Prevalence And Clinical Features Of Vaccine-associated Poliovirus Infection In Hospitalized Children With Respiratory Tract Infection In Chongqing

Objective: To discuss the prevalence，clinical characteristics andeffective measure for reducing the incidence of VAPP and VDPV ofvaccine-associated poliovirus infection in hospitalized children withrespiratory tract infection in Chongqing.Methods: From June2009to March2012,1800nasopharyngealaspirates were collected in children with respiratory tract infection atdepartment of respiratory medicine in children’s hospital, ChongqingMedical University.The sample which were showed obvious cytopathiceffect when specimens for virus isolation was detected by PCR.Thesequence of poliovirus positive samples were blasted in GeneBank.Theclinical characteristics of poliovirus infection was summarized.Results:（1）The detection rate and type of poliovirus:4specimenswere positive in poliovirus.2cases were typeⅠ,other2were type Ⅱ. （2）Epidemic characteristics:in the4poliovirus positive cases,therewere2males and2females.The age ranged from2to7months.They wereall from poor village of the southwest China.（3）Clinical characteristics:in the early stage of infection,2cases hadfever and diarrhea.All cases had cough and sputum.Pulmonary signs weremostly in moist rales.WBC and C-reactive protein was not heightened.Butthe Myocardial enzyme spectrum showed abnormal. Electromyography of1case showed the anterior horn of the spinal cord was damaged.（4）Treatment and prognosis: We gave the4cases symptomatictreatment,like oxygen inhalations,sputum suction and so on.2cases hadacute flaccid paralysis(AFP),and die at last.Other2do not have AFP,andwere still living with good healthConclusion（:1）The2AFP cases whose clinical manifestation fulfilledthe diagnostic criteria of the VAPP according to 《Diagnostic basis andtreatment reference of VAPP》 were diagnosed with the VAPP.（2）At the early stage of VAPP,they often showed respiratory anddigestive symptoms. Myocardial enzyme spectrum showed abnormalgenerally after poliovirus. infection.There was no specific treatment forVAPP. The prognosis was bad generally.（3）The clinician should pay more attention to children who use OPVat the first time.And we can changing our routine childhood immunization:using IPV either alone or together with OPV,to reduce the rate of VAPP.