2010-2020年河南省平顶山市狂犬病流行特征分析

Epidemiological characteristics of rabies in Pingdingshan city of Henan from 2010 to 2020

目的 通过调查平顶山市狂犬病死亡病例,了解狂犬病发病的流行病学特点,为进一步在本地区采取防控措施提供依据。方法 运用描述流行病学分析方法,对2010-2020年网络直报系统报告的平顶山市狂犬病病例资料进行统计分析,并通过电话和现场走访调查死亡家属和相关知情者,进行回顾性分析。结果 2010-2020年平顶山市狂犬病死亡病例共计42例,由2010年的8例下降到2020年的2例;平均潜伏期60.7天;平均病程4.1天;职业全部为农民;地区分布主要在郏县;有明显的季节性,其中7-8月份最高(52.38%);年龄分布以60~岁最多(40.48%);暴露者以男性居多,男女构成比为2.5∶1。致伤动物全部为犬类,以农村放养犬为主(88.57%);暴露伤口以Ⅱ级、单处、上肢暴露最多,分别占66.67%、52.38%、69.04%。暴露后狂犬病疫苗接种率较低(11.90%),大部分病例暴露后未做正规处理,所有死亡病例均未注射免疫球蛋白或抗血清,也未进行过暴露前免疫。结论 加强犬类管理,提高家养犬尤其是农村放养犬的管理、监控和免疫工作,从根源上控制狂犬病的流行和传播,同时加强农村狂犬病的防控宣传和基层卫生人员的技术培训,提高人们的防范意识。

Objective To understand the epidemiological characteristics of rabies in Pingdingshan city by investigating the death cases of rabies,and provide basis for further prevention and control measures in this area.Methods The data of rabies in Pingdingshan city from 2010 to 2020 were statistically analyzed by descriptive epidemiological method,and the family members of the dead and related informants were investigated by telephone and field visits,and a retrospective analysis was conducted.Results The number of rabies deaths in Pingdingshan city decreased from 8 in 2010 to 2 in 2020,with a total of 42 cases in the past 11 years.The mean incubation period was 60.7 days.The mean duration of disease was 4.1 days.All of them were farmers;they mainly distributed in Jiaxian county.There was obvious seasonality,with the highest incidence in July and August,accounting for 52.38%.About the age distribution,the proportion of people aged 60 years and older was the largest,accounting for 40.48%.Most of the exposed patients were male,and the ratio of male to female was 2.5∶1.All the injured animals were dogs,mainly rural free-range dogs,accounting for 88.57%.The most common exposed wounds were grade ⅱ,single site and upper limbs,accounting for 66.67%,52.38% and 69.04%,respectively.The vaccination rate of rabies after exposure was low,only11.90%.Most cases were not treated properly after exposure,and no immunoglobulin or antiserum was injected,or pre-exposure immunization was performed in all deaths.Conclusion In order to stop the rabies epidemic and spread from the source,the management of dogs should be strengthened,and the domestic dog,especially rural free-range dog management,monitoring,and immunization should be improved;at the same time,the publicity of rabies prevention and control in rural area,technical training of grass-roots health workers,and people’s preventive awareness should be enhanced.