MMWR Morb Mortal Wkly Rep. 2019 Mar 8;68(9):225-230. doi: 10.15585/mmwr.mm6809a2.
Widespread use of live attenuated (Sabin) oral poliovirus vaccine (OPV) has resulted in marked progress toward global poliomyelitis eradication (1). However, in underimmunized populations, extensive person-to-person transmission of Sabin poliovirus can result in genetic reversion to neurovirulence and paralytic vaccine-derived poliovirus (VDPV) disease (1). This report updates (as of February 26, 2019) previous reports on circulating VDPV type 2 (cVDPV2) outbreaks during 2017-2018 in the Democratic Republic of the Congo (DRC) and in Somalia, which experienced a concurrent cVDPV type 3 (cVDPV3) outbreak* (2,3). In DRC, 42 cases have been reported in four cVDPV2 outbreaks; paralysis onset in the most recent case was October 7, 2018 (2). Challenges to interrupting transmission have included delays in outbreak-response supplementary immunization activities (SIAs) and difficulty reaching children in all areas. In Somalia, cVDPV2 and cVDPV3 were detected in sewage before the detection of paralytic cases (3). Twelve type 2 and type 3 cVDPV cases have been confirmed; the most recent paralysis onset dates were September 2 (cVDPV2) and September 7, 2018 (cVDPV3). The primary challenge to interrupting transmission is the residence of >300,000 children in areas that are inaccessible for vaccination activities. For both countries, longer periods of surveillance are needed before interruption of cVDPV transmission can be inferred.
广泛使用口服脊髓灰质炎减毒活疫苗（Sabin 疫苗）已显著推动全球消灭脊髓灰质炎工作取得进展（1）。然而，在免疫不足人群中，Sabin 脊髓灰质炎病毒可广泛发生人际传播，导致病毒遗传返祖并引发具有神经毒力的疫苗衍生脊灰病毒（VDPV）疾病（1）。本报告更新（截至 2019 年 2 月 26 日）了先前关于 2017-2018 年刚果民主共和国（刚果（金））和索马里发生的循环 VDPV2 型（cVDPV2）疫情以及同时发生的 cVDPV3 型（cVDPV3）疫情的报告*（2,3）。在刚果（金），4 次 cVDPV2 疫情共报告 42 例病例；最近一起病例的瘫痪发病日期为 2018 年 10 月 7 日（2）。阻断传播的挑战包括疫情应对补充免疫活动（SIAs）延迟，以及难以在所有地区为儿童接种疫苗。在索马里，在出现麻痹病例之前，污水中已检测到 cVDPV2 和 cVDPV3（3）。已确认 12 例 2 型和 3 型 cVDPV 病例；最近的瘫痪发病日期分别为 9 月 2 日（cVDPV2）和 9 月 7 日（cVDPV3）。阻断传播的主要挑战是，30 多万名儿童居住在无法开展疫苗接种活动的地区。两国都需要进行更长时间的监测，才能推断出阻断 cVDPV 传播。
