关键词： 医院药学   杂志   脊髓灰质炎病毒   小儿麻痹病毒   肠道病毒   中国药物应用与监测   癌细胞  

关键词： poliomyelitis   attenuation of neurovirulence   oral poliovirus vaccine  

摘要： As the global eradication of wild poliovirus nears, the World Health Organization (WHO) is addressing challenges unprecedented in public health. The live, attenuated oral poliovirus vaccine (OPV), used for more than four decades to interrupt poliovirus transmission, and the vaccine of choice for developing countries, is genetically unstable. Reversion of the small number of substitutions conferring the attenuated phenotype frequently occurs during OPV replication in humans and is the underlying cause of the rare cases of vaccine-associated paralytic poliomyelitis (VAPP) in OPV recipients and their close contacts. Whereas VAPP has long been recognized, two other adverse events have been identified more recently: (a) long-term excretion of highly evolved vaccine-derived polioviruses (VDPVs) in persons with primary immunodeficiencies, and (b) polio outbreaks associated with circulating VDPVs in areas with low rates of OPV coverage. Developing a posteradication strategy to minimize the risks of VDPV emergence and spread has become an urgent WHO priority.

关键词： poliovirus   coxsackie B5 virus   enterovirus   chromatography paper strip  

摘要： To achieve the goal of poliovirus eradication, surveillance of endemic areas is a crucial step in the poliovirus eradication program. Currently, six countries still have endemic poliovirus. We have tested a novel method which uses SDS/EDTA-treated chromatography paper strips to collect and transport poliovirus-containing stool samples. The SDS/EDTA-treated paper strips were soaked with different dilutions of poliovirus-containing feces and stored at different temperatures. After storing the SDS/EDTA paper strips for 5 months at 37 C, poliovirus RNA could be successfully amplified using RT-PCR. Infectivity of wild-type poliovirus type 1, 2, and 3 was lost upon contact with the SDS/EDTA-treated strips. This easy, inexpensive, and biosafe chromatography paper strip method for the collection and transportation of poliovirus samples can be of use in poliovirus surveillance and polio vaccination programs. (C) 2004 Elsevier Inc. All rights reserved.

关键词： 急性弛缓性麻痹   脊髓灰质炎   疫苗变异脊髓灰质炎病毒   疫苗衍生脊髓灰质炎病毒   监测  

摘要： 安徽省在 2 0 0 1、2 0 0 2、2 0 0 4年急性弛缓性麻痹 (AFP)病例监测中 ,有 8例AFP病例粪便标本分离到疫苗变异脊髓灰质炎 (脊灰 )病毒 ,与脊灰疫苗 (Sabin)株相比 ,VP1 区核苷酸差异率为 0 2 2 %～ 0 99%,其中 1例为疫苗衍生脊灰病毒 (VDPV)。 8例主要分布在几个相邻的县 ,年龄主要在≤ 1岁 (7例 ) ,有明显的类似脊灰症状 ,其中 5例未免疫或未全程免疫。密切接触者及周围儿童粪便标本未分离到疫苗变异脊灰病毒 ,当地口服脊灰疫苗 (OPV)接种率调查 ,除 1个村为 4 0 %外 ,其余均 >80 %。表明安徽省局部地区自然环境中存在疫苗变异脊灰病毒的循环 ,但未在人间传播。今后仍应加强儿童OPV常规免疫 ,加强AFP病例监测 ,有计划地开展OPV强化免疫。

关键词： 急性弛缓性麻痹   脊髓灰质炎病毒   非脊髓灰质炎肠道病毒   病原流行病学  

摘要： 对广东省 2 0 0 3年急性弛缓性麻痹 (AFP)病例进行病原流行病学分析。采集 2 79例AFP病例粪便标本 ,分离到脊髓灰质炎 (脊灰 )病毒 (PV) 2 5株 ,阳性率为 8 96 %,均为疫苗株。其中PVⅡ型 1 4株 ,占 5 6 %。分离到非脊灰肠道病毒 (NPEV) 1 7株 ,阳性率为 6 0 9%。对 2 0 0 3年AFP病例的免疫史、性别、年龄与病原学结果之间的关系进行了分析 ,结果显示 :口服脊灰减毒活疫苗“零”剂次免疫的AFP病例的PV分离率依次高于 1～ 2次和≥ 3次免疫者 ,分别为 4 3 75 %、2 2 2 2 %和 2 37%;1 8例 6 0d后随访残留麻痹的病例PVⅡ分离率为 38 89%。

关键词： 疫苗衍生株   脊髓灰质炎   聚合酶链反应  

摘要： [目的 ]对急性驰缓性麻痹病例粪便标本分离的脊髓灰质炎病毒进行型内鉴定。[方法 ]采用PCR RFLP技术 ,对分离毒株进行鉴定。[结果 ] 1999— 2 0 0 2年福建省脊灰分离株在 3D区有 5株Ⅱ型病毒发生重组或变异 ,表现为Ⅲ型 ;在VP1区有 3株发生变异 ,不同于经典Ⅱ型病毒 ,未发现脊灰野病毒。[结论 ]PCR RFLP技术能快速确认脊灰毒株的基因特征 ,初步区分脊灰病毒是否为野病毒或发生重组变异 。

