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目的评价中国(未包括香港、澳门特别行政区和台湾地区)2015年脊髓灰质炎(脊灰)实验室网络(Polio laboratory network,PLN)运转情况,为中国维持无脊灰状态提供病毒学依据。方法对中国急性弛缓性麻痹(Acute flaccid paralysis,AFP)病例监测信息报告管理系统中31个省(自治区、直辖市)报告的AFP病例和中国疾病预防控制中心(CDC)病毒病预防控制所国家脊灰实验室(National Polio Laboratory,NPL)的监测数据库进行统计分析,对PLN的各项运转指标进行评价。结果 2015年中国共报告5 218例AFP病例,PLN收到5 173例AFP病例的10 335份粪便标本;14天内双份粪便标本采集率为92.76%;合格粪便标本采集率为92.16%,病毒分离结果 14天内反馈率为96%。5 173例病例中,L20B阳性69例(1.33%);非脊灰肠道病毒(Non-polio enterovirus,NPEV)阳性472例(9.12%)。NPL收到省级脊灰实验室送检的分离自AFP病例、非AFP病例、AFP病例接触者及健康人的179株L20B细胞阳性分离物,其中173株为脊灰病毒(Poliovirus,PV),4株为NPEV,2株为非肠道病毒(Non-enterovirus,NEV)。173株PV中,8株为疫苗衍生脊灰病毒(Vaccine-derived poliovirus,VDPV),来自浙江、广东和辽宁;未发现脊灰野病毒(Wild poliovirus,WPV)。从脊灰病毒外环境监测采集的污水标本中分离到1株Ⅱ型VDPV。2015年NPL和31个省CDC脊灰实验室都通过了世界卫生组织(WHO)粪便标本脊灰等肠道病毒的新检测流程的能力验证标本考核。NPL和27个省CDC脊灰实验室通过了WHO型内鉴定能力验证考核。结论中国PLN 2015年运转正常,未发现WPV,为维持中国无脊灰状态,早期发现VDPV或VDPV病例,早期采取应对措施阻断其传播提供了重要的病毒学依据。
Objective To evaluate the 2015 polio laboratory network (PLN) operation in China (excluding Hong Kong, Macau SAR and Taiwan) and to provide a virological basis for the maintenance of polio-free status in China. Methods AFP cases reported by 31 provinces (autonomous regions and municipalities) in the monitoring report system of Acute flaccid paralysis (AFP) cases in China and the poliovirus of the National Institute of Disease Control and Prevention, China Center for Disease Control and Prevention Laboratory (National Polio Laboratory, NPL) monitoring database for statistical analysis of the operation of the indicators to evaluate the PLN. Results A total of 5 218 AFP cases were reported in China in 2015, and 10 335 stool samples from 5 173 AFP cases were collected in PLN. The double stool samples collected in 14 days were 92.76%, the qualified stool samples collected in 92.16% Results within 14 days feedback rate of 96%. Among 5 173 cases, L20B was positive in 69 cases (1.33%) and non-polio enterovirus (NPEV) in 472 cases (9.12%). The NPL received 179 L20B cell positive isolates from AFP, non-AFP, AFP and healthy individuals, of which 173 were Poliovirus (PV), Four were NPEV and two were non-enterovirus (NEV). Of the 173 PVs, 8 were Vaccine-derived poliovirus (VDPV) from Zhejiang, Guangdong and Liaoning Provinces; no wild poliovirus (WPV) was found. One type Ⅱ VDPV was isolated from the sewage samples collected from poliovirus external environment monitoring. In 2015, NPL and 31 provincial CDC polio laboratories passed the proficiency tests of the new testing program for enterovirus such as polio of the World Health Organization (WHO). The NPL and 27 provincial CDC polio laboratories passed the WHO type-in-qualification assessment. Conclusions China PLN was operating normally in 2015 and no WPV was found. In order to maintain poliomyelitis-free status in China, early detection of VDPV or VDPV cases and early response measures to block the spread of WPV provided an important virological basis.