2004—2020年湖北省狂犬病流行特征分析

Epidemiological characteristics of rabies in Hubei Province during 2004-2020

狂犬病发病的流行病学特征分析是深入认识狂犬病传播规律和制定狂犬病防治方案的重要理论依据.通过湖北省法定传染病报告信息管理系统获取湖北省2004-2020年狂犬病发病资料,以描述性流行病学研究分析湖北省狂犬病流行特征规律.2004-2020年湖北省报告发病1467例,死亡1467例,年均发病率0.15(每10万人).湖北省狂犬病报告发病数情况整体呈下降趋势,2013年后维持较低水平,夏秋季为高发季节.狂犬病发病人群中男女比例为2.24∶1,职业以农民为主,集中在50~70年龄组.湖北省17个市(州)中,荆州市累计报告狂犬病发病例数最多,为224例(15.27%),其次为宜昌市(11.52%)、孝感市(9.88%)、随州市(9.61%).荆州市等大部分地市(州)报告发病数总体呈波动下降趋势,与全省趋势相同,但宜昌市、随州市等个别市出现略微回升现象.在病例来源调查中发现,伤人动物种类中,犬占97.34%,猫占1.78%,其他占0.88%;Ⅱ级暴露占19.70%、Ⅲ级暴露占80.30%;未规范处置伤口占67.42%,规范处置伤口占32.58%;全程接种狂犬疫苗者占12.41%;未全程接种87.59%;不完全了解狂犬病知识者占83.50%.基于上述流行病学特征,提出应加强狂犬病实验室检测体系建设和预警监测工作,加强农村地区健康宣教力度,做好犬类免疫工作,进一步巩固狂犬病防治成果.

Epidemiological characterization of rabies incidence is an important theoretical basis for in-depth understanding of rabies transmission law and formulation of rabies prevention and control strategies.The incidence data of rabies in Hubei Province from 2004 to 2020 were obtained from the notifiable infectious disease reporting information management system.Descriptive epidemiological methods were used to analyze the changes of rabies epidemiological characteristics.From 2004 to 2020,1467 cases and 1467 deaths were reported in Hubei Province,with an annual average incidence of 0.14 per 100000 individuals.The number of reported rabies cases in the province fluctuated and decreased,and maintained a low level after 2013,with high incidence in summer and autumn.The male-to-female ratio in the rabies incidence population was 2.24∶1,with farmers as the main occupation,concentrated in the 50-70 age group.Among the 17 cities and states in Hubei Province,Jingzhou City had the highest number of cumulative cases(224 cases,15.27%),followed by Yichang City(11.52%),Xiaogan City(9.88%)and Suizhou City(9.61%).The overall trend in each region was down year by year,with small fluctuations back up in a few years,such as in Jingzhou,where the number of cases nearly doubled in 2006 compared to 2005.However,individual cities such as Yichang and Suizhou showed a slight rebound.In the investigation of the source of cases,it was found that among the types of animals that injured people,dogs accounted for the largest proportion(97.34%),followed by cats(1.78%)and other animals(0.88%);class II and class III exposure accounted for 19.70%and 80.30%,respectively.Only 32.58%of wounds had been treated with post-exposure prophylaxis and 12.41%of the incidences had been fully inoculated with rabies vaccine.83.50%of the incidences did not have full knowledge of rabies.Based on the above epidemiological characteristics,three strategies were proposed for further consolidate the results of rabies prevention and treatment,including strengthen the construction of rabies laboratory testing systems and early-warning monitoring,enhance health education efforts in rural areas and implementing canine immunization.