1955-2009年陕西省狂犬病流行特征分析

Epidemiology of human rabies in Shaanxi province,1995-2009

目的分析陕西省人间狂犬病发病情况和流行特征,探讨发病趋势和疫情回升的因素。方法收集1955-2009年陕西省狂犬病疫情监测资料并进行统计分析。结果陕西省1955-2009年共报告狂犬病474例,分别于1956、1989-1990、2009年出现3次发病高峰。20世纪50-90年代分别报告155、4、8、102和164例;2000年后全省疫情均处于较低水平,但2009年骤然上升,发病26例。1956年为历史发病最高年（108例）。陕西南部的安康、汉中和商洛狂犬病病例数占全省总例数的75.71%,其次是陕西北部的榆林、延安,陕西中部发病较少。发病年龄4555岁占64.52%,男女性别比为1.38∶1。病例农民占80.65%。全年每月均有病例报告,但6-8月病例数占41.13%。结论陕西省狂犬病发病居中国西北地区之最,汉中、安康是狂犬病高发区,青壮年农民是主要发病人群。生活环境,养犬数增加而管理滞后,狂犬病预防知识缺乏,暴露后预防处置不规范等是导致狂犬病疫情上升的主要原因。

Objective To analyze the epidemiological characteristics of human rabies,understand the disease trend and related factors in Shaanxi.Methods The incidence data of human rabies in Shaanxi from 1955 to 2009 were collected to conduct statistical analysis.Results A total of 474 cases of human rabies were reported from 1955 to 2009.Three incidence peaks were observed in 1956,1989-1990 and 2009,and 155,4,8,102 and 164 cases were reported in 1950s,1960s,1970s,1980s and 1990s,respectively.The annual case number was low in nearly whole 2000s,but greatly increased in 2009（26）.The case number reported in 1956 was highest（108）.Ankang,Hanzhong and Shangluo in southern Shaanxi were the mostly affected areas with the reported cases accounting for 75.71% of the total,followed by Yulin,Yan’an in northern Shaanxi and the central part of Shaanxi.The cases mainly occurred in people aged 45-55 years,accounting for 64.52% of the total.The male to female ratio of the cases was 1.38∶1.Most cases were farmers（80.65%）.The cases were reported all the year around,but the cases reported during June-August accounted for 41.13%.Conclusion The incidence of rabies in Shaanxi province was highest in northwestern China.Hanzhong and Ankang were the area with high incidence of human rabies,and young farmers were the mostly affected population.The living environment,poor management of dog raising,poor awareness of rabies prevention and control and inadequate post exposure treatment might explain the rising of the incidence of human rabies.