Sufa Diriba, Gerema Urge
Ethiopian Public Health Institute (EPHI), Center for Public Health Emergency Management (cPHEM), Addis Ababa, Ethiopia.
Department of Biomedical Sciences, Division of Anatomy, College of Medical Sciences, Institute of Health Sciences, Jimma University, Jimma, Ethiopia.
Case Rep Infect Dis. 2020 Aug 26;2020:6917313. doi: 10.1155/2020/6917313. eCollection 2020.
Poliovirus isolates detected in persons or in the environment can fall into three major categories: wild, Sabin and Sabin-like, or vaccine-derived. Detection of wild or vaccine-derived poliovirus may constitute an emergency, which can be categorized as an event that can lead to an outbreak, depending on characteristics of the isolate and the context in which it appears. The aim of the study was investigation report of cVDPV2 outbreak in Bokh woreda of Dollo Zone, Somali regional state, Ethiopia.
A team of experts drawn from different organizations was deployed to Bokh woreda to make detailed field investigation from May 25 to June 17, 2019. By using standard World Health Organization polio outbreak investigation checklist, document review of surveillance, immunization, and clinical data related to the case was made. Key informant's interview was made to health professionals, managers, parents of case, woreda and kebele leaders, religious leaders, and HEWs related to acute flaccid paralysis outbreak.
The notified AFP case was a 39-month-old female from Angalo kebele of Bokh woreda, Dollo Zone. On 19th May 2019, the patient developed high grade fever and was taken to Angalo Health Post on 20th May 2019. As per the examination by a health extension worker, the child had high grade fever and neck stiffness with preliminary diagnosis of meningitis for which ceftriaxone injection was prescribed. Contact sample was taken from three children on 28th May 2019 and 29th May 2019 and was sent to Addis Ababa National Polio Laboratory. All contact stool samples were found to be positive for poliovirus type 2 and referred for sequencing in National Institute of Communicable Diseases (NICD), South Africa, the Regional Polio Reference Laboratory. . The clinical presentation of the cases is compatible with poliovirus infection, improving the quality and coverage of supplementary polio immunization activities through proper planning; strict supervision and follow-up can reduce the occurrence of acute flaccid paralysis.
在人或环境中检测到的脊髓灰质炎病毒分离株可分为三大类:野生型、萨宾株和类萨宾株或疫苗衍生株。检测到野生型或疫苗衍生型脊髓灰质炎病毒可能构成紧急情况,根据分离株的特征及其出现的背景,可将其归类为可能导致疫情爆发的事件。本研究的目的是对埃塞俄比亚索马里州多洛地区博赫县2型循环疫苗衍生脊髓灰质炎病毒(cVDPV2)疫情进行调查报告。
2019年5月25日至6月17日,一支由不同组织抽调的专家团队被部署到博赫县进行详细的现场调查。通过使用世界卫生组织标准的脊髓灰质炎疫情调查清单,对与该病例相关的监测、免疫和临床数据进行了文件审查。对卫生专业人员、管理人员、病例的父母、县和乡领导人、宗教领袖以及与急性弛缓性麻痹疫情相关的卫生推广工作者进行了关键信息提供者访谈。
报告的急性弛缓性麻痹(AFP)病例是一名来自多洛地区博赫县安加洛乡的39个月大女性。2019年5月19日,患者出现高热,并于2019年5月20日被送往安加洛卫生所。根据一名卫生推广工作者的检查,该儿童高热且颈部僵硬,初步诊断为脑膜炎,为此开了头孢曲松注射液。2019年5月28日和29日从三名儿童身上采集了接触者样本,并送往亚的斯亚贝巴国家脊髓灰质炎实验室。所有接触者粪便样本均被检测出2型脊髓灰质炎病毒呈阳性,并被送往南非国家传染病研究所(NICD),即地区脊髓灰质炎参考实验室进行测序。病例的临床表现与脊髓灰质炎病毒感染相符,通过合理规划提高补充脊髓灰质炎免疫活动的质量和覆盖率;严格监督和随访可减少急性弛缓性麻痹的发生。