关键词： Enterovirus   Neonate   Sepsis  

摘要： Introduction: Enteroviruses (EV) are a common cause of neonatal sepsis especially at the junction of summer and fall. Aim: This study was planned to find the frequency of Enteroviral (EV) sepsis among neonates with clinical sepsis. Materials and Methods: This is a prospective descriptive study. Rectal and pharyngeal swab samples were taken from all neonates with clinical sepsis and a control group of neonates with simple jaundice. EV was confirmed by both cell culture and RT-PCR. Anti polio antiserum was used to differentiate Polioviruses from Non Polio EVs (NPEV). Results: We had 67 neonates with clinical sepsis and 31 cases of simple jaundice during 105 days. NPEVs were isolated from 2 cases (2.9%) of the sepsis arm and one neonate (3.2%) of the jaundice group. Polio virus was isolated from 16.2% and 15.3% of OPV recipients in the sepsis and jaundice group respectively. Conclusion: Enteroviruses were not a common cause for neonatal sepsis in Nemazi hospital at the time of this study. OPV vaccinated neonates commonly pass the vaccine virus in their pharynx and stool which can be mistaken with NPEV.

关键词： POLIO -- Prevention   WATCHFUL waiting (Medicine)   IMMUNIZATION   POLIO transmission   POLIO vaccination  

关键词： human infectious diseases   molecular farming   chloroplast transformation   bioencapsulation   oral delivery   mucosal immunity  

摘要： The WHO recommends complete withdrawal of oral polio vaccine (OPV) type 2 by April 2016 globally and replacing with at least one dose of inactivated poliovirus vaccine (IPV). However, high-cost, limited supply of IPV, persistent circulating vaccine-derived polioviruses transmission and need for subsequent boosters remain unresolved. To meet this critical need, a novel strategy of a low-cost cold chain-free plant-made viral protein 1 (VP1) subunit oral booster vaccine after single IPV dose is reported. Codon optimization of the VP1 gene enhanced expression by 50-fold in chloroplasts. Oral boosting of VP1 expressed in plant cells with plant-derived adjuvants after single priming with IPV significantly increased VP1-IgG1 and VP1-IgA titres when compared to lower IgG1 or negligible IgA titres with IPV injections. IgA plays a pivotal role in polio eradication because of its transmission through contaminated water or sewer systems. Neutralizing antibody titres (similar to 3.17-10.17 log(2) titre) and seropositivity (70-90%) against all three poliovirus Sabin serotypes were observed with two doses of IPV and plant-cell oral boosters but single dose of IPV resulted in poor neutralization. Lyophilized plant cells expressing VP1 stored at ambient temperature maintained efficacy and preserved antigen folding/assembly indefinitely, thereby eliminating cold chain currently required for all vaccines. Replacement of OPV with this booster vaccine and the next steps in clinical translation of FDA-approved antigens and adjuvants are discussed.

关键词： Hard to reach   Insecure   Army   Health   Partnership   Vaccines  

摘要： Background: Growing conflict and insecurity played a major role in precipitating polio outbreaks in the Horn of Africa and the Middle East. In Angola, the early post-conflict situation was characterized by the presence of many inaccessible zones and districts due to insecurity and poor infrastructure. Partnership with the Angolan Army health service (AAHS) was one of the innovative strategies that the Polio Eradication Initiative (PEI) introduced into the country to support the polio vaccination campaigns in insecure and hard to reach zones. Methods: Before embarking on creating a partnership with Angolan military it was essential to make high-level advocacy with top military decision makers to engage the leadership in the process for better and sustainable support to the strategy. The principal supports provided by the AAHS were the administration of oral polio vaccine, vitamin A, deworming agents, social mobilization, monitoring campaign quality, and surveillance. Distribution of logistics using military vehicles and helicopters to hard to reach and insecure zones was also part of the support. Results: Using this partnership it was possible to reach a significant number of children in insecure and hard to reach areas with polio vaccine and other child survival interventions. The military partnership also contributed in increasing the demand and addressing rejection for the polio vaccine. Conclusion: Military is a potentially productive force that can be used for any development activities in any country. The Angolan experience has demonstrated that it is possible to form a partnership with the military for basic health intervention activities with little training and investment. (C) 2016 The Authors. Published by Elsevier Ltd.

