对一名手足口病婴儿中发现的3型疫苗衍生脊髓灰质炎病毒的调查和应对——中国广东,2023年

IF 2.4 3区 医学 Q3 ENVIRONMENTAL SCIENCES
Jialing Li, Lance E Rodewald, Wei Zhang, Jian Liang, Xiaoping Shao, Qi Zhu, Jun Liu, Limei Sun, Jianfeng He
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引用次数: 0

摘要

背景:在一名患有手足口病(HFMD)的免疫功能正常婴儿中检测到3型疫苗衍生脊髓灰质炎病毒(VDPV3),引起了人们对潜在传播的关注。本研究旨在通过综合临床、环境和流行病学评估来调查VDPV3传播的风险。现有文献强调了在类似环境中VDPV3的罕见出现,强调需要进行强有力的监测和快速反应以预防疫情。病例介绍:佛山市一名无麻痹或免疫缺陷的8月龄手足口病女婴粪便标本检测VDPV3病毒阳性,并伴有12个核苷酸变化。这名婴儿之前接受过常规疫苗接种,其他方面都很健康。在她的随访样本中未检测到额外的VDPV3,儿童完全康复,无并发症。措施:根据中国国家卫生健康委员会和世界卫生组织的指导方针,成立了一个小组进行调查和应对。调查包括获取该儿童、其接触者和当地健康儿童的粪便标本,以检测脊髓灰质炎病毒的证据;加强对废水中VDPV3的环境监测;衡量疫苗接种覆盖率;在医院和社区搜索未报告的急性弛缓性麻痹病例;评估婴儿免疫缺陷指数。结果:在指示婴儿、其接触者或当地健康儿童的粪便样本中未检测到额外的vdpv3。同样,废水样品中未发现vdpv3。这孩子的免疫功能正常。历史疫苗接种率数据显示,佛山脊髓灰质炎疫苗接种率较高。对AFP病例的积极搜索没有结果。在一年多的时间里,加强了AFP监测和环境监测,在此期间没有发现额外的vdpv3。结论:基于佛山市脊髓灰质炎疫苗接种率高、AFP病例报告系统敏感以及调查结果,确定该地区脊灰病毒传播风险极低。未进行疫苗接种反应。经过一年的环境和AFP监测,没有检测到进一步的vdpv3,表明已停止传播。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Investigation and response to a type 3 vaccine-derived poliovirus detected in an infant with hand, foot, and mouth disease - Guangdong, China, 2023.

Background: The detection of type 3 vaccine-derived poliovirus (VDPV3) in an immunocompetent infant with hand, foot, and mouth disease (HFMD) raised concerns about potential transmission. This study aimed to investigate the risk of VDPV3 spread through comprehensive clinical, environmental, and epidemiological assessments. Existing literature highlights the rare emergence of VDPV3 in similar settings, emphasizing the need for robust surveillance and rapid response to prevent outbreaks.

Case presentation: Stool specimen from an 8-month-old female infant presented with HFMD without paralysis or immunodeficiency was tested positive for VDPV3 with 12 nucleotide changes in Foshan City. The infant had received routine vaccinations before and was otherwise healthy. No additional VDPV3 was detected in her follow-up samples, and the child fully recovered without complications.

Measures: A team was formed to investigate and respond in accordance with China's National Health Commission and World Health Organization guidelines. Investigation included obtaining stool specimens from the child, her contacts, and local healthy children to test for evidence of poliovirus; conducting enhanced environmental surveillance for VDPV3 in wastewater; measuring vaccination coverage; searching hospitals and communities for unreported acute flaccid paralysis (AFP) cases; and evaluating the index infant for immunodeficiency.

Results: No additional VDPV3s were detected in stool samples from the index infant, her contacts, or local healthy children. Similarly, no VDPV3s were identified in wastewater samples. The child's immune function was found to be normal. Historical vaccination coverage data revealed that Foshan had a high polio vaccination rate. An active search for AFP cases yielded no results. Over a period of more than one year, enhanced AFP surveillance and environmental surveillance were implemented, and no additional VDPV3s were detected during this time.

Conclusions: Based on Foshan's high polio vaccine coverage rate, sensitive AFP case reporting system, and findings from the investigation, risk of transmission of VDPVs in the area was determined to be extremely low. No vaccination response was conducted. After one year of environmental and AFP surveillance, no further VDPV3s were detected, indicating cessation of transmission.

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来源期刊
Journal of Health, Population, and Nutrition
Journal of Health, Population, and Nutrition 医学-公共卫生、环境卫生与职业卫生
CiteScore
2.20
自引率
0.00%
发文量
49
审稿时长
6 months
期刊介绍: Journal of Health, Population and Nutrition brings together research on all aspects of issues related to population, nutrition and health. The journal publishes articles across a broad range of topics including global health, maternal and child health, nutrition, common illnesses and determinants of population health.
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