2008年北京市怀柔区狂犬病免疫预防流行病学调查

Characteristics of persons who visited rabies immunization clinic post-exposure in Huairou,Beijing in 2008

目的了解2008年北京市怀柔区疾病预防控制中心狂犬病免疫预防门诊暴露后免疫预防接种者的流行病学特征,以便更好地给动物致伤者提供医疗服务。方法对狂犬病免疫预防门诊2008年免疫预防接种者的登记资料进行统计分析。结果3934例患者中暴露前免疫仅6人;患者男女之比为1.37∶1,工人、农民占59.14%;致伤高发于2、3季度,占63.21%;被犬致伤者占91.00%,有24.06%犬接种疫苗;致伤部位为下肢的占51.48%。受伤程度Ⅱ类伤口占78.16%;致伤后,16.14%的伤者超过24h就医处理,66.37%未清洗消毒伤口,5.78%的致伤者使用狂犬病免疫球蛋白或血清。结论加强狂犬病防治知识宣教,提高暴露前免疫预防接种率,达到真正免疫预防。政府部门应加强犬的管理及免疫工作,从源头防止狂犬病的发生。做好致伤患者伤口处理、狂犬疫苗接种和被动免疫制剂的应用,最大限度地阻断狂犬病毒入侵神经组织,减少狂犬病的发生。

Objective To understand post-exposure prophylaxis for rabies at immunization clinic of Huaireu District Disease Control and Prevention （CDC） in 2008 in order to provide better service for those by animal bites. Methods Data of rabies immunization registered at the clinic in- 2008 were analyzed. Results In 3 934 persons bit by animals and visited the clinic were registered, only six （all pet raisers ） with pre-exposure rabies immunization and 3 928 with post-exposure immunization, with a sex ratio of 1.37 and workers and farmers accounting for 59.14 percent of them. Among those injured, 63.2 percent of animal （91.00% by dog） bites occurred in the second and third quarters of the year, and only 24.06 percent of the dogs that bit them were immunized before, and 51.4 percent of them were injured at their lower extremities and 78.16 percent judged as wound of class II. 16. 14 percent of them visited clinic and treated there more than 24 hours after injury and wounds in 66. 37 percent of them were not washed, cleaned and disinfected. And, 5.78% of the injured persons also received rabies immune globulin or serum injection. Conclusions It is suggested that to strengthen publicity of knowledge of rabies prevention and control, and to improve pre-exposure immunization for those pet raisers achieving real immune. Governmental sectors should strengthen management and immunization for dogs to prevent rabies from its source. Adequate treatment for wounds by animal bites is very important, as well as application with active immunization and passive immunization of anti-rabies globulin or serum to block viral invading the nerve tissues and reduce incidence of human rabies.