关键词： Polio   Eradication   New vaccine introduction   Africa  

摘要： Background: Significant progress has been made to increase access to vaccines in Africa since the 1974 launch of the Expanded Programme on Immunization (EPI). Successes include the introduction of several new vaccines across the continent and likely eradication of polio. We examined the contribution of polio eradication activities (PEI) on new vaccine introduction in the countries of the African Region. Methods: We reviewed country specific PEI reports to identify best practices relevant to new vaccine introduction (NVI), and analyzed trends in vaccine coverage during 2010-2015 from immunization estimates provided by WHO/UNICEF. Results: Of the 47 countries in,African Region 35 (74%) have introduced PCV, 27 (57%) have introduced rotavirus, and 14 (30%) have introduced IPV. National introductions for HPV vaccine have been done in 5 countries, while 15 countries have held demonstration and pilot projects. In 2014, the regional coverage for the third dose of PCV (PCV3) and rotavirus vaccines was 50% and 30% respectively. By end of 2015, all countries within the meningitis belt will have introduced MenAfriVac (TM) vaccine. Conclusions: PEI activities had a positive effect in strengthening the process of new vaccine introduction in the African Region. The major contribution was in availing immunization funding and providing trained and experienced technical staff to introduce vaccines. More investment is needed to advocate and sustain funding levels to maintain the momentum gained in introducing new vaccines in the region. (C) 2016 The Authors. Published by Elsevier Ltd.

关键词： 口服脊髓灰质炎减毒活疫苗   疫苗相关麻痹型脊髓灰质炎  

摘要： 目的分析河南省口服脊髓灰质炎（脊灰）减毒活疫苗（OPV）接种后疫苗相关麻痹型脊灰（Vaccine-associated Paralytic Poliomyelitis,VAPP）病例发生规律,为其防控措施制定提供科学依据。方法采用描述性分析方法对河南省2004-2015年VAPP病例进行分析。结果 2004-2015年河南省共报告VAPP病例26例,发生率为0.16/100万剂次;其中首剂OPV接种后VAPP 20例（73.08%）,发生率为1.11/100万剂次。发生数男女性比为5.5∶1。23例（88.46%）为2-6月龄儿童。接种至麻痹平均时间间隔为23天。病例麻痹部位主要为双下肢、单下肢。麻痹60天后随访均有残留麻痹。14例（53.85%）病例合并其他疾病,其中9例合并肛周脓肿。在13例脊灰疫苗病毒分离阳性的VAPP病例中,Ⅱ型占61.54%。结论 VAPP病例以低月龄、首剂OPV接种儿童为主。应密切关注脊灰疫苗免疫策略调整后VAPP发生情况。

关键词： 肠道病毒   脊髓灰质炎病毒   药物研究进展   病毒基因组   轻度症状   甲型肝炎病毒   病毒科   解螺旋酶   口服生物利用度   临床试验阶段  

摘要： 人类肠道病毒（EVs）是小RNA病毒科下的一属病毒,通常在夏秋季节爆发流行。在肠道病毒中,目前只有脊髓灰质炎病毒（PV1-3）、甲型肝炎病毒（HAV）和肠道病毒71型（EV71）有相应的疫苗,仍有超过110种的肠道病毒对人类健康造成巨大威胁。

