关键词： 固有免疫   肠道病毒   Ⅰ型干扰素   脊髓灰质炎病毒   Enterovirus   感染过程   柯萨奇病毒   动物病毒   免疫反应   细胞因子  

摘要： 肠道病毒（Enterovirus,EV）属于小RNA病毒科,为无囊膜、单股正链RNA病毒,包括肠道病毒A-D型、鼻病毒A-C型以及肠道病毒E-J型等共12个属,包含多种人类和动物病毒,如肠道病毒71型（EV-71）、柯萨奇病毒B3（Coxsackievirus B3,CVB3）、脊髓灰质炎病毒（Poliovirus,PV）等[1,2]。

关键词： 急性弛缓性麻痹监测人员   脊髓灰质炎疫苗   免疫策略转换   认知  

摘要： 目的了解2016年省级急性弛缓性麻痹(Acute flaccid paralysis,AFP)监测人员对脊髓灰质炎(脊灰)疫苗免疫策略转换的认知度。方法抽取全国(未包括香港、澳门特别行政区和台湾地区)31个省(自治区、直辖市)64名省级AFP监测人员进行问卷调查,对数据进行描述性流行病学分析。结果调查对象对全球脊灰野病毒流行类型、脊灰新疫苗及程序、脊灰实验室方面内容的认知度分别为35.94%(23/64)、88.28%(113/128)、93.75%(180/192)。84.38%(56/64)的调查对象认为新脊灰疫苗和免疫程序对接种率有影响,原因为疫苗供应不足、不信任疫苗接种、引入二价脊灰减毒活疫苗(Bivalent oral attenuated poliovirus vaccine,bOPV)、引入国产脊灰灭活疫苗(Inactivated polio vaccine,IPV)、公众疑虑等。调查对象认为单例疫苗衍生脊灰病毒(Vaccine-derived poliovirus,VDPV)检出风险较高,循环VDPV(Circulating VDPV,cVDPV)检出风险较低;78.88%(46/64)的调查对象认为在脊灰疫苗免疫策略转换后需更加重视Ⅱ型免疫缺陷者VDPV(Immunodeficient VDPV,iVDPV)。结论 AFP监测人员对脊灰疫苗免疫策略转换的认知度较低,对引入IPV的意义认识不足,应加强对AFP监测人员的培训,以促进策略的顺利实施。

关键词： 脊髓灰质炎实验室网络   脊髓灰质炎病毒   疫苗衍生脊髓灰质炎病毒  

摘要： 目的评价中国(未包括香港、澳门特别行政区和台湾地区)2015年脊髓灰质炎(脊灰)实验室网络(Polio laboratory network,PLN)运转情况,为中国维持无脊灰状态提供病毒学依据。方法对中国急性弛缓性麻痹(Acute flaccid paralysis,AFP)病例监测信息报告管理系统中31个省(自治区、直辖市)报告的AFP病例和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(National Polio Laboratory,NPL)的监测数据库进行统计分析,对PLN的各项运转指标进行评价。结果 2015年中国共报告5 218例AFP病例,PLN收到5 173例AFP病例的10 335份粪便标本;14天内双份粪便标本采集率为92.76%;合格粪便标本采集率为92.16%,病毒分离结果 14天内反馈率为96%。5 173例病例中,L20B阳性69例(1.33%);非脊灰肠道病毒(Non-polio enterovirus,NPEV)阳性472例(9.12%)。NPL收到省级脊灰实验室送检的分离自AFP病例、非AFP病例、AFP病例接触者及健康人的179株L20B细胞阳性分离物,其中173株为脊灰病毒(Poliovirus,PV),4株为NPEV,2株为非肠道病毒(Non-enterovirus,NEV)。173株PV中,8株为疫苗衍生脊灰病毒(Vaccine-derived poliovirus,VDPV),来自浙江、广东和辽宁;未发现脊灰野病毒(Wild poliovirus,WPV)。从脊灰病毒外环境监测采集的污水标本中分离到1株Ⅱ型VDPV。2015年NPL和31个省CDC脊灰实验室都通过了世界卫生组织(WHO)粪便标本脊灰等肠道病毒的新检测流程的能力验证标本考核。NPL和27个省CDC脊灰实验室通过了WHO型内鉴定能力验证考核。结论中国PLN 2015年运转正常,未发现WPV,为维持中国无脊灰状态,早期发现VDPV或VDPV病例,早期采取应对措施阻断其传播提供了重要的病毒学依据。

