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The author:(作者)delvpublished in(发表于) 2014/1/10 8:23:19 Hunan communicating the results of suspected vaccinations of infant death investigation
Newspaper in Changsha suspected cases of hepatitis b vaccination of abnormal reaction of concern survey results came out. On January 9, the CDC press briefing will be held in Hunan province. At the meeting, the Deputy Director of the provincial CDC, Gao Lidong, spokesman said, after a comprehensive diagnosis of the 3 cases, hengsh, Changning two cases belonging to the coupling, hanshou County has an abnormal reactions after vaccination cannot be excluded (discharged).
Gao Lidong said, January 2, 2014 and 8th, Hunan province health office points two times organization provincial prevention vaccination exception reaction expert group integrated clinical records information, and scene investigation information, and vaccine detection results and two cases death cases of autopsy results, respectively on 3 cases cases for has integrated diagnosis, which Hengshan County, and Changning two a cases belonging to coupled syndrome, hanshou County has a cannot excluded prevention vaccination exception reaction (has rehabilitation discharged). In accordance with the relevant provisions, is expected to receive no more than $ 40,000 worth of cover in hanshou County.
Gao Lidong introduced January 4, 2014, the State food and drug administration, the National Health Commission informed of the progress of the investigation on hepatitis b vaccine issues shows that involved hepatitis b vaccine quality and qualified in the near future. After on-site investigation, Hunan provincial Center for disease control and prevention, vaccination vaccine storage, transport specification, 3 cases of vaccination, vaccination personnel have appropriate qualifications, personnel against vaccination practices.
Hunan provincial Center for disease control, Li Junhua, Director says: "coincidence, it just goes to show that two deaths and hepatitis b vaccine does not matter, so we urge people to safely vaccinated, which is conducive to the protection of people's health, not choking. ”
Reporter Liu Shaolong correspondent Wang Hongyan
Expert analysis of 3 cases
On January 9, after the provincial CDC press briefings, 3 case diagnosis, xiaoxiang morning news reporter in Hunan provincial CDC immunization expert Professor Zhang Shujun, she is also one of the vaccine incident investigation experts. Professor Zhang Shujun said: "vaccination is difficult to death cases, mostly coupling. ”
Changning Zhou
Cover your chance syndrome
Diagnostic findings, Zhou cover their possibilities by syndrome, does not rule out infection; excluding vaccination adverse reaction.
According to the survey, Zhou to before you go to sleep for 10 hours after vaccination is no exception; sleep to death are unknown. The autopsy found no pathological evidence of allergic reactions.
Analysis on Professor Zhang Shujun, children are sleeping with MOM, before going to bed without exception, 10 hours after the children were found to have died. According to the inspection, hand nail cyanosis, laryngeal edema-free; vital organs congestion, edema, which were in line with her characteristics of the syndrome. Lymphocytes, mononuclear cell infiltration, which might indicate infection.
Provincial children's Hospital experts, cover is heat syndrome by syndrome, also known as baby cover, is more common in babies under 1 years of age, generally occurs in the cold season from November to next April each year. Newborn or baby's body surface area is relatively larger than the adult, and heat sink faster than adults, if held too long or warm too much around the child's body temperature rises dramatically, the small blood vessels in the skin to compensatory expansion, resulting in children a lot of sweat and even dehydration. How to prevent over heat syndrome? Provincial children's Hospital experts, dressed in moderation, as long as the baby's hands and feet and head warmer, no sweat, it means not cold. More children than adults clothing. Cover is low to moderate, to wear too much baby don't sleep at night, not sleeping blankets, don't build a bed with adults, but also to prevent the baby's heads in the quilt while sleeping.
Hengsh Liao
Family holds their child motorbike blew the wind
Diagnostic findings show Liu with acute bronchial pneumonia (severe), excluding abnormal reactions after vaccination.
According to the survey, Liu some before and after vaccination possible harm poor clinical manifestations of Geithner, spiritual malaise, cyanosis, consistent with infant pneumonia; an autopsy results for bronchial pneumonia complicated with pulmonary hemorrhage, in line with the changes in severe pneumonia. Airway has more grey-white cloudy liquid, and deaths in children with reflux aspiration speed cannot be ruled out.
Analysis on Professor Zhang Shujun, Liao's death, she was involved in the investigation, found them on December 4 when the hepatitis b vaccine, family members holding his motorcycle taxi blew a wind of about 8 km, rushed to the inoculation point. Colder weather that day, did not rule out cold. She saw the boy's body, found her lips purple, blue in the face, this is a typical feature of acute bronchial pneumonia. This acute pneumonia, children usually cry less, difficulty in breathing, lip purple, blue in the face, who is only 30 days, such an acute pneumonia, can easily become severe and great threat to the formation of a child's life.
