Clinical characteristics of vaccine-associated paralytic poliomyelitis and risk factors in Xicheng district, Beijing, 2007-2011

Objective To understand the clinical characteristics of vaccine-associated paralytic poliomyelitis (VAPP) and related risk factors. Methods A questionnaire was designed for the survey of VAPP cases. Eleven cases of acute flaccid paralysis (AFP), from whom polio vaccine strains were isolated, were selected. The questionnaire survey was conducted among them. Results Nine VAPP cases were detected in the 11 AFP cases, in which 8 occurred after the first dose of oral poliovirus vaccine (OPV) immunization and 1 was caused by close contact with VAPP case. The male to female ratio of the cases was 8:1. Seven VAPP cases had other diseases, 4 had perianal abscess and all the 4 cases were related with OPV. Conclusion VAPP patients has typical acute flaccid paralysis, AFP monitoring system can detect VAPP cases. Some VAPP cases may have perianal abscess. To reduce and prevent VAPP, attention should be paid to perianal abscess. Interrogation and examination are necessary before giving OPV. OPV vaccination may be postponed for children with perianal abscess or inactivated poliovirus vaccine (IPV) can be given for them. Timely vaccination is necessary for the elimination of VAPP in contacts and immunization gap. In addition, it is still necessary to strengthen AFP surveillance management and standardize the diagnostic criteria of VAPP.