2013-2017年广东省广州市狂犬病暴露监测结果分析

Rabies exposure surveillance and analysis in Guangzhou, 2013–2017

目的分析广东省广州市狂犬病监测数据,掌握狂犬病发生情况及狂犬病暴露流行特征;并探讨狂犬病防治工作存在的问题,提出有效的防治措施。方法收集2013-2017年广州市狂犬病暴露预防处置门诊接诊的所有暴露者相关数据信息和狂犬病病例个案调查资料,进行描述性分析。结果 2013-2017年广州市狂犬病暴露率分别为823.64/10万、822.86/10万、901.72/10万、988.30/10万和1 187.20/10万,暴露率水平呈逐年上升趋势(P<0.05)。各年暴露时间均以夏秋季为主(6-10月),占当年暴露总例数的45.17%~48.41%。致伤动物以犬伤为主,占65.53%。从伤口分级来看,各年均以Ⅱ级暴露病例为主,占当年全部暴露预防处置人数的56.16%~61.02%,Ⅲ级暴露人数占28.61%~31.38%。暴露人群均接种了狂犬病疫苗,但被动免疫制剂接种率较低,2013-2017年狂犬病被动免疫制剂注射率分别为15.06%、6.91%、7.30%、5.38%和7.06%。结论广州市狂犬病暴露人数较多,同时,Ⅲ级暴露者狂犬病被动免疫制剂的接种率低。急需建立有效措施加强犬只管理,加强狂犬病宣传教育,提高狂犬病被动免疫制剂的接种率。

Objective To understand the epidemiological characteristics of rabies in Guangzhou. Methods The surveillance data of rabies in Guangzhou from 2013 to 2017 were used for descriptive analysis. Results The rabies exposure rates were 823.64/100 000, 822.86/100 000, 901.72/100 000, 988.30/100 000, and 1 187.20/100 000, respectively, in Guangzhou from 2013 to 2017, showing an increasing trend(P<0.05). Animal-related injuries in each year mainly occurred in summer and autumn(June-October), accounting for 45.17%–48.41% of the total cases. Dogs were responsible for most animalrelated injuries, accounting for 65.53% of all the injuries. The proportions of degree Ⅱ and Ⅲ exposures ranged from 56.16%to 61.02% and from 28.61% to 31.38%, respectively, during 2013–2017. All the exposed persons received rabies vaccination.However, the annual passive immunization rate was relatively low during this period, which was only 15.06%, 6.91%, 7.30%,5.38% and 7.06%, respectively. Conclusion A large number of people exposed to rabies in Guangzhou. The injection rate of rabies immunoglobulin was low in local degree Ⅲ exposure cases. It is suggested that the health education about rabies should be strengthened to increase the passive immunization rate and the joint prevention and control mechanism by multi departments should be established to strengthen dog management.