关键词： 健康儿童   脊髓灰质炎   脊髓灰质炎病毒   中和抗体  

摘要： 目的了解江苏省健康儿童脊髓灰质炎（脊灰）中和抗体水平,评价江苏省儿童脊灰减毒活疫苗免疫效果。方法收集江苏省2011-2015年14岁以下健康儿童血清样本,应用细胞中和实验方法检测脊灰中和抗体。使用SPSS 20.0统计软件进行统计分析。结果共检测2 000名健康儿童的血清样本,脊灰Ⅰ、Ⅱ、Ⅲ型抗体阳性率分别为98.55%、98.25%、95.15%;几何平均滴度（GMT）分别为1∶154.88、1∶75.86、1∶31.62。3种型别脊灰中和抗体GMT各年龄组间差异有统计学意义,均为1～岁组最高,随着年龄的增长有下降的趋势。不同免疫史次数儿童的脊灰抗体水平差异也均有统计学意义,完成3次免疫的儿童中和抗体GMT最高。结论江苏省保持了高水平的脊灰疫苗免疫覆盖率,对儿童脊髓灰质炎起到良好的免疫保护作用。值得注意的是脊灰中和抗体几何平均滴度总体呈逐年下降的趋势,需引起相关部门的重视。

关键词： 脊髓灰质炎灭活疫苗   接种意愿   电话调查  

摘要： 目的调查济南市儿童家长脊髓灰质炎灭活(脊灰)疫苗(IPV)接种意愿并分析其影响因素,为中国脊灰免疫策略的顺利调整提供依据。方法设计统一调查问卷,随机抽取儿童家长的电话号码,对被抽取的儿童家长进行电话调查。共获得IPV接种组和口服脊灰减毒活疫苗(OPV)接种组儿童家长有效问卷各241份。结果 IPV、OPV接种组儿童家长的脊灰及脊灰疫苗知晓率分别为42.26%和27.92%(χ2=10.818,P=0.001)。多因素分析显示,预防接种门诊服务的便利性、医生介绍有2种预防脊灰的疫苗及医生给家长介绍2种疫苗的优缺点是影响家长接种IPV的因素。结论家长对脊灰和脊灰疫苗知晓率低。在脊灰疫苗策略调整阶段,对接种门诊医生开展针对性培训以便与家长进行有效的沟通和交流,是促使脊灰疫苗策略顺利转型的关键因素。

关键词： 减毒   疫苗接种   乙肝疫苗   联合疫苗   麻疹疫苗   接种者   工艺处理   麻腮   脊髓灰质炎疫苗   及时接种率  

摘要： 为什么接种疫苗能预防疾病？当细菌或病毒侵入人体时,身体就会产生一种抵抗这种细菌或病毒的物质,这种物质叫做抗体。针对不同的细菌或病毒会产生不同的抗体,又被称为特异性抗体。病愈后,这种特异性抗体仍然存留在体内,如再有相应的细菌或病毒侵入体内,这种特异性抗体就能保护身体不受这些细菌或病毒的伤害。预防接种就是人为地将经过减毒或灭活等工艺处理的少量细菌或病毒及其代谢产物接种给人,

关键词： 脊髓灰质炎疫苗   世界卫生组织   2型   对消   口服疫苗   相关感染   马达加斯加   病毒株  

摘要： 2015年10月23日，卫生领域专家向世界卫生组织提议，应停止给儿童接种2型脊髓灰质炎疫苗。目前口服疫苗是预防脊髓灰质炎的主要措施，该类病毒株主要有l型、2型和3型。但自1999年以来，世界范围内未再检出2型脊髓灰质炎病毒株。另外，口服疫苗接种者排出的病毒也可能感染未接受疫苗的人群。近期在疫苗低覆盖地区如老挝、乌克兰、马达加斯加及几内亚等地已出现多起与使用疫苗相关感染。

