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目的评估北京市丰台区急性弛缓性麻痹(Acute Flaccid Paralysis,AFP)病例监测系统的质量,分析环境污水中脊髓灰质炎(脊灰)病毒(Poliovirus,PV)的生物学特征。方法选择吴家村污水处理厂作为监测点,2011年5月～2012年9月,每月采集监测点污水进行肠道病毒(Enterovirus,EV)分离和鉴定,并对分离到的PV进行VP1编码区核苷酸序列测定和分析。结果北京市丰台区AFP病例监测系统保持很高的敏感性,2011、2012年<15岁儿童AFP病例报告发病率均为1.62/10万。从环境污水中共分离到107株EV和12株腺病毒,包括28株疫苗株PV,其中I型5株,II型7株,III型16株。序列分析结果表明,与赛宾(Sabin)疫苗株相比,环境监测分离到的疫苗株PV VP1编码区核苷酸变异0～5个。结论AFP病例监测和环境监测均未发现脊灰野病毒或疫苗衍生脊灰病毒。环境监测为北京市丰台区AFP病例监测系统提供了重要的补充信息,显示北京市丰台区口服脊灰减毒活疫苗接种质量较高,疫苗病毒并未在人群中形成较长时间的循环。同时分离到的非脊灰肠道病毒,为北京市丰台区外环境中的EV研究提供了重要的背景信息。
Objective To assess the quality of acute flaccid paralysis (AFP) surveillance system in Fengtai District of Beijing and analyze the biological characteristics of poliovirus (PV) in environmental sewage. Methods Wujiacun WWTP was selected as the monitoring point. From May 2011 to September 2012, contaminated water was collected from the monitoring sites every month for the isolation and identification of Enterovirus (EV). The VP1 coding region Nucleotide sequence determination and analysis. Results The AFP case surveillance system in Fengtai District of Beijing maintained a high sensitivity. The incidence of AFP cases in children aged <15 years and 2011 and 2012 was 1.62 / 100,000. A total of 107 strains of EV and 12 strains of adenovirus were isolated from environmental sewage, including 28 vaccine strains, including 5 strains of type I, 7 of type II and 16 of type III. Sequence analysis showed that compared with the Sabin vaccine strain, the number of nucleotides in the PV VP1 coding region of vaccine strains isolated from environmental monitoring varied from 0 to 5. Conclusion No poliovirus or vaccine-derived poliovirus were detected in both AFP case surveillance and environmental monitoring. Environmental monitoring provided important supplementary information for the AFP case surveillance system in Fengtai District of Beijing City. It showed that the vaccinated live attenuated oral poliomyelitis vaccine in Fengtai District of Beijing had a high quality of vaccination, and the vaccine virus did not form a long cycle in the population. The isolated non-polio enterovirus simultaneously provided important background information for EV research in the environment outside Fengtai District of Beijing.