关键词： 疫苗衍生脊髓灰质炎病毒   无丙种球蛋白血症   防控措施  

摘要： 目的对云浮市2015年2月发生的1例免疫缺陷疫苗衍生脊髓灰质炎（脊灰）病毒（iVDPV）病例进行调查和采取防控措施,以阻断VDPV循环。方法对病例进行个案调查、免疫功能检测/脊灰中和抗体检测,每月定期采集粪便标本进行病毒分离与鉴定及测序;对云浮市所有县级以上综合性医院2013~2015年3月急性弛缓性麻痹（AFP）病例进行主动搜索;对病例所在县5岁以下儿童开展脊灰疫苗查漏补种（患儿居住镇实施补充免疫）及接种率调查;对密切接触者和周围儿童进行粪便标本检测、常规疫苗的接种率评估及查漏补种。结果病例患有无丙种球蛋白血症,最终分类为Ⅱ型iVDPV病例。未发现医院漏报15岁以下儿童AFP病例;2015年3月9日至2016年1月21日共对患儿连续14次采集粪便标本,前11次均检出Ⅱ型VDPV;后3次均未检出脊灰病毒,2016年2月1日疫情控制措施终止;3月30日采集4名患儿家庭成员和8名5岁以下接触者的粪便标本共12份,其中2名家庭成员的标本检测出脊灰病毒,并有3个核苷酸变异,其余标本未检测出脊灰病毒,接触者均排除VDPV;病例所在县开展查漏补种后脊灰疫苗接种率达96.50%。本次疫情未发生VDPV循环。结论该病例为iVDPV病例,采取排泄物消毒、脊灰疫苗查漏补种、AFP主动监测等措施后,阻断了VDPV循环的发生。

关键词： 脊髓灰质炎疫苗高变异株   庞贝氏症   流行病学调查  

摘要： 目的对北京市1例庞贝氏症携带脊髓灰质炎(脊灰)疫苗高变异株(Vaccine High-mutant Poliovirus,VHMPV)患儿进行流行病学调查分析。方法开展病例的个案调查、消毒隔离、排毒监测、病毒传播风险评估,召开急性弛缓性麻痹(AFP)病例分类诊断专家会对病例进行最终分类诊断。结果 2015年7月报告1例AFP病例,麻痹后采集2份合格粪便标本,经国家脊灰实验室核苷酸序列测定为VHMPVⅢ。患儿2月龄接种1剂脊灰灭活疫苗,3、4月龄分别口服1剂脊灰减毒活疫苗;排毒监测患儿及其密切接触者粪便标本中脊灰病毒分离均为阴性;患儿所在居委会接种率普查发现1例脊灰疫苗零剂次免疫儿童;昌平区所有街乡学龄前儿童脊灰疫苗查漏补种发现漏种率0.18%,补种率100%;医院AFP主动搜索发现1例AFP漏报病例;病例采取消化道隔离措施直至疫情结束。病例分类诊断为脊灰排除病例,临床诊断为庞贝氏症。结论患儿的弛缓性麻痹症状为其原发病庞贝氏症所致,是一名VHMPVⅢ携带者。病例所在区应进一步加强AFP病例监测,夯实常规免疫和查漏补种工作。

关键词： 疫苗接种   免费接种   公共卫生   人的生命   疫苗冷链   第二类疫苗   水痘减毒活疫苗   亿人   国家免疫规划   脊髓灰质炎疫苗  

摘要： 预防接种毫无疑问是最具成本效益的公共卫生措施.预防接种在世界各地的推广已使上亿人免于传染病的痛苦,并拯救了上百万人的生命.新中国成立后,得益于预防接种的有力推动,我国在20世纪60年代初消灭了牛痘.自1978年起我国开始实施计划免疫,对全部儿童免费接种可预防6种疾病的4种疫苗,2007年进一步将可预防15种传染病的疫苗纳入国家免疫规划，有效地控制了疫苗可预防传染病的发生和传播，对保障儿童身体健康和生命安全、维护社会稳定起到了不容低估的作用．

