I Chung, BHY Chung, SHS Chan

Abstract

Poliovirus spread has been described as a "Public Health Emergency of International Concern" despite effective immunisation programmes. With the rare but serious adverse effect of vaccine-associated paralytic poliomyelitis after oral polio vaccination, the target for global eradication has evolved to include both endemic and vaccine-related poliomyelitis. Until oral vaccines are completely withdrawn, the risks of vaccine-associated paralysis continue to exist, requiring a high index of suspicion and timely investigations to evaluate the etiology of acute flaccid paralysis. Here we present a four year old boy with acute paralysis one month after oral polio booster dose. This case illustrates how vaccine-associated paralytic poliomyelitis should be queried as a possible differential during the work-up for acute flaccid paralysis, especially after excluding all other causes and in the context of a positive immunisation history.

儘管有效的疫苗接種計畫行之已久，脊髓灰質炎病毒的傳播仍被認為是「國際關注的公共衛生緊急事件」，而服用口服脊髓灰質炎疫苗後可能引起疫苗相關麻痹型脊髓灰質炎，雖然發生的可能性小，但是後果可以很嚴重。在口服疫苗完全撤出前，疫苗相關性麻痹的風險都會持續存在，需要高度關注，應及時調查急性遲緩性麻痹的病因。這裡我們介紹一名4歲男孩在服用口服脊髓灰質炎加強疫苗1個月後出現急性麻痹的病例。這個病例說明在急性遲緩性麻痹中，尤其是排除其他原因和有確定的免疫史時，疫苗相關麻痹型脊髓灰質炎應予以識別。