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

摘要： 目的分析河北省2013年-2015年急性弛缓性麻痹(AFP)病例及其密切接触者中脊髓灰质炎病毒(PV)核苷酸变异情况,及时发现可能出现的疫苗衍生脊髓灰质炎病毒(VDPV)及VDPV循环(c VDPVs)。方法对河北省2013年-2015年949例AFP病例(每例采双份便标本)及84例AFP病例密切接触者的粪便标本进行病毒分离与鉴定,分离的脊髓灰质炎病毒送国家脊髓灰质炎实验室进行核苷酸序列测定与分析。结果从26例AFP病例和5例AFP病例密切接触者粪便标本中分离到脊髓灰质炎病毒,将混合株进行单型分离后,共得到47株PV,以Ⅰ型PV为主。最大变异个数为6个。在1例AFP病例的粪便标本中,分离到2株Ⅱ型VDPV。结论河北省2013年-2015年分离到2株Ⅱ型VDPV,其余均为疫苗株,河北省继续保持无脊髓灰质炎状态。

关键词： 二价脊髓灰质炎减毒活疫苗   损耗系数   脊灰疫苗转换  

摘要： 目的估算二价脊髓灰质炎(脊灰)减毒活疫苗(bOPV)损耗系数。方法收集全国各省(自治区、直辖市)自2016年5月1日开始实施脊灰疫苗转换至2016年11月30日bOPV的下发、使用和接种情况。采用方便抽样,从各省分别选择5个预防接种单位,调查bOPV损耗系数和影响因素。结果全国bOPV的测算损耗系数为1.79,各省在1.34(重庆市)-4.57(青海省)之间。共调查接种单位182个,测算平均损耗系数为1.53。日、周/旬、月接种单位的损耗系数分别为1.70、2.16、2.87(F=11.52,P<0.05)。日平均接种量和损耗系数呈负相关(r=-3.01,P<0.05)。结论 bOPV损耗系数较大,且受多种因素影响,应根据各地实际情况使用损耗系数进行疫苗用量预测。

关键词： 肠道病毒71型灭活疫苗(人二倍体细胞)   接种儿童   抗体   动态观察  

摘要： 目的观察适龄健康婴幼儿接种肠道病毒71型灭活疫苗（人二倍体细胞）后血清中抗EV71中和抗体、抗脊髓灰质炎病毒中和抗体及抗甲肝病毒IgG抗体的动态变化。方法收集接种EV71灭活疫苗后受试者的血清进行中和试验检测抗EV71、抗脊髓灰质炎病毒Ⅰ、Ⅱ、Ⅲ型中和抗体滴度：用ELISA方法检测抗甲肝病毒IgG抗体浓度。结果首剂接种EV7l灭活疫苗后引起儿童血清中抗EV71中和抗体平均几何滴度（GMTs）上升至4．85，第2剂免疫28d后GMTs明显上升至64．37。对这些受试儿童血清内抗脊髓灰质炎病毒Ⅰ、Ⅱ、Ⅲ型中和抗体及抗甲肝病毒IgG抗体动态观察发现，0d（EV71疫苗接种前）相比，3个型别的抗脊髓灰质炎病毒中和抗体在28d（第1剂疫苗接种后28d）出现了轻微波动（P〈0．05），在56d（第2剂接种后28d）时I、Ⅲ型抗脊髓灰质炎病毒抗体也有轻微差异，但Ⅱ型已恢复至0d水平（P〉0．05）；抗甲肝病毒IgG抗体水平保持稳定，在观察期间内的波动差异无统计学意义（P〉O．05）。结论EV71灭活疫苗在两剂全程免疫并诱导特异性抗EV71中和抗体的过程中，对儿童体内原先存在的抗甲肝病毒IgG抗体无影响但对3个型别抗脊髓质炎病毒中和抗体有轻微干扰，总体来说抗体变化均不影响免疫应答的临床有效性。

关键词： 急性弛缓性麻痹   脊髓灰质炎病毒   核苷酸序列   测定和分析  

摘要： 目的检测分析急性弛缓性麻痹(acute flaccid paralysis,AFP)病例及其密切接触者脊髓灰质炎(脊灰)病毒,为河北省继续维持"无脊灰野病毒状态"提供理论依据。方法收集2015年河北省15岁以下急性弛缓性麻痹(AFP)病例及其密切接触者粪便标本,采用L20B和RD细胞,按照《WHO脊髓灰质炎实验室手册第4版》操作规程进行脊灰病毒阳性检测,用逆转录-聚合酶链反应(RT-PCR)法扩增VP1区基因片段并进行核苷酸序列测定和分析。结果从采集的303例AFP病例中共检出脊灰阳性7例,分离率为2.31%,分离到非脊灰肠道病毒(non-polio enterovirus,NPEV)59株,分离率为19.47%。与Sabin株相比,脊灰病毒VP1区核苷酸发生0个变异的有3株,发生1个变异的有6株;NPEV的分离以6~9月较多,占全年总数的64.41%。结论 2015年河北省脊灰实验室各项监测指标均符合WHO认证要求,脊灰病毒型别以Ⅰ型为主,VP1区核苷酸以低变异为主,均为脊灰疫苗相关株,NPEV呈夏秋季感染高峰。

