Chiba Y, Hikita K, Matuba T, Chosa T, Kyogoku S, Yu J, Wang Z
China Polio Control Project, Japan International Cooperation Agency (JICA).
Bull World Health Organ. 2001;79(2):103-10.
On 29 October 2000 poliomyelitis was officially declared to have been eradicated from the Western Pacific Region. This article describes the results of surveillance for cases of acute flaccid paralysis (AFP) in China during the final phase of the eradication effort.
We conducted hospital-based active surveillance in high-risk areas for poliomyelitis in 5 provinces of southern-China (Sichuan, Yunnan, Guizhou, Guangxi and Jiangxi) between 1995 and 1997 to determine the adequacy of reporting and laboratory diagnosis of cases of AFP.
A total of 1069 AFP cases occurring since 1993 were identified in 311 hospital visits. Less than 50% of AFP cases occurring in 1993 and 1994 had been reported by AFP surveillance, and laboratory diagnosis had been carried out on only a small proportion of these. However, improved cooperation between hospital sectors increased the rate of case reporting and laboratory diagnosis to 85% and 78%, respectively, in 1997. Despite this overall improvement, these two indicators were approximately 10-20% lower in Yunnan Province. Epidemiological analysis revealed that cases of clinical poliomyelitis accounted for as much as one-third of all AFP in 1993 and that some of these cases were clustered. Clusters were rarely observed after 1994. Active surveillance in the China-Myanmar border areas of Yunnan over 1995-96 detected 9 cross-border cases of clinical poliomyelitis, including 2 of wild poliomyelitis. Import of poliomyelitis was thus considered to have occurred frequently until 1996 in this border area of Yunnan. These data were important for the outbreak response immunization carried out in 1996 in the border prefectures of Yunnan.
Our investigation confirmed a high level of AFP surveillance in poliomyelitis high-risk areas of the five provinces and provided valuable information on the interruption of wild poliovirus circulation in southern China that will be of use to countries in other regions that have yet to eradicate poliomyelitis.
2000年10月29日，西太平洋地区正式宣布已根除脊髓灰质炎。本文描述了中国在根除脊髓灰质炎工作最后阶段对急性弛缓性麻痹（AFP）病例的监测结果。
1995年至1997年期间，我们在中国南方5个省份（四川、云南、贵州、广西和江西）脊髓灰质炎高风险地区开展了以医院为基础的主动监测，以确定AFP病例报告和实验室诊断的充分性。
在311次医院就诊中，共发现自1993年以来发生的1069例AFP病例。1993年和1994年发生的AFP病例中，不到50%通过AFP监测报告，且其中只有一小部分进行了实验室诊断。然而，医院各部门之间加强合作后，1997年病例报告率和实验室诊断率分别提高到了85%和78%。尽管总体有所改善，但云南省这两项指标仍比其他地区低约10%-20%。流行病学分析显示，1993年临床脊髓灰质炎病例占所有AFP病例的三分之一，其中一些病例呈聚集性。1994年后很少观察到聚集性病例。1995-1996年在云南中缅边境地区进行的主动监测发现了9例跨境临床脊髓灰质炎病例，其中2例为野生脊髓灰质炎。因此，直到1996年，云南这个边境地区脊髓灰质炎的输入被认为很频繁。这些数据对1996年在云南边境地区开展的疫情应急免疫接种很重要。
我们的调查证实了这五个省份脊髓灰质炎高风险地区对AFP的高水平监测，并提供了关于中国南方野生脊髓灰质炎病毒传播中断的宝贵信息，这将对其他尚未根除脊髓灰质炎的地区的国家有用。
