2016-2021年湖北省荆州市狂犬病暴露处置与流行特征分析

Analysis on exposure disposal and epidemiological characteristics of rabies in Jingzhou city,Hubei province from 2016 to 2021

目的 了解荆州市狂犬病暴露与预防处置情况,分析2016-2021年狂犬病流行特征,为狂犬病的规范处置和防治提供科学依据。方法 收集2016-2021年荆州市各县(市、区)狂犬病暴露预防处置门诊就诊登记资料进行统计汇总,对病例的暴露和处置情况进行描述性分析。通过中国疾病预防控制信息系统2016-2021年报告狂犬病病例和收集狂犬病的个案调查表,描述狂犬病的发病特征。结果 就诊暴露人群累计274 032例。各县(市、区)年暴露发生率波动在206.34/10万~2 210.58/10万之间。II级、Ⅲ级暴露分别占54.44%、40.70%,均进行狂犬病疫苗接种。Ⅲ级暴露狂犬病免疫球蛋白数使用率为55.62%。暴露动物主要为犬,占68.84%,其次为猫,占25.20%。共报告狂犬病病例12例,暴露者中狂犬病发病率为4.44/10万。报告狂犬病例分布于6个县(市、区),以农民(75.00%,9/12)、男性(75.00%,9/12)为主,所有病例均未及时、规范处置伤口和进行全程免疫。结论 加强重点人群狂犬病防治知识宣教,加强犬只、猫的管理和免疫,暴露人群及时、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 understand the exposure and preventive disposal of rabies in Jingzhou city, analyze the epidemiological characteristics of rabies from 2016 to 2021, and provide a scientific basis for the standardized disposal and prevention of rabies.Methods The registration data of rabies exposure prevention and treatment clinics in counties(cities and districts) of Jingzhou city from 2016 to 2021 were collected, and the case exposure and disposal were analyzed descriptively. The characteristics of rabies were described based on the reported rabies cases through National Notifiable Disease Reporting System(NNDRS) and rabies case investigation forms collected from 2016 to 2021. Results A total of 274 032 cases were exposed. The annual exposure incidences among counties(cities, districts) fluctuated between 206.34/10 million~2 210.58/10 million. The exposure levels were mainly at grades II and Ⅲ, accounting for 54.44% and 40.70%, respectively. The exposure-caused animals were mainly dogs, accounting for 68.84%, followed by cats(25.20%). and all were vaccinated against rabies. The proportion of utilization of rabies immunoglobulin among persons with grade Ⅲ exposure was 55.62%. 12 rabies cases were reported, and the incidence of rabies cases was 4.44/100 000 among the exposed persons. Reported rabies cases were distributed in 6 counties(cities and districts), mainly farmers(75.00%, 9/12), and men(75.00%, 9/12). All cases had not received timely and standardized treatment of wound and whole-process immunization. Conclusion The effective measures to prevent rabies are to strengthen the publicity and education of rabies prevention and control among key populations, improve the management and immunization of dogs and cats, and timely conduct standardized and thorough treatment of exposed wounds among exposed populations as well as full vaccination of rabies vaccine and rabies immunoglobulin.