Hanshou County
Vitamin K1 or hepatitis b vaccines trigger anaphylactic shock
Diagnosis shows that have a possibility of anaphylactic shock, but allergens are Vitamin K1 is HepB vaccine not sure, asphyxia cannot be ruled out.
According to the survey, had a hepatitis b vaccine and injection of Vitamin K1 anaphylactic shock occurs after about 2 hours. However, Vitamin K1, hepatitis b vaccines have the potential to cause anaphylactic shock; in hanshou County in Prince Township in children with Transthoracic external heart pressing emergency measures such as rescue after about 1 minute spray 15-20 ml milk clots.
Analysis on Professor Zhang Shujun, anaphylactic shock is more typical abnormal reactions such as vaccination. Vitamin K1 and hepatitis b vaccines have the potential to cause anaphylactic shock. Vitamin K1 is mainly used for treatment of vitamin k deficiency bleeding disorders caused by, play a role in blood coagulation. Are mainly used for prevention of neonatal intracranial hemorrhage, neonatal commonly used drugs. Vitamin K1 anaphylactic severe than hepatitis b vaccine caused allergic.
Finishing/reporter Liu Shaolong
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Recent hepatitis b vaccination reduces 30%
Speaking of coupling, Hunan provincial CDC immunization expert Li Fang introduced coupling refers to the species are in some sort of incubation period of the disease, or had an underlying diseases have been found, coincidence after vaccination disease (recurrence or exacerbation), coincidence and unrelated to the vaccine itself. Higher vaccination rates, more coupling more.
Recently hepatitis b vaccination, and let common people had a wait-and-see mood on hepatitis b vaccination. In this regard, Professor Li Junhua said, according to national statistics, the decline in hepatitis b vaccination 30%. This statistical data, Hunan also provided data.
"In fact, immunization program is vital to people's health. "Professor Li Junhua said. He explained that the vaccination work is the effectiveness of health care one of the most visible and the most extensive work, and States the main means of prevention and control of infectious diseases. Through immunization, global success of the eradication of smallpox and poliomyelitis (polio) decline in the incidence of 99%, most of the countries and regions, including China, transmission of wild polio virus, diphtheria, pertussis, tetanus and measles cause significant decrease in morbidity, disability and mortality.
After the implementation of hepatitis b vaccination, the national rate of hepatitis b virus surface antigen carried the crowd from 7.18% per cent in 1992 to 2006 years and people under 5 years of age has been reduced to 1%, from reduced vaccination for hepatitis b-infected more than 30 million people. Japanese encephalitis, epidemic cerebrospinal meningitis incidence dropped to historical lows.
