2009年浙江省金华市狂犬病暴露人群监测结果分析

Surveillance of people exposed to rabies in Jinhua,2009

目的通过对2009年浙江省金华市狂犬病门诊暴露人群监测结果进行分析,为狂犬病暴露后的正确处置及控制狂犬病的流行提供参考。方法通过在全市犬伤门诊建立的狂犬病暴露人群监测系统,收集首次就诊人群的暴露和处置信息,采用描述性流行病学方法对收集的资料进行分析。结果 2009年金华市共计报告狂犬病暴露病例54 942例,暴露率为1080.37/10万。病例的时间分布呈现"春末上升,夏季高峰,秋季回落"的特点,病例以青壮年为主,20～59岁病例占总数的59.57%,病例职业以农民为最多,占总数的57.56%。伤人动物最多的为犬,占91.17%;其次为猫,占4.87%。暴露程度Ⅰ级17.96%、Ⅱ级71.24%、Ⅲ级10.81%,受伤部位以小腿为最多,占总数的40.89%。就诊人群狂犬疫苗全程接种率为99.85%,Ⅲ级暴露被动免疫制剂接种率为26.56%。结论近年来金华市的狂犬病疫情呈上升趋势。加强行政领导,规范犬只管理,切实落实"管、免、灭"的措施;加强宣传教育;将疫苗和被动免疫制剂纳入农村医保,降低经济负担等是今后防制工作的重点。

Objective To analyze the results of the surveillance of people exposed to rabies in Jinhua,2009,providing the basis for appropriate treatment of post-exposure patients and control of rabies epidemic.Methods Surveillance systems for people exposed to rabies were set up at all out-patient clinics in the city to collect the information on exposure and treatment of first visitors.Descriptive epidemiological analysis of the data was conducted.Results A total of 54 942 cases exposed to rabies were reported in Jinhua,2009,with an exposure rate of 1080.37/lakh.The incidence increased in late spring,peaked in summer and dropped in autumn.The victims were mostly youngsters and adults;59.57% were at the age from 20 to 59.Most cases were farmers,accounting for 57.56%.The predominant attacking animal was dogs,accounting for 91.17%,followed by cats that accounted for 4.87%.Grade Ⅰ exposure accounted for 17.96%,grade Ⅱ exposure 71.24%,and grade Ⅲ exposure 10.81%.The most frequently injured site was the calf,accounting for 40.89%.The whole-course inoculation rate among the clinic patients was 99.85%,and 26.56% of those with grade Ⅲ exposure received passive immunization.Conclusion In view of the increasing prevalence of rabies in Jinhua,it is essential to strengthen administrative measures and standardize canine management to effectively manage and immunize healthy dogs and eliminate affected dogs.Moreover,the future work should be focused on the enhancement of public education and inclusion of vaccines and passive immunization agents to rural health insurance to reduce patients＇ economic burden.