河南省人间狂犬病流行特征与防控策略探讨

Epidemiology and control strategy on human rabies in Henan Province,China

目的总结和分析河南省人间狂犬病流行特征,探讨防控策略。方法收集并整理河南省1951-2015年人间狂犬病疫情相关资料,对2007-2015年病例进行流行病学调查,用SPSS17.0建立数据库并进行统计分析。结果河南省人间狂犬病上世纪80年代曾严重流行、90年代得到有效控制。本世纪初以来疫情上升明显,近10年又有下降趋势。病例以农村地区居民为主,男多于女,多为35-65岁组及15岁以下组人群。7-9月份是发病高峰期。豫东和豫南是人间狂犬病病例较为集中区域。病例平均潜伏期为60d,平均病程为3d。病例暴露后约45.9%未作任何伤口处理,76.5%未曾接种疫苗,伤口肉眼可见出血的占93.6%,抗狂犬病免疫球蛋白注射率仅为0.64%。传染源98.7%是犬只,其中非栓养犬占82.1%以上。犬只狂犬病毒感染率为0.63%-6.00%。农村地区犬只免疫率为0.64%,人犬比值平均为6.50。结论河南省是狂犬病流行地区,应开展以农村地区为重点的综合防控。

We summarized and analyzed the epidemiological characteristics and control strategy of human rabies in Henan Province, China. The data of rabies from 1951 to 2015 in the province were sorted and analyzed. We investigated 468 cases from 2007 to 2015. All the data were input into database and analyzed with SPSS17.0 software. Results showed that two peaks of incidence had occurred in 1980s, and was under control in 1990s. The incidence was increased rapidly from 2004 to 2015, but was decreased in the past ten years. The 98.09% of the cases from 2005 to 2015 occurred in rural areas. Male cases were more than female case. Most of the cases were children under fifteen year old and peasants from 40 to 60 year old. The 65.05% of the human rabies cases distributed in the five areas of the South and the East of Henan Province. Human rabies cases are fit to negative binomial distribution and represent cluster in county level. Canine （dog especially） was the main （98.7 %） reservoir of infection, 82.1% of which were unconfined. The infection rate of canine was 0.63% to 6.00%, vaccination rate was 0. 64%, and the ratio of human to canine was 6.50 （median）. The results indicate that human rabies has been epidemic in Henan Province in the past sixty-six years. Multi-measure of control and prevention for rabies in rural area are necessary for rabies control.