(Original title: hanshou case does not rule out abnormal reactions after vaccination)
本报长沙讯 备受关注的疑似乙肝疫苗接种异常反应病例的调查结果出来了。1月9日，湖南省疾控中心召开新闻通报会。会上，省疾控中心副主任、新闻发言人高立冬说，在对3例病例进行综合诊断后，衡山县、常宁市两个病例属于偶合症，汉寿县曾某不能排除预防接种异常反应（已康复出院）。
高立冬说，2014年1月2日和8日，湖南省卫生厅分两次组织省级预防接种异常反应专家组综合临床病历资料、现场调查资料、疫苗检测结果和两例死亡病例的尸检结果，分别对3例病例进行了综合诊断，其中衡山县、常宁市两个病例属于偶合症，汉寿县曾某不能排除预防接种异常反应（已康复出院）。按照相关规定，汉寿县患者有望获得不高于4万元的补偿。
高立冬介绍，2014年1月4日，国家食品药品监管总局、国家卫生计生委关于乙肝疫苗问题调查进展情况的通报表明，近期涉事乙肝疫苗检测质量合格。经过现场调查，湖南省各级疾病预防控制中心、预防接种单位疫苗储藏、运输符合规范要求，3例病例疫苗接种的单位、接种人员具有相应资质，接种人员接种操作规范。
湖南省疾控中心主任李俊华教授说：“偶合症，这就说明那两例死亡病例和接种乙肝疫苗没有关系，所以请市民放心地接种疫苗，这有利于保护大家健康，不能因噎废食。”
记者刘少龙 通讯员王红艳
专家解析3个病例
1月9日，在省疾控中心的新闻通报会后，就3个病例调查诊断的情况，潇湘晨报记者采访了湖南省疾控中心免疫规划专家张淑君教授，她也是本次疫苗事件调查专家之一。张淑君教授说：“接种疫苗很难出现死亡病例，大多为偶合。”
常宁市周某
捂被综合征可能性大
诊断结论显示，周某捂被综合征可能性大，不排除病毒感染；排除预防接种异常反应。
根据调查，周某接种疫苗后至入睡前的10个小时里无异常；入睡后至死亡情况不明。尸检未发现过敏反应的病理形态学证据。
张淑君教授分析，孩子是跟妈妈一起睡的，在睡前没有异常，10个小时后，发现孩子已死亡。根据检查，双手指甲青紫，无喉头水肿；重要器官瘀血、水肿，这些都符合捂被综合征的特点。有淋巴细胞、单核细胞浸润，这说明可能病毒感染。
省儿童医院专家介绍，捂被综合征又称婴儿捂热综合征，多见于1周岁以下的婴儿，一般发生在每年11月至次年4月的寒冷季节。新生儿或小婴儿的体表面积相对比成人大，因此，散热也比成人快，如果捂得过久或保暖过度，孩子身体周围的温度会急剧上升，使人体皮肤上的小血管出现代偿性扩张，导致孩子大量出汗甚至脱水。如何预防捂热综合征呢？省儿童医院专家介绍，穿衣要适中，只要宝宝手脚和头部温温的，没有汗，就说明不冷。孩子比成人多一件衣服就可。盖被要适中，夜晚睡觉时不要给宝宝穿得太多，不宜睡电热毯，不要与大人盖一床被，还要防止宝宝熟睡时头蒙在被子里。
衡山县廖某
家人抱着孩子坐摩托车吹了风
诊断结论显示，廖某患急性支气管肺炎（重症）；排除预防接种异常反应。
根据调查，廖某接种疫苗前后有可能受凉；临床表现为纳差，精神萎靡、发绀，符合婴儿肺炎表现；尸检结果为支气管肺炎合并肺出血，符合重症肺炎改变。气道内有较多灰白色混浊液，不能排除返流误吸加速患儿死亡。
张淑君教授分析，廖某死后，她参与了调查，发现12月4日孩子接种乙肝疫苗时，家人抱着他坐摩托车吹了8公里左右的风，赶到接种点。那天天气比较冷，不排除受凉了。她看到孩子的尸体，发现嘴唇呈现紫色，脸部发青，这是典型的急性支气管肺炎的特征。这种急性肺炎，孩子通常哭闹的少，但呼吸困难，嘴唇呈现紫色，脸部发青，孩子很小只有30天，这样一种急性肺炎，很容易变成重症，对孩子生命形成巨大威胁。
汉寿县曾某
维生素K1或乙肝疫苗引发过敏性休克
诊断结论显示，曾某系过敏性休克可能性大，但过敏原是维生素K1还是乙肝疫苗不能确定，不能排除窒息。
根据调查，曾某接种乙肝疫苗并同时注射维生素K1约2小时后出现过敏性休克。但维生素K1、乙肝疫苗均有引起过敏性休克的可能；患儿在汉寿县太子庙镇卫生院经胸外心脏按压等急救措施抢救约1分钟后喷出15—20毫升母乳凝块。
张淑君教授分析，过敏性休克是接种疫苗等比较典型的异常反应。维生素K1和乙肝疫苗均有引起过敏性休克的可能。维生素K1主要用于各种维生素K缺乏引起的出血性疾病的治疗，起到凝血作用。目前主要用于预防新生儿颅内出血，是新生儿的常用药品。但维生素K1引起过敏性比接种乙肝疫苗引起的过敏性要严重。
整理/记者刘少龙
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近期乙肝疫苗接种减少三成
谈到偶合症，湖南省疾控中心免疫规划专家李放军介绍，偶合症是指受种者正处于某种疾病的潜伏期，或者存在尚未发现的基础疾病，接种后巧合发病（复发或加重），因此偶合症的发生与疫苗本身无关。疫苗接种率越高、品种越多，偶合症的发生越多。
近段时间乙肝疫苗接种的事情，让老百姓对乙肝疫苗接种产生了观望情绪。对此，李俊华教授说，根据全国的统计，乙肝疫苗接种下降了30%。当然这份统计数据里，也有湖南提供的数据。
“其实，免疫规划工作对老百姓的健康至关重要。”李俊华教授说。他介绍，预防接种工作是卫生事业成效最为显著、影响最为广泛的工作之一，也是各国预防控制传染病最主要的手段。通过预防接种，全球成功消灭了天花，脊髓灰质炎（脊灰）的发病率下降了99%，包括中国在内的大多数国家和地区实现了无脊髓灰质炎野病毒传播，因白喉、百日咳、破伤风和麻疹导致发病、致残与死亡显著下降。
实施乙肝疫苗接种后，全国人群乙肝病毒表面抗原携带率从1992年的9.75%降至2006年的7.18%，5岁以下人群已降到1%以下，因接种疫苗减少乙肝病毒感染者3000多万人。乙脑、流脑等发病人数降至历史最低水平。
（原标题：汉寿病例不排除预防接种异常反应）
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