关键词： 脊髓灰质炎灭活疫苗   基础免疫   替代  

摘要： 目的了解宁波市鄞州区2008～2014年出生儿童脊髓灰质炎（脊灰）灭活疫苗（IPV）替代口服脊灰减毒活疫苗（OPV）基础免疫情况，为调整脊灰疫苗（PV）免疫策略提供参考。方法通过宁波市免疫规划信息管理系统收集2008～2014年出生儿童的PV基础免疫资料，对IPV替代接种现状进行描述性分析，采用Logistic回归模型进行多因素分析。结果宁波市鄞州区2008-2014年出生儿童125555人，PV基础免疫全程接种率为99．92％，IPV全程替代率为16．42％；IPV全程替代率随儿童年龄增长呈下降趋势（X^2=21039．53，P〈0．001）；多因素分析表明，本地户籍儿童全程替代率高于外地户籍儿童（OR=3．22，95％CI=3．1l-3．34）；城区全程替代率高于农村地区（OR=1．31，95％CI=1．26～1．36）；与Ⅲ类经济水平地区相比，Ⅱ类（OR=1．41，95％C1=1．32～1．51）和I类（OR=1．09，95％CI=1．03～1．17）全程替代率更高；替代免疫程序以I-I-I型（3剂次均为1PV）和D-D-D型（3剂次均为***／Hib）为主，分别占53．35％和40．56％，二者全程替代接种的比例均呈逐年递增趋势（z。=215．84，P〈0．001；X^2=588．01，P〈0．001）；序贯免疫以I-I-O型（IPV-IPV-OPV）和I-0-0型（IPV-OPV-OPV）为主，分别占3．07％和1．58％，其他替代程序占1．44％。结论宁波市鄞州区儿童IPV基础免疫全程替代率低，存在人群和地区差异性；替代免疫程序种类较多，需通过健康教育提高家长科学选择替代免疫程序。

关键词： AZITHROMYCIN   VACCINATION of infants   VACCINE effectiveness   LOW-income countries   RANDOMIZED controlled trials   POLIO vaccination  

摘要： Background Oral poliovirus vaccine is less immunogenic and effective in low-income countries than in high-income countries, similarly to other oral vaccines. The high prevalence of intestinal pathogens and associated environmental enteropathy has been proposed to explain this problem. Because administration of an antibiotic has the potential to resolve environmental enteropathy and clear bacterial pathogens, we aimed to assess whether antibiotics would improve oral poliovirus vaccine immunogenicity. Methods We did a double-blind, randomised, placebo-controlled trial of the effect of azithromycin on the immunogenicity of serotype-3 monovalent oral poliovirus vaccine given to healthy infants living in 14 blocks of Vellore district, India. Infants were eligible to participate if they were 6-11 months old, available for the study duration, and lacked serum neutralising antibodies to serotype-3 poliovirus. Infants were randomly assigned (1:1) at enrolment to receive oral 10 mg/kg azithromycin or placebo once daily for 3 days, followed by serotype-3 monovalent oral poliovirus vaccine on day 14. The primary outcome was detection of serum neutralising antibodies to serotype-3 poliovirus at a dilution of one in eight or more on day 35 and was assessed in the per-protocol population (ie, all those who received azithromycin or placebo, oral poliovirus vaccine, and provided a blood sample according to the study protocol). Safety outcomes were assessed in all infants enrolled in the study. The trial is registered with the Clinical Trials Registry India, number CTRI/2014/05/004588. Findings Between Aug 5, 2014, and March 21, 2015, 754 infants were randomly assigned:376 to receive azithromycin and 378 to placebo. Of these, 348 (93%) of 376 in the azithromycin group and 357 (94%) of 378 infants in the placebo group completed the study per protocol. In the azithromycin group, 175 (50%) seroconverted to serotype-3 poliovirus compared with 192 (54%) in the placebo group (risk ratio 0.

