广东省梅州市2002年狂犬病流行病学分析

目的 了解梅州市狂犬病流行病学特点。方法 收集该市2002年狂犬病疫情资料、个案调查表和病历资料等进行分析。结果 共有狂犬病29例，男女之比为2、22：1。≤10岁占44．83％，潜伏期最短15d，最长270d。病程最短2d，展长7d，3～5d占72．41％，病死率100％。对伤口未作处理和未注射杭狂犬病血清占75．86％，全程接种狂犬疫苗仅3例(10．34％)。结论 应认真落实时犬类“管、免、灭”和加大健康教育力度等综合性控制措施。     

2002～2003年永州市165例狂犬病例个案调查分析

目的：探讨永州市近年狂犬病发病率急剧上升的原因，为制定有效的防治对策提供科学依据。方法分析永州市各县区2002～2003年上报的部分狂犬病个案调查表。结果：165例狂犬病人中，55．15％的病例为农民，93．33％的病人通过犬只感染；所有伤人动物都没有接种狂犬疫苗；87．87％病例受伤后伤口没有处理或没有规范处理；81．21％的病例没有接种狂犬疫苗。结论：应加强狂犬病防治知识的宣传，教育人们受伤后及时进行规范的伤口处理和注射狂犬疫苗及抗狂犬血清；政府要组织相关部门加强犬只的管、免、灭。     

Serum-free purified Vero rabies vaccine is safe and immunogenic in children: Results of a randomized phase II pre-exposure prophylaxis regimen study

BackgroundA serum-free, highly purified Vero rabies vaccine (PVRV-NG) has been developed with no animal or human components and low residual DNA content. A phase II randomized clinical study aimed to demonstrate the non-inferiority of the immune response and assess the safety profile of PVRV-NG versus a licensed human diploid cell culture rabies vaccine (HDCV) in a pre-exposure regimen in healthy children and adolescents in the Philippines.MethodologyChildren aged 2–11 years and adolescents aged 12–17 years were randomized (2:1) to receive three injections of either PVRV-NG or HDCV (on day [D] 0, D7 and D28). Rabies virus-neutralizing antibodies (RVNA) were measured at D0, D42 and 6 months after the first injection (month [M] 6). Safety was assessed during the vaccination period and up to 28 days after the last vaccination. Serious adverse events were followed until 6 months after last vaccination.Principal findings342 healthy participants (171 children and 171 adolescents) were randomized and followed for 6 months after the last dose. All participants in both groups had an RVNA titer ≥ 0.5 IU/ml at D42, demonstrating non-inferiority in seroconversion rate for PVRV-NG versus HDCV. Over 90% of participants had RVNA titer ≥ 0.5 IU/ml at M6. PVRV-NG was well tolerated after each vaccination and up to 6 months following the last dose. There were no major safety concerns during the study, and the type and severity of solicited adverse events was similar for both treatment groups.ConclusionsThis study demonstrated the non-inferior immune profile of PVRV-NG compared with HDCV in a pre-exposure setting within a pediatric population. PVRV-NG was well tolerated with no safety concerns. This study is registered at ClinicalTrials.gov (NCT01930357) and EU Clinical Trials Register (2015–003203-30).     

Neutralizing antibody activity,safety and immunogenicity of human anti-rabies virus monoclonal antibody (Ormutivimab) in Chinese healthy adults: A phase Ⅱb randomized,double-blind,parallel-controlled study

