湖南省1996-2010年狂犬病流行趋势和防治现状

Epidemic Trend and Control of Rabies in Hunan Province During the Period of 1996～2010

目的分析1996-2010年湖南省狂犬病的流行趋势及防治现状。方法利用疫情报告资料回顾分析狂犬病的流行趋势;采用直接免疫荧光法(DFA)和巢式PCR等方法对监测标本进行病原学检测及病毒基因特征分析;通过抽样调查了解农村居民对狂犬病防治知识的知晓情况和狂犬病暴露后的处置情况。结果湖南省狂犬病疫情自1996年以来持续上升,于2004年达到高峰,2007年起呈逐步下降的态势;2008-2010年共检测健康犬脑组织标本2 437份,其中DFA初筛阳性72份,阳性率为2.95%;72份标本经巢式PCR复核,23份阳性(0.94%);巢式PCR检测疑似狂犬病例唾液、脑脊液、血清及尿液标本104份,11份阳性(10.58%);病毒流行株为基因Ⅰ型;90%以上的农村居民听说过狂犬病,但对于狂犬病的高危行为和暴露后的预防措施的知晓率仅为20.1%和17.3%;89.09%的Ⅲ级暴露者未使用狂犬病被动免疫制剂。结论随着各项防治措施的落实,湖南省的狂犬病疫情已呈下降趋势,居民对狂犬病缺乏科学认识、经济条件有限是导致狂犬病暴露后处置不合规范要求的主要原因。

Objective To analyze the epidemic trend and current status of rabies control in Hunan Province from 1996 to 2010. Methods Rabies case reports were collected to retrospectively analyze the epidemic trend.Direct immunofluorescence assay（DFA） and nested PCR were employed to detect the monitoring samples,including brain tissues of dogs and saliva,cerebrospinal fluid,serum or urine which were collected from the rabies patients from 2008 to 2010.Genetic characteristics of rabies virus were also analyzed.We investigated the current situation of disposal after exposure to rabies among rural residents by sampling survey. Results The rabies case reports in Hunan Province were increasing continuously from 1996 until reaching to the peak in 2004,and decreasing since 2007.Of the 2,437 tissue samples from the dogs＇ brain,72 were positive under DFA and the positive rate was 2.95%.The DFA positive samples were redetected by RT-PCR and the positive rate was 0.94%（23/72）.104 samples of saliva,cerebrospinal fluid,serum and urine were detected by RT-PCR from the rabies patients,with 11 positives and the positive rate was 10.58%.All the isolated rabies viruses belonged to genotype I.More than 90% rural residents knew about rabies,but only 20.1% knew the high risk behaviors of rabies and 17.3% knew the prevention measures after exposure to rabies.89.09% of the patients with level III exposure did not use rabies passive immune agents. Conclusions The epidemic situation of rabies in Hunan Province has been decreasing with the implementation of a series of measures.Lack of correct understanding of rabies and the poor economic condition are the main reasons for nonstandard disposal after exposure to rabies.