153例狂犬病流行病学分析

Analysis on the epidemic character of 153 rabies cases

目的分析湖北省狂犬病的流行规律,为制定控制策略提供依据。方法对湖北省2006年153例狂犬病进行流行病学个案调查和分析。结果50岁以上年龄组发病占53.59%,20～29岁年龄组发病最低(1.31%),发病以农民和学生为主。潜伏期最短5d,最长11年,潜伏期中位数57.5d,四分位数间距28～101.5d。84.67%病例潜伏期<6个月,28.00%在15～29d,<15d短潜伏期占12.00%。犬为绝对优势暴露动物。153例病例暴露后只有26.80%到医疗机构处理,1.31%接种抗狂犬病免疫球蛋白,20.92%接种过狂犬疫苗,3.27%全程免疫。结论犬数量大,免疫水平低,管理差,和人在暴露后未得到正确处理是狂犬病高发和流行的因素,短潜伏期狂犬病也是需要关注的问题。加强犬类的"管、免、灭",做好暴露后人群的伤口处理、抗狂犬病免疫球蛋白和狂犬疫苗接种工作是防控狂犬病的重要措施,建议高发省份将狂犬疫苗暴露后免疫纳入免疫规划。

Objective To analyze the epidemic character of rabies in Hubei province in 2006, and to improve the control strategy of rabies. Methods Case investigation and retrospective survey were used. Results 153 rabies cases were investigated, 53.59% of the cases were ≥50 years old, 20 to 29 were the lowest age group（ 1.31% ）, most of the cases were farmers and students. The incubation period was 5 days to 11 years, the median incubation period was 57.5d and the semi-quartile range was 28d to 101.5d. The incubation period of 84.67% cases was less than 6 months, 28.00% was between 15d and 29d, 12.00% was less than 15d. dog was the main animal host of rabies. Only 26.80% of the cases received medical treatment after exposure, 1.31% received human rabies immunoglobnlin, 20.92% were immunized with rabies vaccine and only 3.27% got the full schedule of vaccination. Conclusion The main reason of rabies death was the large number of dog with low rabies vaccination coverage, and part of the people received improper treatment after exposure. The management of dog and the promotion of the post-exposure preventive measure should be greatly strengthened.