1998-2014 年俄罗斯联邦与疫苗相关的麻痹性脊髓灰质炎。

Vaccine-associated paralytic poliomyelitis in the Russian Federation in 1998-2014.

机构信息

Institute of Poliomyelitis and Viral Encephalitides, Chumakov Federal Scientific Centre for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences (FSBSI "Chumakov FSC R&D IBP RAS"), Moscow, 108819, Russia; Sechenov First Moscow State Medical University, Moscow, 119991, Russia.

出版信息

Int J Infect Dis. 2018 Nov;76:64-69. doi: 10.1016/j.ijid.2018.08.017. Epub 2018 Sep 7.

DOI:10.1016/j.ijid.2018.08.017

PMID:30201507

Abstract

OBJECTIVES

Different polio vaccination schemes have been used in Russia: oral polio vaccine (OPV) was used in 1998-2007 and inactivated polio vaccine (IPV) followed by OPV in 2008-2014. This article presents the characteristics of vaccine-associated paralytic poliomyelitis (VAPP) cases in Russia during this period.

METHODS

VAPP cases were identified through the acute flaccid paralysis surveillance system, classified by the National Expert Classification Committee. Criteria for a 'recipient VAPP' (rVAPP) case were poliomyelitis symptoms 6-30days after OPV administration, isolation of the vaccine virus, and residual paralysis 60days after disease onset. Unvaccinated cases with a similar picture 6-60days after contact with an OPV recipient were classified as 'contact VAPP' (cVAPP) cases.

RESULTS

During 1998-2014, 127 VAPP cases were registered: 82 rVAPP and 45 cVAPP. During the period in which only OPV was used, rVAPP cases prevailed (73.8%); cases of rVAPP were reduced during the sequential scheme period (15%). Poliovirus type 3 (39.5%) and type 2 (23.7%) were isolated more often. Vaccine-derived poliovirus types 1, 2, and 3 were isolated from three cases of cVAPP. The incidence of VAPP cases was higher during the period of OPV use (1 case/1.59 million OPV doses) than during the sequential scheme period (1 case/4.18 million doses).

CONCLUSION

The risk of VAPP exists if OPV remains in the vaccination schedule.

摘要

目的

俄罗斯曾使用过不同的脊髓灰质炎疫苗接种方案：1998-2007 年使用口服脊髓灰质炎疫苗（OPV），2008-2014 年使用灭活脊髓灰质炎疫苗（IPV）后接着使用 OPV。本文介绍了在此期间俄罗斯疫苗相关麻痹性脊髓灰质炎（VAPP）病例的特征。

方法

通过急性弛缓性麻痹监测系统发现 VAPP 病例，并由国家专家分类委员会进行分类。“受种者 VAPP”（rVAPP）病例的标准为 OPV 接种后 6-30 天出现脊髓灰质炎症状、分离出疫苗病毒以及发病后 60 天残留麻痹。与 OPV 受种者接触后 6-60 天出现类似症状且未接种疫苗的病例被归类为“接触者 VAPP”（cVAPP）病例。

结果

1998-2014 年共登记了 127 例 VAPP 病例：82 例 rVAPP 和 45 例 cVAPP。仅使用 OPV 期间 rVAPP 病例占多数（73.8%）；序贯方案期间 rVAPP 病例减少（15%）。分离出的脊灰病毒 3 型（39.5%）和 2 型（23.7%）更为常见。3 例 cVAPP 分离出疫苗衍生的脊灰病毒 1、2 和 3 型。OPV 使用期间 VAPP 病例的发病率较高（每 159 万 OPV 剂 1 例），而序贯方案期间发病率较低（每 418 万剂 1 例）。