宜昌市30年狂犬病流行学特征和防制对策

Epidemiological features and control strategies of rabies in Yichang city of 30 years

目的分析宜昌市30年狂犬病的流行规律,为制定控制策略提供科学依据。方法对我市狂犬病病例进行流行病学个案调查,采用SPSS10.0软件进行统计分析。结果 30年间,全市共报告狂犬病例473例,死亡473例,病死率100.0%。以10年为一个监测周期,我市狂犬病平均发病率呈现下降趋势。40~70岁以上年龄组发病占67.94%,发病以农民和学生为主。肇事动物以犬为主,占96.15%;致伤动物均无疫苗免疫史。84.05%的暴露人群的致伤动物是犬;潜伏期时间为头面部〈上肢、躯干〈下肢（2χ=90.29,P〈0.01）。结论犬只管理不规范,群众防病意识差,暴露后未注射疫苗是狂犬病流行的因素;加强狂犬病疫情监测与预警、加强犬类＂管、免、灭＂、做好暴露人群伤口处理、注射狂犬病疫苗,加强已确诊狂犬病患者隔离治疗是防控狂犬病的重要措施。

Objective To analyze the rabies epidemic regularity in 30 years in Yichang city,and provide basis for making control strategies.Method Using epidemiology case study to investigate the rabies cases in our city and statistical analysis by SPSS 10.0 software.Results There were 473 rabies cases in the past 30 years,all were died and mortality rate was 100%.10 year as monitoring cycle,the average annual incidence rate declined.67.94% of the cases were at 40~70 years old group,most of the patients were farmers and students,main animal were dogs and accounted for 96.15%,the dogs without inoculation history.84.05% of the persons under exposure were bitten by dogs.Incubation period showed that head and face wounds were shorter than upper limbs and trunk,and the longest were lower limbs（χ2=90.29,P0.01）.Conclusions The main reasons of rabies epidemic were dogs management irregular,poor awareness of disease prevention,and without vaccination when exposure.So strengthened the monitoring and early warning of rabies,enhanced the management,immunization and extinguishment of dogs,treatment the exposure wound,injection prevention rabies vaccine,isolation confirmed patients were the important measures to prevention and control rabies.