Mauel C, Merten C, Bewermeyer H
Medizinische Klinik, Landeskrankenhaus Bad Ischl.
Med Klin (Munich). 1998 Jan 15;93(1):39-42. doi: 10.1007/BF03045039.
We describe a 69 year-old female who became ill with polio after having changed the nappies of her grandchild who, six weeks earlier, had been vaccinated with oral live-vaccine against polio. Anamnesis and neurological status with limp paralysis in both legs oblige, with their implications, that the patient be isolated initially. Proof of poliomyelitis was to be found, in addition to typical medical findings, in the virus analysis in the stool, determined by polymerase chain reaction and in the discovery of antibodies from the serum by means of a neutralisation test. The neurological disorders could not be treated medically. The main priority was intensive physiotherapy. With walking aids the patient had only limited walking ability three months later.
Discussed are: the meaning of anamnesis and specific diagnosis of illness and immune deficiency, the morbidity and necessity for certain protection against children recently vaccinated with live-vaccine, also the provision for an individually structured plan for vaccination after satisfactory information.
我们描述了一名69岁女性,她在为六周前口服脊髓灰质炎活疫苗接种的孙子换尿布后感染了脊髓灰质炎。既往史及双腿弛缓性麻痹的神经学状况表明,患者最初需隔离。除典型的医学检查结果外,通过聚合酶链反应对粪便进行病毒分析以及通过中和试验从血清中发现抗体,均可确诊脊髓灰质炎。神经功能障碍无法通过药物治疗。主要重点是强化物理治疗。三个月后,借助助行器,患者的行走能力仍有限。
讨论了以下内容:既往史的意义、疾病的特异性诊断和免疫缺陷、近期接种活疫苗儿童的发病率及采取特定防护措施的必要性,以及在提供充分信息后制定个性化疫苗接种计划。