1950-2010年浙江省金华市狂犬病流行特征分析

Epidemiological characteristics of rabies in Jinhua,Zhejiang from 1950 to 2010

目的通过对浙江省金华市1950-2010年狂犬病流行特征的分析,探讨疫情回升的因素,提出针对性防治措施。方法收集1950-2010年疫情资料和2005年以后病例个案调查资料,用Excel软件对资料进行统计,用描述流行病学方法进行分析。结果 1950-2010年共报告狂犬病174例,20世纪70年代报告30例,80年代报告107例,是当时浙江省狂犬病的主要流行地区之一,1992-2004年连续13年无病例,2005-2010年共计报告32例;金华市狂犬病夏秋季高发,64.94%病例集中在7-11月。2005年以来的病例以农民为主,绝大多数患者在暴露后未及时对伤口进行处理和接种狂犬病疫苗。结论犬数量的快速增加和管理不到位,群众防病意识缺乏,暴露后未能及时规范处理伤口和免疫接种,狂犬病疫苗和狂犬病免疫球蛋白价格过高使低收入群体难以承担等是影响狂犬病疫情回升的因素;提高政府的重视程度,督促管理部门切实落实"管、免、灭"的措施;加强宣传教育;将狂犬病疫苗和狂犬病免疫球蛋白纳入农村医保,降低经济负担等是今后防制工作的重点。

Objective To identify the factors driving rebound epidemic of rabies and formulate specific control measures based on analysis of the epidemiological characteristics of this disease in Jinhua,Zhejiang from 1950 to 2010. Methods Descriptive epidemiological analysis was performed using epidemic data from 1950 to 2010 and case investigations after 2005. Results A total of 174 rabies cases were reported from 1950 to 2010,including 30 in the 1970s and 107 in the 80s,suggesting prevalence in Zhejiang province in that period. After a 13-year period of zero case report from 1992 through 2004,32 cases were reported from 2005 to 2010. In Jinhua,high incidence rates of rabies were observed in summer and autumn,with 64.94% of cases occuring from July to November. Since 2005,most cases were farmers without proper post-exposure treatment and immunization. Conclusion Increased numbers of dogs,poor public awareness of prevention,lack of prompt,proper post-exposure treatment and immunization,and oppresive costs of vaccines and immune globulins have contributed to the rebound of rabies epidemics. Therefore,governmental support for management and immunization strategies,promotion of public education and inclusion of vaccines in rural medical care coverage is crucial for future prevention and control.