百色市2009—2020年人狂犬病流行特征及监测分析

Epidemic characteristics and surveillance analysis of human rabies in Baise City,2009-2020

目的探讨百色市狂犬病流行规律,研究其发病的原因和影响因素,为制定疾病预防控制措施提供依据。方法收集整理统计分析百色市2009—2020年人狂犬病发病资料及2019—2020年被动物致伤后进行狂犬病预防的人群资料。结果2009—2020年百色市报告人狂犬病病例105例,均为被动物致伤后未及时得到规范处置而发病,其中农民占79.05%,犬伤所致发病占87.62%,病例暴露后伤口未处置率为78.10%,自行处置率为19.05%,疫苗注射率为1.90%,全程注射率为0.00%,被动免疫制剂注射率仅为1.69%。2019—2020年百色市各县(市、区)疾病预防控制中心狂犬病暴露处置门诊就诊者30320人次,免疫接种率为97.36%,Ⅲ级暴露者中被动免疫制剂注射率为29.22%;犬类伤人占狂犬病暴露的51.35%,猫伤人占33.95%,均以外观无异常疑似健康动物伤人为主,2年间所规范处置狂犬病暴露者无一例发病。结论百色市仍为狂犬病的高发地区,加强多部门联防联控,加大对重点人群的狂犬病防制知识宣教,及时、规范、彻底处置暴露伤口,全程接种狂犬疫苗及狂犬免疫球蛋白是预防狂犬病的有效措施。

Objective To explore the epidemic regularity of rabies in Baise City,to study the causes and influencing factors of its incidence,and to provide evidence for formulating its prevention and control measures.Methods We collected and statistically analyzed the data regarding the incidence of human rabies in Baise City from 2009 to 2020 and the data about population with rabies prevention after injuring by animals from 2019 to 2020.Results One hundred and five cases of human rabies were reported in Baise City from 2009 to 2020,and all of them were injured by animals and not treated in time.Among them,79.05%were farmers,87.62%were caused by dog injury,and 78.10%were induced by untreated wound after exposure,with the self-disposal rate,the vaccine injection rate,the rate of injection with a full course of vaccine,and the injection rate of rabies passive immune preparation being 19.05%,1.90%,0.00%,and 1.69%,respectively.There were 30,320 visits due to rabies exposure in disposal outpatient clinics of county-level(city-level and district-level)centers for disease control and prevention in Baise City from 2019 to 2020,and the immunization vaccination rate was 97.36%.The injection rate of rabies passive immune preparation in cases with gradeⅢrabies exposure was 29.22%.Canine-induced injuries accounted for 51.35%of the rabies exposure cases,cat-induced injuries for 33.95%,and all injuries were mainly caused by suspected healthy animals with no abnormal appearance.No rabies case was found in the rabies-exposed cases with normal handling within the two years.Conclusion Baise City is still an area with high incidence of rabies.The effective measures for rabies prevention include reinforcing the multi-department joint prevention and control,devoting greater effort to disseminating knowledge of rabies prevention to high risk group,treating exposed wounds timely,standardly and thoroughly,and receiving a full course of rabies vaccine and rabies immunoglobulin.