that the antibodies used recognize viruses with functional affinities in the picomolar range permitting an effective capture of the antigen. In addition we demonstrate that the antibodies are highly specific to a given virus type and that the heat induced destruction of the D-antigen abolishes antibody recognition entirely. The technique was found to be reproducible and robust and its response was linear to the antigen concentration. Due to the rapidity of analysis this technique permits an almost real-time follow-up of the industrial production process and may present an alternative to the established ELISA assay for the analysis of the intermediates and the final product. (C) 2012 Elsevier Ltd. All rights reserved.

关键词： Poliovirus   Genomics   Polymerase chain reaction   Recombinant vaccines   RNA structure   Homologous recombination   Emulsions   DNA recombination  

摘要： The control and prevention of communicable disease is directly impacted by the genetic mutability of the underlying etiological agents. In the case of RNA viruses, genetic recombination may impact public health by facilitating the generation of new viral strains with altered phenotypes and by compromising the genetic stability of live attenuated vaccines. The landscape of homologous recombination within a given RNA viral genome is thought to be influenced by several factors;however, a complete understanding of the genetic determinants of recombination is lacking. Here, we utilize gene synthesis and deep sequencing to create a detailed recombination map of the poliovirus 1 coding region. We identified over 50 thousand breakpoints throughout the genome, and we show the majority of breakpoints to be concentrated in a small number of specific "hotspots," including those associated with known or predicted RNA secondary structures. Nucleotide base composition was also found to be associated with recombination frequency, suggesting that recombination is modulated across the genome by predictable and alterable motifs. We tested the predictive utility of the nucleotide base composition association by generating an artificial hotspot in the poliovirus genome. Our results imply that modification of these motifs could be extended to whole genome re-designs for the development of recombination-deficient, genetically stable live vaccine strains.

关键词： IMMUNE response -- Regulation   POLIO   VACCINATION   POLIOVIRUS   MEDICAL care cost control   SEROCONVERSION  

摘要： Background To reduce the costs of maintaining a poliovirus immunization base in low-income areas, we assessed the extent of priming immune responses after the administration of inactivated poliovirus vaccine (IPV). Methods We compared the immunogenicity and reactogenicity of a fractional dose of IPV (one fifth of a full dose) administered intradermally with a full dose administered intramuscularly in Cuban infants at the ages of 4 and 8 months. Blood was collected from infants at the ages of 4 months, 8 months, 8 months 7 days, and 8 months 30 days to assess single-dose seroconversion, single-dose priming of immune responses, and two-dose seroconversion. Specimens were tested with a neutralization assay. Results A total of 320 infants underwent randomization, and 310 infants (96.9%) fulfilled the study requirements. In the group receiving the first fractional dose of IPV, seroconversion to poliovirus types 1, 2, and 3 occurred in 16.6%, 47.1%, and 14.7% of participants, respectively, as compared with 46.6%, 62.8%, and 32.0% in the group receiving the first full dose of IPV (P< 0.008 for all comparisons). A priming immune response to poliovirus types 1, 2, and 3 occurred in 90.8%, 94.0%, and 89.6% of participants, respectively, in the group receiving the fractional dose as compared with 97.6%, 98.3%, and 98.1% in the group receiving the full dose (P = 0.01 for the comparison with type 3). After the administration of the second dose of IPV in the group receiving fractional doses, cumulative two-dose seroconversion to poliovirus types 1, 2, and 3 occurred in 93.6%, 98.1%, and 93.0% of participants, respectively, as compared with 100.0%, 100.0%, and 99.4% in the group receiving the full dose (P< 0.006 for the comparisons of types 1 and 3). The group receiving intradermal injections had the greatest number of adverse events, most of which were minor in intensity and none of which had serious consequences. Conclusions This evaluation shows that vaccinating infants with a