中国2005年狂犬病流行相关因素分析

Analysis on the factors related to rabies epidemic in China,in 2005

目的分析中国2005年狂犬病流行相关因素。方法收集2005年全国狂犬病疫情及监测资料,通过对流行特点以及与流行有关的各个环节进行整理,Excel 2002软件进行统计分析其与流行的关系。结果2005年全国共报告狂犬病例2548例。其中5个省调查885例病例中未进行伤口处理、疫苗接种与抗血清注射的比例分别为60．56%、49．04%、96．16%。暴露治疗人群中89．95%进行了伤口处理,94．93%接种了疫苗,8．56%接受了抗血清注射；在接受疫苗接种者中,94．86%的门诊暴露者完成了全程接种,仍有5．14%未完成全程接种。病例致伤动物88．50%是犬,暴露治疗人群致伤动物92%是犬；犬密度最低为3．20只/100人,最高为13．37只/100人；犬免疫率最低为5．31%,最高为75．11%；两个高发病省犬感染病毒率最低为2．93%,最高为6．40%。结论病例暴露后预防治疗率低以及没有按照要求完成全程治疗,门诊狂犬病暴露后预防治疗不规范,主要宿主动物犬的免疫率低和感染病毒率较高可能是造成2005年狂犬病流行的主要原因。

Objective To analyse the related epidemic factors of rabies and to provide basic evidence for developing rabies control and prevention programs in China. Methods Possible factors that causing rabies epidemics in the southern part of China were obtained through collecting both epidemic and surveillance data of rabies in 2005, and to analyse every factor by software of Excel 2002, Results The number of rabies cases was 2548 in 2005. Among 885 cases being investigated, 60.56 % ,49.04 %, 96.16 % had not had any chance to receive treatment, vaccine or immunoglobulin. Among the exposed persons, 89.95% received treatment on wounds and 94.93% were immunized, and 8.56% received immunoglobulin. 94.86 % of them accomplished the full rabies post-exposure prophylaxis course, but 8.56 % of them did not accomplish it. 88.50 % of the cases and 92 % of the persons under exposure were bitten by dogs. The density of dogs was 3.20-13.37 per 100 persons. The vaccination coverage rates among dogs were 5.31% -75.11% with a positive rate of 2.93 % -6.40 %. Conclusion Factors as： low rate of post-exposure prophylaxis and failed to have finished the necessary post-exposure treatment （PET） of the cases, nonstandard PET in hospital or local clinic, low rabies vaccination coverage and high infectivity of rabies virus in animal host （mainly for dog） might be responsible for rabies epidemics in China,in 2005.