40032例狂犬病暴露者特点和血清抗体分析

Analysis of characteristics and serum antibody among 40 032 patients exposed to animal bitting

目的了解狂犬病暴露人群的情况及接种人用狂犬病疫苗效果。方法对2015~2017年40 032例受动物致伤就诊的可疑狂犬病暴露者,分析暴露人群特点、暴露级别、暴露部位和暴露时间,并对暴露者进行一般处置和采集2 844例就诊者全程接种人用狂犬病疫苗者的血样,采用ELASA方法检测狂犬病毒抗体。结果 40 032例狂犬病暴露者中,男性20 180例,占50.41%;女性19852例,占49.59%;0~10岁儿童11 169例,占总暴露人群的27.90%;5~8月份受伤者18 101例,占总暴露人群的45.22%。伤口部位主要为上肢20 616例,占51.50%;II级暴露人群24 300例,占60.70%。所有暴露者经正确处理伤口,全程规范接种狂犬病疫苗,2 844例就诊者全程接种狂犬疫苗后14~21 d血清狂犬病毒抗体阳性率96.87%。所有接种者没有发生狂犬病。结论 5~8月份是狂犬病暴露者多发季节,暴露人群以0~10岁儿童为主,暴露部位主要为上肢。暴露后及时正确处置,能够有效防止狂犬病的发生。

Objective To understand the situation of people exposed to animal bitting and the effect of vaccination with rabies vaccine.Methods A total of 40 032 patients with suspected rabies who were injured by animals from 2015 to 2017 were analyzed for characteristics,exposure level,exposure location and exposure time of the exposed population.2 844 patients were treated generally and blood samples were collected from people who received rabies vaccine during the whole course.The rabies antibody was detected by ELASA method.Results Among 40 032 cases of rabies exposure,20 180 cases were male,accounting for 50.41 %,19 852 cases were female,accounting for 49.59 %,and 11 169 cases were children aged 0～10 years,accounting for 27.90 % of the total exposed population.From May to August,18 101 people were injured,accounting for 45.22 % of the total exposed population.The wound site mainly consisted of 20,616 upper limbs,accounting for 51.50 %.There were 24 300 cases of the class II exposed population,accounting for 60.70 %.All the exposed patients were correctly treated with rabies vaccine throughout the whole course.The positive rate of rabies virus antibody was 96.87 % in 14 to 21 days after the rabies vaccine was given to 2,844 patients in the whole course.All vaccinators did not have rabies.Conclusion May to August is the season of frequent rabies exposure,and children aged 0～10 years are the main exposed population.The exposed parts were mainly upper limbs.Timely and correct disposal after exposure can effectively prevent the occurrence of rabies.