来宾市2008～2013年狂犬病流行特征分析

Analysis of epidemiological characteristics of rabies in Laibin city from 2008 to 2013

目的了解来宾市2008~2013年狂犬病流行特征及其流行因素,为狂犬病防控提供依据。方法收集来宾市2008~2013年狂犬病疫情和监测资料进行流行病学描述和统计学分析。采集市场上销售狗脑组织,用DFA和RT-PCR方法检测狂犬病病毒感染情况。结果来宾市2008~2013年共报告狂犬病例139例,年平均发病率为1.05/10万。病例分布主要在兴宾区和武宣县,占总例数的79.86%。一年四季均有发病,7~12月份占58.99%。50~74岁人群发病最多占47.48%,其次为15岁以下儿童占17.98%。男女性别比为3.21：1。农民占总发病数的66.91%。被家犬咬（抓）伤占77.70%、被猫咬（抓）伤占14.38%。狂犬病例中有73.38%的患者暴露后未进行伤口处理,85.61%患者未进行疫苗接种,97.03%患者未注射抗狂犬病毒血清或免疫球蛋白。2008年犬只密度最高为13.31只/100人,最低2013年为10.01只/100人;犬只免疫率最高2013年为43.45%,最低2008年为34.35%。犬狂犬病毒核酸阳性率为1.43%。结论来宾市2008~2013年狂犬病发病率虽然呈逐年下降趋势,但疫情形势依然严峻。犬只密度高、免疫率低和带毒率高、暴露后预防处置率低和未按要求进行预防处置、犬只管理不到位和相关部门缺乏沟通协作等是狂犬病发生和扩散的主要原因。应进一步加强对狂犬病监测。

Objective To analyze the epidemiological characteristics of rabies, and provide the basis for better controland prevention of rabies in Laibin city. Methods The epidemic data of rabies in Laibin from 2008 to 2013 were collected.Rabies virus was identified with both direct fluorescent antibody assay（DFA）and RT-PCR. All data were descriptively andstatistically analysed. Results A total of 139 rabies cases were reported.The average annual incidence rate of rabies was1.05/100 000 and 79.86% of the rabies cases were distributed in Wuxuan County and Xingbin District. The percentage ofrabies cases fromn July to December accounted for 58.99% of the total cases and the case were reported all the year round.Most cases（47.48%） were in the age group of 50-74 years and followed by the age group of 15 years（.17.98%）. The male tofemale ratio was 3.21：1. Farmer cases accounted for 66.91% of all cases, 77.70% of the cases were bitten or scratched by dogsand 14.38% were hurt by cats. While the wounds of 73.38% of the cases were untreated, 85.61% were not immunized withvaccine, and 97.03% were not injected with hyper- immune anti- rabies serum or anti- rabies immunoglobulin. Thepopulation density of dogs in 2008 was 13.31/100 persons and it was 10.01/ 100 persons in 2013. The highest dogvaccination rate was 43.45% in 2013 and the lowest was 34.35% in 2008. The positive rate of rabies virus nucleic acid was1.43%.Conclusion The incidence rate of rabies showed a decreasing trend year by year in Laibin city. Butpopulation density and low vaccination rate of dogs and high positive rate of rabies virus nucleic acid, the low treatment rate ofbitten wounds and the low immunization rate of the cases after hurt by dogs or cats were the main challenges. Thus themonitoring of rabies, the management of dogs and coordination between various departments for rabies control and preventionbe strengthened