关键词： 脊髓灰质炎疫苗   接种意愿   宣传沟通   儿童监护人  

摘要： 目的了解中国部分地区儿童监护人对脊髓灰质炎（脊灰）疫苗知识知晓的情况和接种意愿,为开发有针对性的灭活脊灰病毒疫苗（Inactivated Poliovirus Vaccine,IPV）纳入国家免疫规划宣传策略提供依据。方法在北京、上海、安徽、河南、云南、新疆等6省份12个县,对0~5岁儿童的监护人采用方便抽样方法,由培训合格的调查人员入户进行面对面问卷调查。结果共调查2 402名儿童监护人,口服脊灰减毒活疫苗（OPV）可能引起疑似预防接种异常反应（AEFI）及IPV的知晓率均为24.6%。5.2%的儿童监护人发生过接种犹豫,其中OPV居国家免疫规划疫苗的第一位（22.4%）。在未具体向儿童监护人解释IPV、OPV区别前,24.9%的儿童监护人选择IPV是因为听说发生AEFI少,16.7%是因为IPV是进口疫苗;解释后,超过40%儿童监护人选择IPV。49.2%的儿童监护人愿意选择国产免费的IPV。当发生国产IPV供应不足时,59.0%的儿童监护人愿意听从接种医生的推荐。92.9%的儿童监护人表示获取预防接种信息主要依赖于医生,其中91.6%表示接种医生是其最信赖的信息获取途径。结论在IPV纳入国家免疫规划过程中应适度宣传,主要向基层接种医生做好正确引导和免疫策略的解读和宣传,提高其沟通能力,使其在面对儿童监护人询问时能够正确回答相关问题。

关键词： 疫苗接种   疫苗生产   批发企业   脊髓灰质炎疫苗   冷链管理   疫苗流通   疫苗冷链   麻疹疫苗   公共卫生事业   受种者  

摘要： 2016年3月,山东警方破获了一起重大非法经营疫苗案,涉案疫苗批发企业伙同其他非法经销商在5年间将25种儿童、成人用二类疫苗未经冷链存储运输销往全国18个省市,涉案金额达5.7亿元,问题疫苗数量则无法统计.涉案疫苗虽然由正规疫苗生产厂家生产,但未按规定进行冷链存储和运输,并且部分属于临期疫苗，流通过程中存在过期和变质风险．

关键词： Poliomyelitis   Wild poliovirus   Importation   Immunization   Eradication  

摘要： Background: Efficient implementation of the global eradication strategies consisting of Acute Flaccid Paralysis (AFP) surveillance and mass immunization campaigns led to interruption of indigenous wild poliovirus transmission in Cameroon in 1999. Objectives: This study describes type 1 and type 3 wild poliovirus (WPV) importation, incidence, geographic distribution and control since the original interruption of transmission in Cameroon. Study design: Stool samples from AFP patients under the age of 15 years in Cameroon were collected nationwide and subjected to virus isolation on RD and L2OB cell cultures. Resulting virus isolates were typed by intratypic differentiation (ITD) and analysis of the VP1 coding sequence of the viral genome. Surveillance data originating from Cameroon between 2000 and 2014 were considered for retrospective descriptive analyses. Results: From 2003 to 2009, multiple WPV importation events from neighboring countries affected mainly in the northern regions of Cameroon but did not led to sustained local transmission. Throughout this period, 16 WPV1 and 5 WPV3 were detected and identified as members of multiple clusters within type specific West Africa B genotypes (WEAF-B). In 2013-2014, a polio outbreak associated to a highly evolved ("orphan") WPV1 affected four southern regions of Cameroon. Conclusions: The appearance of highly evolved lineage of type 1 WPV suggests potential surveillance gap and underscore the need to maintain comprehensive polio immunization activities and sensitive surveillance systems in place as long as any country in the world remains endemic for WPV. (C) 2016 Elsevier B.V. All rights reserved.

关键词： adolescents   diphtheria   tetanus   and acellular pertussis/inactivated poliovirus vaccine (DTaP/IPV)   meningitis   rLP2086   vaccine  