关键词： Inactivated polio vaccine   Intradermal delivery   Vaccines   Delivery devices   Vaccine wastage  

摘要： Introduction: Intradermal delivery of a fractional dose of inactivated poliovirus vaccine (IPV) offers potential benefits compared to intramuscular (IM) delivery, including possible cost reductions and easing of IPV supply shortages. Objectives of this study were to assess intradermal delivery devices for dead space, wastage generated by the filling process, dose accuracy, and total number of doses that can be delivered per vial. Methods: Devices tested included syringes with staked (fixed) needles (autodisable syringes and syringes used with intradermal adapters), a luer-slip needle and syringe, a mini-needle syringe, a hollow micro needle device, and disposable-syringe jet injectors with their associated filling adapters. Each device was used to withdraw 0.1-mL fractional doses from single-dose IM glass vials which were then ejected into a beaker. Both vial and device were weighed before and after filling and again after expulsion of liquid to record change in volume at each stage of the process. Data were used to calculate the number of doses that could potentially be obtained from multidose vials. Results: Results show wide variability in dead space, dose accuracy, oVerall wastage, and total number of doses that can be obtained per vial among intradermal delivery devices. Syringes with staked needles had relatively low dead space and low overall wastage, and could achieve a greater number of doses per vial compared to syringes with a detachable luer-slip needle. Of the disposable-syringe jet injectors tested, one was comparable to syringes with staked needles. Discussion: If intradermal delivery of IPV is introduced, selection of an intradermal delivery device can have a substantial impact on vaccine wasted during administration, and thus on the required quantity of vaccine that needs to be purchased. An ideal intradermal delivery device should be not only safe, reliable, accurate, and acceptable to users and vaccine recipients, but should also have low dead spa

关键词： Glutathione   Poliomyelitis   Cold chain   Vaccine   Sabin  

摘要： Glutathione (GSH) is the most abundant thiol peptide in animal cells and has a critical role in antioxidation. GSH was reported to be essential for stabilization of some enteroviruses, including poliovirus (PV), during viral morphogenesis. Here, we explored the potential use of GSH as a thermostabilizer of oral poliomyelitis vaccine (OPV) formulations. GSH significantly protected the three types of PV from heat inactivation in a concentration-dependent manner. At a GSH concentration of 20 mM, nearly complete protection was observed against heating temperatures up to 53 degrees C for 2 min. GSH also markedly protected PV1 from heat-inactivation and this up to 6 h at temperatures of 44 degrees C and 46 degrees C and 3 h at 48 degrees C. The fact that GSH is naturally present at high concentration in the human body makes it an efficient candidate stabilizer for OPV formulations. (C) 2017 Elsevier Ltd. All rights reserved.

关键词： Poliovirus vaccine   Vaccination   VAPP  

摘要： Background: China's Expanded Program on Immunization (EPI) has provided 4 doses of oral poliovirus vaccine (OPV) since the 1970s. Inactivated poliovirus vaccine (IPV) became available in 2010 in Hangzhou as a private-sector, parent-chosen alternative to OPV. In 2015, WHO recommended that countries with all-OPV vaccination schedules introduce at least one dose of IPV, to mitigate risk associated with the withdrawal of type 2 OPV. We analyzed polio vaccine coverage and utilization in Hangzhou to determine patterns of IPV use and the occurrence of vaccine-associated paralytic polio (VAPP) in the various patterns identified. Methods: Children born between 2010 and 2014 and registered in Hangzhou's Immunization Information System (HZIIS) were included. VAPP cases were detected through the acute flaccid paralysis surveillance system. We used descriptive epidemiological methods to determine IPV and OPV usage patterns and VAPP occurrence. Results: HZIIS data from 566,894 children were analyzed. Coverage levels of polio vaccine were greater than 92% for each birth cohort. Percentages of children using OPV-only, IPV-only, and IPV/OPV sequential schedules were 70.57%, 27.01% and 2.41%, respectively. IPV-only schedule utilization increased by birth cohort regardless of geographical area or whether the child was locally-born. The highest use of an all-IPV schedule (79.85%) was among urban, locally-born children in the 2014 birth cohort. Five VAPP cases were identified during the study years;all cases occurred following the first polio vaccine dose, which was always OPV for the cases. Type 2 vaccine virus was isolated from 2 VAPP cases, and type 2 and type 3 vaccine virus was isolated from one VAPP case. The incidence of VAPP in the 2010-2014 birth cohorts was 3.76 per 1 million doses of OPV. Conclusion: Children in Hangzhou had high polio vaccination coverage. IPV-only schedule use increased by year, and was highest in urban areas among locally-born children. All cases of VAPP w