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[全球根除脊髓灰质炎的前景]

[The perspective of global eradication of poliomyelitis].

作者信息

Knolle H, Egli A, Candrian U

机构信息

Medizinische Hochschule Hannover, Institut für Biometrie.

出版信息

Gesundheitswesen. 2004 Jan;66(1):1-6. doi: 10.1055/s-2004-812828.

Abstract

In recent years, Germany and Switzerland have changed national policies to recommend vaccination with IPV (inactivated polio vaccine) instead of OPV (oral polio vaccine) for protection against poliomyelitis. An all IPV-schedule in routine childhood polio vaccination eliminates the - albeit minimal - risk of OPV-associated paralytic poliomyelitis. However, the impact of such a vaccination scheme on the goal to eventually eradicate poliomyelitis on a global level remains debatable. Published studies indicate that vaccine-derived poliovirus may persist in the environment for prolonged periods of time even after completion of a global eradication programme that relies on the near-exclusive use of OPV in the developing countries. Travellers vaccinated with IPV only might become silently infected with vaccine-derived virus, shedding it in large quantities. We therefore plead for a vaccination schedule that includes at least one last dose of OPV to induce strong mucosal immunity.

摘要

近年来,德国和瑞士已改变国家政策,建议使用灭活脊髓灰质炎疫苗(IPV)而非口服脊髓灰质炎疫苗(OPV)来预防脊髓灰质炎。在儿童常规脊髓灰质炎疫苗接种中采用全IPV接种程序可消除与OPV相关的麻痹性脊髓灰质炎的风险,尽管这种风险极小。然而,这种疫苗接种方案对最终在全球根除脊髓灰质炎目标的影响仍存在争议。已发表的研究表明,即使在发展中国家主要依靠OPV完成全球根除计划之后,疫苗衍生脊髓灰质炎病毒仍可能在环境中长时间持续存在。仅接种IPV的旅行者可能会被疫苗衍生病毒隐性感染,并大量排出病毒。因此,我们主张采用一种至少包含最后一剂OPV的疫苗接种程序,以诱导强大的黏膜免疫。

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