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麻痹型脊灰炎是有特殊临床病理学表现的一种疾病。它不仅由三型脊灰炎病毒引起,而且其它19种肠道病毒也可偶而引起发病。因此,只含三型脊灰炎病毒的疫苗并不能指望完全消除麻痹型脊灰炎。1975年于保加利亚以及1978年于匈牙利都发生了由肠道病毒71型引起的重度麻痹型脊灰炎暴发,有许多病例死亡。所以令人惊奇的是口服疫苗消除了经济发达的温带国家的麻痹型脊灰炎,而这些国家中却有相当比例的儿童,特别是较低经济阶层的儿童未作过免疫或免疫不完全。作者认为并无充分的证据证明极少见的与口服疫苗有关的麻痹型病例是由脊灰炎疫苗株引起的。在美国,尽管有毒力的脊灰炎病毒仍继续不断输入(特别
Paralytic poliomyelitis is a disease that has a special clinical and pathological appearance. It is not only caused by three types of poliovirus, but also the other 19 kinds of enterovirus can occasionally cause disease. Therefore, vaccines containing only type 3 poliovirus do not count on the complete elimination of paralytic poliomyelitis. Severe paralytic polio episodes caused by enterovirus 71 occurred in Bulgaria in 1975 and in Hungary in 1978, with many deaths. It is therefore surprising that oral vaccines eliminate paralytic poliomyelitis in economically developed temperate countries, where a substantial proportion of children, especially those in the lower economic classes, have not been immunized or immunologically incomplete. The authors conclude that there is insufficient evidence to demonstrate that the rare paralytic cases associated with oral vaccines are caused by polio vaccine strains. In the United States, virulent poliovirus continues to be imported (especially