2011-2017年无锡市锡山区狂犬病暴露人群流行病学特征分析

Epidemiological Characteristics of Rabies Exposed Population in Xishan District, Wuxi, 2011-2017

目的了解无锡市锡山区狂犬病暴露人群的流行病学特征及狂犬病发病情况,为制定狂犬病防控措施提供依据。方法采用描述性流行病学方法对锡山区2011-2017年狂犬病暴露人群及病例资料进行分析。结果 2011-2017年锡山区共报告狂犬病暴露者59 486例,年平均暴露率为1 067.60/10万。暴露高峰是7月,最低是1月或2月,呈现"春季上升,夏秋季高峰,冬季回落"的特点。报告暴露人数前3位分别为锡山人民医院东亭分院、锡山中医医院东港院区和锡山人民医院安镇分院。男女性别比为1.06:1,年龄以16~45岁最多,占40.12%。暴露人群以被犬致伤最多,占78.86%;伤口部位以上肢最多,占48.32%;伤口仅一处者为主,占87.92%;受伤程度以浅层者为主,占84.14%。99.94%的暴露者及时进行伤口处理,99.13%的暴露者主动接种狂犬病疫苗,仅5.31%的暴露者注射狂犬病免疫球蛋白。2011-2017年锡山区报告1起一犬伤多人事件,无人发病。报告1例狂犬病病例,为宰杀野犬时病毒通过破损皮肤感染人体。结论无锡市锡山区狂犬病暴露人群有不同的地区、年龄、性别分布特征,预防狂犬病的关键在于多部门的联防联控,相关部门应加强犬类管理,提高狂犬病暴露后规范处置率、抗血清应用率,以减少狂犬病的发生。

Objective To understand the epidemiological characteristics of rabies exposed population and the incidence of rabies in Xishan District of Wuxi City, and to provide basis for the formulation of rabies prevention and control measures.Methods Descriptive epidemiological methods were used to analyze rabies exposed population and case data in Xishan District from 2011 to 2017. Results A total of 59 486 cases of rabies were reported in Xishan District from 2011 to 2017, with an average annual exposure rate of 1 067.60/100,000. The peak exposure is July and the lowest is January or February, showing the characteristics of "rising in spring, peaking in summer and autumn, and falling in winter". The top three reported persons were Donggang Branch of Xishan People’s Hospital, Donggang District of Xishan Traditional Chinese Medicine Hospital,and Anzhen Branch of Xishan People’s Hospital. The sex ratio between men and women was 1.06: 1, and the age ranged from 16 to 45 years old, accounting for 40.12%. Dogs were the most injured by dogs, accounting for 78.86%;wounds above limbs were the most, accounting for 48.32%;wounds were located only in one place, accounting for 87.92%;injuries were mostly shallow, accounting for 84.14%. 99.94% of the exposed people treated the wound in time, 99.13% of the exposed volunteers were vaccinated against rabies, and only 5.31% of the exposed were injected with rabies immunoglobulin. From2011 to 2017, one case of dog injuries was reported in Xishan District, and no one was sick. One case of rabies was reported.The virus infected the human body through the broken skin when slaughtering wild dogs. Conclusion The rabies-exposed population in Xishan District of Wuxi City has different regional, age, and gender distribution characteristics. The key to preventing rabies lies in multi-sector joint prevention and control. Relevant departments should strengthen canine management,improve the standardized treatment rate after rabies exposure, and use of antiserum rate to reduce the incidence of rabies.