|
|
|
| Epidemiological investigation on a case of acute flaccid paralysis with detection of vaccine-derived poliovirus |
| TANG Xuewen1, BAI Yiran2, SU Ying3, GONG Liming1, YAN Rui1, ZHU Yao1, HE Hanqing1,4
|
1. Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China;
2. Henan Provincial Center for Disease Control and Prevention, Zhengzhou, Henan 450016, China;
3. Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China;
4. Zhejiang Key Lab of Vaccine, Infectious Disease Control and Prevention, Hangzhou, Zhejiang 310051, China |
|
|
|
|
Abstract In April 2021, type Ⅰ vaccine-derived poliovirus (VDPV) was detected from two fecal samples of a male infant with acute flaccid paralysis (AFP) in Zhejiang Province when he was admitted to the Children's Hospital Affiliated to Fudan University in Shanghai, with 12 and 14 nucleotide mutations in the VP1 region, respectively. The case had a history of immunization with three doses of poliovirus vaccines, and grade Ⅲ proximal muscle strength and grade Ⅱ distal muscle strength of the right lower limb. After symptomatic treatment, the activity of the right lower limb and the muscle strength was significantly restored, thus he was discharged. VDPV was not detected from subsequent (the 8th to 12th) fecal samples of the case and fecal samples of close contacts. No similar cases were found in medical institutions in the county, surrounding areas, neighboring villages or towns. Since the case did not exhibit clinical symptoms of poliomyelitis caused by VDPV, poliomyelitis was excluded, and the case was diagnosed with hemophilia type A based on the epidemiological investigation, laboratory tests, and the history of poliomyelitis vaccination. This event involved cross-provincial (municipal) cooperation and was responsed promptly, preventing further spread of the virus. It suggested that the sensitivity of the AFP case surveillance system should be maintained, environmental monitoring methods should be increased, and the poliomyelitis vaccination should be promoted to prevent the spread of the virus.
|
|
Received: 01 November 2024
Revised: 30 December 2024
Published: 13 February 2025
|
|
|
|
|
|
[1] WILKINSON A L,DIOP O M,JORBA J,et al.Surveillance to track progress toward polio eradication-worldwide,2020-2021[J].MMWR,2022,71(15):538-544.
[2] 温宁,苏琪茹,安志杰,等.中国脊髓灰质炎疫苗免疫策略的思考及建议[J].中国疫苗和免疫,2018,24(3):349-353.
WEN N,SU Q R,AN Z J,et al.Considerations and suggestions for polio vaccination strategies in China[J].Chin J Vaccines Immunization,2018,24(3):349-353.(in Chinese)
[3] World Health Organization.Global Wild AFP cases and environmental samples2018-2024[EB/OL].[2024-12-30].https://polioeradication.org/wild-poliovirus-count.
[4] World Health Organization.Global circulating vaccine-derived(cVDPV)AFP cases and environmental samples2021-2024[EB/OL].[2024-12-30].https://polioeradication.org/circulating-vaccine-derived-poliovirus-count.
[5] 中国疾病预防控制中心.脊髓灰质炎野病毒输入性疫情和疫苗衍生病毒相关事件应急处置技术方案(试行)[EB/OL].[2024-12-30].https://www.chinacdc.cn/nip/ywdt/jbfk/fkjswj/202112/t20211230_255291.html.
[6] 中华人民共和国国家卫生和计划生育委员会.脊髓灰质炎诊断:WS/T 294—2016[S].2016.
National Health and Family Planning Commission of the People's Republic of China.Diagnosis for poliomyelitis:WS/T 294—2016[S].2016.(in Chinese)
[7] 祝双利,李晓嫘,朱晖,等.中国2015年脊髓灰质炎实验室网络的运转与评价[J].中国疫苗和免疫,2017,23(2):127-133.
ZHU S L,LI X L,ZHU H,et al.Running status and evaluation of the China polio laboratory network in 2015[J].Chin J Vaccines Immunization,2017,23(2):127-133.(in Chinese)
[8] LINK-GELLES R,LUTTERLOH E,RUPPERT P S,et al.Public health response to a case of paralytic poliomyelitis in an unvaccinated person and detection of poliovirus in wastewater:New York,June-August 2022[J].Am J Transplant,2022,22(10):2470-2474.
[9] ZHAO H H,MA X Z,TANG H S,et al.Circulation of type 2 vaccine-derived poliovirus in China in 2018-2019[J].Open Forum Infect Dis,2021,8(12):1-8.
[10] YAO N,LIU Y,XU J W,et al.Detection of a highly divergent type 3 vaccine-derived poliovirus in a child with a severe primary immunodeficiency disorder:Chongqing,China,2022[J].MMWR,2022,71(36):1148-1150. |
|
|
|
