18例狂犬病病例临床及流行病学特征分析

Clinical and epidemiological characteristics of 18 rabies cases

目的了解2017—2019年某院收治的18例狂犬病病例的临床表现及流行病学特征,为科学指导狂犬病的防控工作提供依据。方法采用描述流行病学法对2017—2019年来某院治疗的18例狂犬病病例的临床及流行病学资料进行分析。结果某院收治的18例狂犬病病例全部来自农村地区,其中10例来自周口、新乡、濮阳三市;秋季为狂犬病高发季节,男女病例之比为5∶1,多为儿童和老年人;伤人动物均为犬类,近一半的伤人动物逃逸或被售出;病例被咬伤部位均为四肢,其中右侧肢体占2/3;暴露后仅1例病例接种了3针疫苗,无注射免疫球蛋白者;部分病例在狂犬病前驱期未得到及时诊断,当恐风恐水症状出现后才确诊。结论应在农村地区开展动物免疫接种和狂犬病知识宣传工作,加强基层医疗人员的技术培训,从源头控制狂犬病毒的传播,减轻人群狂犬病的医疗负担。

Objective To understand the clinical and epidemiological characteristics of 18 rabies cases in a hospital from 2017 to 2019,and to provide scientific basis for prevention and control of rabies.Methods The descriptive epidemiology was used to analyze the clinical and epidemic data of 18 rabies cases in a hospital from 2017 to 2019.Results All 18 cases admitted from a hopsital were from rural areas, 10 cases were came from three cities including Zhoukou, Xinxiang and Puyang, maximum cases occurred in autumn;the ratio of male to female was 5∶1,most of the cases were children and the elderly;all the attracting animals were dogs, nearly half of attracting animals escaped or were sold;all the cases were bitten in their limbs, the right limbs accounted for 2/3;only one case was vaccinated with three doses of vaccine after exposure, and no case was injected with immunoglobulin;some cases fails to get timely diagnosis in the prodromal stage until the symptoms of fear of wind and water appeared.Conclusion Animal immunization and rabies knowledge propaganda should be implemented in rural areas, and the trainings on grassroots medical workers on the diagnostic ability of rabies should be strengthened, the spread of rabies virus from the source should be controlled, the medical burden of rabies on the people should be relieved.