关键词： 急性弛缓性麻痹   非脊髓灰质炎肠道病毒   监测  

摘要： 河北省 1 997～ 2 0 0 2年急性弛缓性麻痹 (AFP)病例病毒学监测中 ,共有 2 0 2例分离到非脊髓灰质炎肠道病毒(NPEV) ,年均NPEV分离率 1 0 1 %。对分离到的NPEV毒株进行了型别鉴定 ,在明确定型的 1 0 3株NPEV中 ,包括柯萨奇病毒 (Coxsackievirus ,Cox )A组 1个型 ;Cox B组 5个型 ;埃可病毒 (ECHO) 1 4个型。RD细胞对ECHO和Cox A9敏感 ,HEp 2细胞对Cox B敏感。取消HEp 2细胞的使用 ,会造成多数Cox B和一些未能定型的NPEV漏检 ,使NPEV分离率明显降低。NPEV感染有明显的夏秋季高峰 ,主要集中在小年龄组儿童 ,以 1岁和 2岁为多。

关键词： 脊髓灰质炎病毒   支原体污染   套式聚合酶链反应  

摘要： 为探讨脊髓灰质炎 (脊灰 )实验室网络中非脊灰肠道病毒 (NPEV)分离率下降的原因 ,采用套式聚合酶链反应(PCR)法对 2 4个省 (自治区、直辖市 )的 4 0份脊灰病毒 (PV)分离物 ,用国家脊灰实验室的RD、HEp 2、L2 0B细胞及3个不同厂家生产的牛血清进行了支原体检测。结果显示 :4 0份PV分离物中 ,37份检测到支原体 ,阳性率为92 5 %,其中 9份PV分离物感染了 2种支原体 ;3种细胞悬液均被同种支原体污染 ;3份牛血清中未检出支原体。经核苷酸序列测定证明 ,污染的 2种支原体为猪鼻支原体 (M hyorhinis)和精氨酸支原体 (M arginini)。该实验表明 ,脊灰实验室网络中普遍存在支原体污染 ,这也许是导致近年来NPEV分离率普遍下降的原因之一。NPEV分离率是评价脊灰实验室监测敏感性的重要指标之一。我国正处于消灭脊灰后期的一个关键时期 ,除了有来自邻国脊灰野病毒输入的危险外 ,因为我国是使用减毒活疫苗预防脊灰的国家 ,还有发生疫苗相关麻痹型脊灰或由疫苗衍生脊灰病毒引起病例的危险。实验室监测敏感性下降会导致这些病毒的漏检 ,从而增加其向外扩散的危险。因此必须彻底消除支原体污染 ,以提高脊灰实验室网络的敏感性 ,保证网络监测的质量。

关键词： Philippines   Type 1   Vaccines   Poliovirus Vaccines   Poliovirus  

摘要： In 2001, highly evolved type 1 circulating vaccine-derived poliovirus (cVDPV) was isolated from three acute flaccid paralysis patients and one contact from three separate communities in the Philippines. Complete genomic sequencing of these four cVDPV isolates revealed that the capsid region was derived from the Sabin 1 vaccine strain but most of the noncapsid region was derived from an unidentified enterovirus unrelated to the oral poliovirus vaccine (OPV) strains. The sequences of the cVDPV isolates were closely related to each other, and the isolates had a common recombination site. Most of the genetic and biological properties of the cVDPV isolates were indistinguishable from those of wild polioviruses. However, the most recently identified cVDPV isolate from a healthy contact retained the temperature sensitivity and partial attenuation phenotypes. The sequence relationships among the isolates and Sabin 1 suggested that cVDPV originated from an OPV dose given in 1998 to 1999 and that cVDPV circulated along a narrow chain of transmission. Type 1 cVDPV was last detected in the Philippines in September 2001, and population immunity to polio was raised by extensive OPV campaigns in late 2001 and early 2002.

关键词： Child   Nucleotides   Vaccines   Polioviruses   Body Excretions  

摘要： A child was found to be excreting type I vaccine-derived poliovirus (VDPV) with a 1.1% sequence drift from Sabin type 1 vaccine strain in the VP1 coding region 6 months after he was immunized with oral live polio vaccine. Seventeen type 1 poliovirus isolates were recovered from stools taken from this child during the following 4 months. Contrary to expectation, the child was not deficient in humoral immunity and showed high levels of serum neutralization against poliovirus. Selected virus isolates were characterized in terms of their antigenic properties, virulence in transgenic mice, sensitivity for growth at high temperatures, and differences in nucleotide sequence from the Sabin type 1 strain. The VDPV isolates showed mutations at key nucleotide positions that correlated with the observed reversion to biological properties typical of wild polioviruses. A number of capsid mutations mapped at known antigenic sites leading to changes in the viral antigenic structure. Estimates of sequence evolution based on the accumulation of nucleotide changes in the VP1 coding region detected a "defective" molecular clock running at an apparent faster speed of 2.05% nucleotide changes per year versus 1% shown in previous studies. Remarkably, when compared to several type 1 VDPV strains of different origins, isolates from this child showed a much higher proportion of nonsynonymous versus synonymous nucleotide changes in the capsid coding region. This anomaly could explain the high VP1 sequence drift found and the ability of these virus strains to replicate in the gut for a longer period than expected.