桂林市2007～2010年人狂犬病流行特征及监测分析

Prevalent characteristics of rabies in Guilin City in 2007～2010

目的总结分析桂林市疾病预防控制中心预防医学门诊近4年狂犬病暴露特征和发病情况,进一步探讨狂犬病防治对策。方法收集整理统计分析桂林市2007～2010年被动物致伤后进行狂犬病预防的人群资料和人狂犬病发病资料。结果 4年桂林市报告狂犬病例174例,均为暴露后未进行伤口处理和接种疫苗而发病。农民占83.33%,犬伤所致发病占91.95%,病例暴露后伤口未处置率为61.49%,自行处置率为34.48%,疫苗注射率为7.47%,全程注射率为1.15%,被动免疫制剂注射率为1.72%。4年来狂犬病暴露处置门诊就诊者中,免疫接种率为100%,就诊前自行伤口处理率低;犬类伤人占狂犬病暴露的86.85%,家犬伤人达74.60%,又以无反常表现外观健康动物伤人为主。Ⅲ级暴露者中被动免疫制剂注射率为58.59%。4年规范处置的36 630例人狂犬病暴露患者无一例发病。结论桂林市狂犬病疫情在下降,病例多发于农村地区,犬仍是主要的狂犬病宿主动物。犬的管理和暴露后预防处置不当,疫苗接种不规范和不及时是狂犬病发病的主要影响因素。加强家犬等动物饲养管理,加大狂犬病防治知识普及力度,及时、规范、彻底处置暴露伤口、全程接种狂犬疫苗、积极选用狂犬免疫球蛋白是预防狂犬病的有效措施。

Objective To analyze the prevalence of rabies in Guilin City from 2007 to 2010.Methods The data of vaccinated patients after being bitten by animals from 2007 to 2010 in Guilin City were collected and analyzed.Results A total of 174 rabies cases were reported in the last 4 years.The majority of cases were farmers（83.33%）.Up to 91.95% of cases were bitten by dog and 61.49% without treatment,34.48% treated by themselves.The vaccination rate after exposure was 7.47%,the full series vaccination rate was 1.15%,the injection rate of rabies immunoglobulin（RIG）was 1.72% and the vaccination rate after exposures in rabies clinics was 100%.Up to 86.85% of the people visiting rabies clinics was due to dog bites.The self wound treatment rate before seeking medical care was low in all surveillance areas and RIG injection rate was 58.59% for gade Ⅲ exposure.No rabies occurred to the 36 630 cases bitten and properly treated in the last 4 years.Conclusions The incidence of human rabies continued to decline in Guilin in recent years.Most rabies cases were reported in rural area.Dogs were still the major animal responsible for the disease.Thus Effective measures be taken to control the prevalence of rabies by proper treatment of the Wounds and timely immunization with rabies vaccine and son.