关键词： 脊髓灰质炎灭活疫苗   免疫规划   认可度  

摘要： 目的了解儿童监护人对脊髓灰质炎（脊灰）灭活疫苗（IPV）纳入国家免疫规划（NIP）的认识和有关政策了解情况,为中国脊灰疫苗转换宣传沟通提供依据。方法在天津市、吉林省、湖北省、广东省、宁夏回族自治区,通过省级预防接种信息系统随机抽取500名0-1岁儿童的监护人,借助12320卫生热线平台开展IPV纳入NIP认可程度电话调查。结果实际调查2 198名儿童监护人,有效调查问卷完成95.6%。89.26%调查对象知道口服脊灰减毒活疫苗（OPV）,49.95%知道OPV可以预防脊灰。20.2%知道IPV,仅14.79%知道IPV可以预防脊灰。仅5.28%调查对象知道OPV能引起疫苗相关麻痹型脊灰（VAPP）,知道IPV局部接种反应调查对象比例为3.78%。如果IPV自费,58.83%的儿童监护人会自愿接种;如果IPV免费接种,有88.67%愿意接种,80.57%的儿童监护人愿意接种国产IPV。近10.79%的调查对象知道国家拟计划将IPV纳入常规免疫。当IPV短缺时,82.0%愿意听从医生安排。通过接种点医生来获得疫苗接种有关信息占84.2%。结论儿童监护人对OPV和其预防作用了解较多,但对IPV了解较少,IPV纳入NIP政策知晓率低。监护人愿意为儿童接种IPV,对预防接种人员的安排依从性较好。儿童监护人支持IPV纳入NIP,预防接种人员应将此政策充分告知儿童监护人。

关键词： 脑内法神经毒力试验   脊髓灰质炎疫苗   病理学评价  

摘要： 目的探讨脊髓灰质炎疫苗脑内法猴体神经毒力试验病理评价方法。方法采用恒河猴双侧丘脑内注射给药,观察21 d后进行解剖,完整取出脑和脊髓,经修切后脱水包埋,切片经HE染色和没食子蓝染色后在光镜下观察,对神经组织病变进行评分,根据分值对病变严重程度进行判定。本研究涉及12批实验中的240动物。结果本方法对左右大脑包括针迹在内的不同部位、中脑、小脑、脑桥、延髓、颈膨大、腰膨大进行取材,参照脊髓法神经毒力试验病理学评价的半切面评分方法,对双侧脑干、颈髓和腰髓的病变进行评价并计分,根据平均分值并结合具体病变情况分别判定此3个部位的病变程度。本研究中特异性的神经系统病变的发生率15%。各型疫苗病变发生率相似,轻微病变出现的比例最高。较严重的病变主要见于Ⅲ型疫苗。结论在脑内法神经毒力试验中,用半切面评分方法对病变进行评分,较客观地反映了神经系统病变的情况,方法简便易行,实用性较强,利于判断标准的统一,可作为脊髓灰质炎疫苗脑内法神经毒力试验病理学评价方法的参考。

关键词： 脊髓灰质炎病毒   病毒颗粒   免疫原性  

摘要： 目的评价不同形式的脊髓灰质炎病毒（poliovirus,PV）颗粒的免疫原性。方法采用蔗糖密度梯度超速离心法分别将经56℃加热1.5 h处理和未经加热的PV进行分离纯化,收集相应组分,进行电镜观察及SDS-PAGE分析,并测定各组分的D抗原及蛋白含量。用不同PV颗粒组分分别免疫大鼠,均经腿部肌肉注射,共接种3次,每次间隔21 d,于免疫前和第1、2次免疫后21 d经眼眶采血,末次免疫后21 d经心脏穿刺采血,分离血清,微量细胞病变（CPE）抑制法检测血清中抗Ⅰ、Ⅱ、Ⅲ型PV中和抗体几何平均滴度（GMT）。结果未经加热处理的PV可分离获得EP（蔗糖浓度16%~19%）和FP（蔗糖浓度22%~24.5%）两种病毒颗粒,电镜观察分别为空心颗粒和实心颗粒,EP经SDS-PAGE分析可见VP0、VP1和VP3病毒蛋白条带,FP可见VP1、VP2、VP3和VP4条带;经56℃加热处理的PV可分离获得HP（蔗糖浓度15%~17%）一种病毒颗粒,电镜观察为空心颗粒,SDS-PAGE分析可见VP0、VP1、VP2、VP3病毒蛋白条带。EP、FP免疫大鼠后,均可诱导产生针对PV的中和抗体,但EP诱导产生的中和抗体GMT低于FP;HP不能诱导产生中和抗体。结论未经加热的PV可分离获得EP和FP两种病毒颗粒,均具有免疫原性;经加热处理的PV仅分离获得HP一种病毒颗粒,不具有免疫原性。