2008～2014年北京市顺义区狂犬病暴露人群流行病学特征分析

Epidemiological characters of population exposed to rabies in Shunyi District, Beijing during 2008～2014

目的分析2008-2014年北京市顺义区狂犬病暴露人群流行病学特征,为狂犬病暴露后的正确处置及控制狂犬病的流行提供参考。方法收集北京市顺义区疾病预防控制中心狂犬病免疫预防门诊登记表上就诊人群的暴露和处置信息,并采用描述性流行病学方法对收集的信息进行分析。结果 2008-2014年北京市顺义区共收集狂犬病暴露患者76 484例,暴露后免疫占99.70%;致伤动物主要以犬为主,占致伤总数的87.05%;5-8月份为动物致伤高峰期;各年龄段男性动物致伤比例均高于女性;20~29岁组致伤比例最高,为19.41%;民工、农民和职工占全区致伤者总数的65.88%;致伤部位以下肢和手部居多,分别占44.46%和37.27%;Ⅲ度伤所占比例逐年提高,被动免疫制剂平均使用率为13.67%。流动人口聚集区由于人口密集,养犬密度大,是发生一犬伤多人事件及人狂犬病病例的高发区域。结论应继续加强狂犬病防治知识健康教育;至少选择一家二级及二级以上综合医院设置狂犬病免疫预防门诊,以提高抗狂犬病被动免疫制剂的使用率及伤口处置能力;对于一犬伤多人事件中致伤者和人狂犬病疫情中密切接触者应急接种的狂犬病疫苗、被动免疫制剂的费用应考虑适当给与减免;加强犬只管理,提高动物疫苗接种率。

Objective To analyze the epidemiological characters of population exposed to rabies in Shunyi District during2008 to 2014 in order to provide a reference for proper disposal and prevention after exposure. Methods The data on population exposed to rabies in Shunyi District Center for Disease Control and Prevention were collected and analyzed by descriptive epidemiological method. Results A total of 76 484 cases of victims exposed to rabies were collected in Shunyi District from 2008 to 2014, of which 99. 70% received post-exposure immunization. A portion of 87. 05% of the victim were hurt by dogs. Most of the injury appeared from May to August. The rates of male victims in various age groups were higher than those of female victims. The victims at ages of 20 ~ 29 years accounted for 19. 41% of the total victims.Of the victims, 65. 88% were migrant workers, farmers and staff. The majority of injury sites were lower extremities and hands, accounting for 44. 46% and 37. 27% respectively. The proportion of injury of degree Ⅲ increased year by year.The average utilization rate of passive immune preparations was 13. 67%. Most of events in which several people were hurt by one dog and cases of rabies occurred in ghetto of migrant population with high densities of humans and dogs.Conclusion The health education of knowledge of rabies prevention should be strengthened. At least one general hospital not less than grade Ⅱ should be selected to set rabies immunization clinics in order to improve the utilization of passive immune preparations and the capabilities of wound management. The costs of vaccine and passive immune preparations in events in which several people were hurt by one dog or the close contacts in epidemic of rabies should be properly decreased or remitted. The management of dogs should be strengthened to increased the immunization rate of animals.