摘要： Key points. Concomitant administration of bivalent rLP2086 (Trumenba [Pfizer, Inc] and diphtheria, tetanus, and acellular pertussis and inactivated poliovirus vaccine (DTaP/IPV) was immunologically noninferior to DTaP/IPV and saline and was safe and well tolerated. Bivalent rLP2086 elicited robust and broad bactericidal antibody responses to diverse Neisseria meningitidis serogroup B strains expressing antigens heterologous to vaccine antigens after 2 and 3 vaccinations. Background. Bivalent rLP2086, a Neisseria meningitidis serogroup B (MnB) vaccine (Trumenba [Pfizer, Inc]) recently approved in the United States to prevent invasive MnB disease in individuals aged 10-25 years, contains recombinant subfamily A and B factor H binding proteins (fHBPs). This study evaluated the coadministration of Repevax (diphtheria, tetanus, and acellular pertussis and inactivated poliovirus vaccine [DTaP/IPV]) (Sanofi Pasteur MSD, Ltd) and bivalent rLP2086. Methods. Healthy adolescents aged >= 11 to <19 years received bivalent rLP2086 + DTaP/IPV or saline + DTaP/IPV at month 0 and bivalent rLP2086 or saline at months 2 and 6. The primary end point was the proportion of participants in whom prespecified levels of antibodies to DTaP/IPV were achieved 1 month after DTaP/IPV administration. Immune responses to bivalent rLP2086 were measured with serum bactericidal assays using human complement (hSBAs) against 4 MnB test strains expressing fHBP subfamily A or B proteins different from the vaccine antigens. Results. Participants were randomly assigned to receive bivalent rLP2086 + DTaP/IPV (n = 373) or saline + DTaP/IPV (n = 376). Immune responses to DTaP/IPV in participants who received bivalent rLP2086 + DTaP/IPV were noninferior to those in participants who received saline + DTaP/IPV. The proportions of bivalent rLP2086 + DTaP/IPV recipients with prespecified seroprotective hSBA titers to the 4 MnB test strains were 55.5%-97.3% after vaccination 2 and 81.5%-100% after vaccination 3. The

关键词： Bivalent oral polio vaccine   Seroconversion   Poliomyelitis   Diarrhea   Nepal  

摘要： Background: A globally -coordinated phase out of all type 2 containing oral polio vaccine (OPV) is planned for April 2016 during which bivalent 1 + 3 OPV (bOPV) will replace trivalent OPV (tOPV) in routine immunization schedules and campaigns. Diarrhea impairs the immune response to tOPV, but the effect of diarrhea on bOPV is unknown. Methods: Infants aged 6 weeks to 11 months, who had received <3 doses of OPV and had mild-moderate diarrhea or no diarrhea, were recruited at five health facilities in Nepal. Neutralizing antibody titers to poliovirus types 1 and 3 were measured before and 28 days after bOPV administration. The effect of diarrhea and other factors on seroconversion or boosting in antibody titers to poliovirus was assessed by multivariable analysis. Results: Infants with diarrhea, versus those without diarrhea, had reduced response for poliovirus types I (56% [87/156] vs 66% [109/164]) and 3 (34% [70/209] vs 52% [122/236]). After adjusting for other factors, infants with diarrhea had significantly reduced response for type 3 (odds ratio [OR] = 0.44, 95% CI 0.29-0.68), as did infants with >5 loose stools per day (OR = 0.36, 95% CI 0.21-0.62). Conclusions: Diarrhea reduced the immune response to bOPV. Provision of additional doses of polio vaccine is necessary to maintain high population immunity in areas with high prevalence of diarrheal disease. Published by Elsevier Ltd.

关键词： 肠道病毒   柯萨奇病毒   脊髓灰质炎病毒   诺如病毒   多重RT-PCR  

摘要： 建立同时能检测蝇类携带的肠道病毒EV71、柯萨奇病毒CA16、脊髓灰质炎病毒PV1 及诺如病毒Noro GI 型的多重RT-PCR 检测体系。方法:采用随机引物法对病毒RNA 逆转录后,用四条引物在同一管中通过一次PCR 反应成功检测EV71、CA16、PV1 及Noro GI 型。结果:建立的多重RT-PCR 检测方法能够特异性的检测出蝇类模拟阳性样本携带的病毒。结论:成功建立蝇类携带的四种病毒的多重RT-PCR 检测方法。

关键词： 肠道病毒   西南边疆   灭活疫苗   疫苗研发   脊髓灰质炎疫苗   疫苗生产   接种对象   免疫程序   动物模型试验   丙类传染病  

摘要： 每年4月,手足口病总是随着天气转暖不断增多,如何有效预防让家长犯难。而今年,随着全球首个预防手足口病的肠道病毒71型(EV71)灭活疫苗获批并投入使用,使手足口病预防有了坚实之盾。疫苗是如何研发出来的?它的出生地为何会落在西南边疆的云南昆明呢?