目的了解四川省分离检出脊髄灰质炎(脊灰)疫苗病毒(PV)阳性的急性弛缓性麻痹(AFP)病例流行病学特征,为消灭脊灰后期我国适时调整免疫策略提供依据。方法利用四川省AFP病例监测系统有关资料,对2006-2012年检出脊灰疫苗病毒48例AFP病例,采用描述流行病学方法进行分析。结果 2006~2012年四川省报告2492例AFP病例,其中48例标本中检出PV,经鉴定均为脊灰疫苗相关病毒。48例PV阳性的AFP病例分布于15个市(州)的36个县(区),发病时间无明显的聚集趋势。<3岁儿童72.92%(35/48);未免疫和未全程免疫(包括免疫史不详)60.42%(29/48)。48例PV型别差异明显,以脊灰Ⅱ型占优势(24例,占50.00%),残留麻痹病例中,以Ⅱ型居多,占51.85%(14/27)。疫苗相关麻痹型脊灰病例(VAPP)发生率平均为0.14/100万;服苗者与接触者VAPP发生率分别为0.08/100万和0.06/100万;首次服苗VAPP发生率为0.45/100万。2012年1月在阿坝县发生1例脊灰疫苗衍生病毒(VDPV)病例。结论四川省VAPP发生率很低,提示接种口服脊灰减毒活疫苗(OPV)安全有效。鉴于OPV的生物学特性,有极罕见出现VAPP的可能,在维持无脊灰时代,应尽快研究灭活脊灰疫苗(IPV)的免疫策略。 Objective To understand the epidemiological characteristics of acute flaccid paralysis (AFP) cases in Sichuan Province with positive detection of poliomyelitis (polio) virus (PV), and to provide a basis for the timely adjustment of immunization strategies in China. Methods AFP case surveillance system in Sichuan Province, the relevant information on the detection of 48 cases of AFP cases of poliovirus vaccine from 2006 to 2012, the use of descriptive epidemiological methods for analysis. Results A total of 2492 cases of AFP were reported in Sichuan Province from 2006 to 2012. Of the 48 cases, PV was detected in 48 cases and all were identified as poliovirus. 48 cases of PV-positive AFP cases were distributed in 36 counties (districts) of 15 cities (states), with no obvious trend of aggregation at the time of onset. 72.92% (35/48) of children <3 years of age; 60.42% (29/48) of unimmunized and incomplete immunizations (including unknown history of immunization). 48 cases of PV type difference was obvious, with polio type Ⅱ dominant (24 cases, accounting for 50.00%), residual paralysis cases, the majority of type Ⅱ, accounting for 51.85% (14/27). The average incidence of vaccine-associated paralytic poliovirus (VAPP) was 0.14 / 1 million; VAPP incidence rates were 0.08 / 1 million and 0.06 / 1 million respectively for those who took the vaccine and those who were contacted; the incidence rate of VAPP for the first service was 0.45 / 100 Million In January 2012, one case of polio vaccine-derived virus (VDPV) occurred in Aba County. Conclusion The incidence of VAPP in Sichuan Province is very low, suggesting that oral administration of live attenuated oral poliomyelitis vaccine (OPV) is safe and effective. In view of the biological characteristics of OPV, there is a very rare possibility of VAPP. In the era of maintaining a non-polio, the immunization strategy of inactivated polio vaccine (IPV) should be studied as soon as possible.