关键词： Poliomyelitis   Polio vaccination   War zones   GIS  

摘要： Background: Poliomyelitis is a highly infectious disease caused by poliovirus, which becomes difficult to manage/eradicate in politically unstable areas. The objectives of this study were to determine the movement and management of such polio outbreaks in endemic countries and countries with reoccurring cases of polio and to determine the effect of political instability on polio eradication. Methods: In this study, the extent of polio outbreaks was examined and modeled using statistical methodologies and mapped with GIS software. Data on polio cases and immunization were collected for countries with polio cases for the period 2011 to 2014. Weekly data from the Global Polio Eradication Initiative were collected for selected countries. The recent virus origin and current movement was mapped using GIS. Correlations between immunization rates, the Global Peace Index (GPI), and other indicators of a country's political stability with polio outbreaks were determined. Data were analyzed using SAS 9.4 and ArcGIS 10. Results: For several reasons, Pakistan remains highly vulnerable to new incidences of polio (306 cases in 2014). Overall immunization rates showed a steady decline over time in selected countries. Countries with polio cases were shown to have high rates of infant mortality, and their GPI ranked between 2.0 and 3.3;displaced populations, level of violent crime rating, and political instability also were ranked high for several countries. Conclusion: Polio was shown to be high in areas with increased conflict and instability. Displaced populations living in hard-to-reach areas may lack access to proper vaccination and health care. Wars and conflict have also resulted in the reemergence of polio in otherwise polio-free countries. (C) 2016 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

关键词： POLIO -- Prevention   IMMUNIZATION   MEDICAL protocols   PARENTS   POLIOMYELITIS vaccine   SOCIAL networks   SOCIAL media   CHILDREN  

摘要： The May 28, 2013 isolation of wild poliovirus type 1 (WPV1) in routine sewage samples signaled the beginning of the first protracted incident of WPV1 transmission in Israel since 1988. A door-to-door catch-up vaccination program with inactivated polio vaccine (IPV) was initiated in the area where the isolations were first identified. Although no cases of paralytic illness were diagnosed, evidence of continued and widespread transmission among children <9 years old necessitated the reintroduction of live oral attenuated polio vaccine in a country-wide campaign on August 18. 1 To maximize safety, the bivalent live oral attenuated polio vaccine (bOPV) used in 2013 was given only to children previously immunized with IPV.(2) The campaign was accompanied by extensive public discussion, particularly in the online social networks. The authors describe their experience answering vaccine-related questions online from June through October 2013, 1 (K.L.) as a volunteer and the other (L.R.) as a representative of the Ministry of Health.

关键词： Multiplex RT-PCR   Identification   Recombination   OPV derivatives   VAPP  

摘要： Polioviruses (PVs) are the causal agents of acute paralytic poliomyelitis. Since the 1960s, poliomyelitis has been effectively controlled by the use of two vaccines containing all three serotypes of PVs, the inactivated poliovirus vaccine and the live attenuated oral poliovirus vaccine (OPV). Despite the success of OPV in polio eradication programme, a significant disadvantage was revealed: the emergence of vaccine-associated paralytic poliomyelitis (VAPP). VAPP is the result of accumulated mutations and putative recombination events located at the genome of attenuated vaccine Sabin strains. In the present study, ten Sabin isolates derived from OPV vaccinees and environmental samples were studied in order to identify recombination types located from VP1 to 3D genomic regions of virus genome. The experimental procedure that was followed was virus RNA extraction, reverse transcription to convert the virus genome into cDNA, PCR and multiplex-PCR using specific designed primers able to localize and identify each recombination following agarose gel electrophoresis. This multiplex RTPCR assay allows for the immediate detection and identification of multiple recombination types located at the viral genome of OPV derivatives. After the eradication of wild PVs, the remaining sources of poliovirus infection worldwide would be the OPV derivatives. As a consequence, the immediate detection and molecular characterization of recombinant derivatives are important to avoid epidemics due to the circulation of neurovirulent viral strains.

关键词： POLIO -- Prevention   DISEASE eradication   COST effectiveness   POLIO vaccination   DEVELOPING countries  

摘要： Various factors have been suggested as causes of the poorer immunogenicity of oral vaccines in developing countries including concurrent infections and diarrhoea, often a result of poor sanitation and malnutrition.1-3 Environmental enteropathy, a condition commonly found in children in low-income countries, consisting of inflammation, malabsorption, and increased permeability of the small intestine, might also play a part.4,5 Studies have identified increased community fatigue to multiple polio campaigns in polio-affected countries, potentially contributing to vaccine refusal and threatening eradication.6-9 Determining how to improve the immunogenicity of each dose of oral poliovirus vaccine in developing country settings would facilitate eradication and could enhance the effectiveness of other oral vaccines.