ObjectiveThis study was a randomized, double-blind, parallel-controlled trail to evaluate the rabies virus neutralizing activity（RVNA）, safety and immunogenicity of Ormutivimab + rabies vaccine in Chinese healthy adults.MethodsSubjects were randomly and equally assigned to 4 groups (20 IU/kg Omtv + vaccine, 40 IU/kg Omtv + vaccine, 20 IU/kg HRIG + vaccine, and placebo + vaccine). Subjects received vaccine as the WHO Essen regime combined with Omutivimab、HRIG or placebo on Day 0. The study lasted for 43 days.ResultsA total of 240 subjects were simultaneously assigned to both FAS and SS. Fifty subjects with baseline RVNA > 0.05 IU/ml (detection limit) were excluded, 190 were included into mITT.All the subjects from 40 IU/kg Omtv + vaccine group had a protection level of RNVA (≥0.5 IU/ml, WHO) on Day 14, and those in 20 IU/kg Omtv + vaccine group and placebo + vaccine group converted positive 100 % on Day 28. In contrast to 20 IU/kg HRIG + vaccine and placebo + vaccine, Ormutivimab + vaccine provided a higher RVNA during Days 0 to 7. And RVNA in 40 IU/kg Omtv + vaccine and 20 IU/kg Omtv + vaccine groups were always higher than 20 IU/kg HRIG + vaccine group during the whole study. Although anti-Omtv antibody were detected in some subjects, it did not influence the RVNA. The incidence of adverse reactions was significantly lower in 20 IU/kg Omtv + vaccine group (17.2 %) than in 40 IU/kg Omtv + vaccine (36.7 %) and 20 IU/kg HRIG + vaccine groups (40.3 %).ConclusionCompared with HRIG + vaccine and placebo + vaccine, Omtv + vaccine provided higher RNVA for earlier immune protection. The interference of Ormutivimab on the long-term immune protection induced by rabies vaccine is weaker than HRIG. At the same dose, the adverse reactions of Omtv + vaccine group were less than HRIG + vaccine group.Registration: ClinicalTrials.gov #NCT02559921.     

青岛市2009—2013年狂犬病暴露处置监测分析

目的掌握青岛市2009-2013年狂犬病暴露处置现状。方法按月统计狂犬病暴露预防处置数据,并对全部资料进行描述分析。结果 2009-2013年,全市狂犬病暴露率呈逐年上升趋势,平均为518.26/10万。其中开发区暴露率位居所有区（市）之首,为1008.54/10万。每年夏秋季暴露数均高于春冬季,5-10月占总数的64.34%。男性暴露率高于女性,0～14岁暴露率最高,为784.21/10万。Ⅱ级和Ⅲ级暴露人数分别占总数的43.38%和56.62%。被犬致伤占92.94%,所有暴露者均接种了狂犬病疫苗,Ⅲ级暴露者被动免疫制剂使用率为1.00%。结论 2009-2013年青岛市狂犬病暴露逐年增加。应以暴露处置为重点,加强狂犬病综合防控。     

长沙市2004-2012年狂犬病流行病学调查分析及防控对策

目的分析近年来长沙市狂犬病流行特点,为制定和调整防控对策提供依据。方法收集长沙市2004-2012年的疫情资料和个案调查资料,进行统计分析。结果长沙市2004-2012年共报告狂犬病病例124例,死亡124例;病例以农村为主,4县(市)病例数为114例,占全市发病数的91.94%;每个月份都有病例报告,8月份最多,3月份最少;男性病例多于女性,男女发病比为2.35:1,年龄最小者2岁,最大者82岁,50~59岁组报告最多,占总病例数的29.03%;职业以农民为主,占发病数的79.03%;主要伤人动物为犬,占97.24%,伤人动物以自家养的为主,占48.62%;暴露部位以手部最多,44.04%;暴露后规范处置率和疫苗使用率低,在医疗机构进行伤口处置的仅占12.84%,暴露后狂犬病疫苗使用率仅9.17%;潜伏期最短的为9 d,最长为5 319 d(14.78年);发病至死亡最短为发病当天死亡,最长为9 d。结论长沙近年来狂犬病疫情相对平稳,距离消除人间狂犬病的目标还有大量工作要做。     

1999—2012年广西全州县狂犬病流行学特征分析

目的了解广西桂北地区的全州县本世纪以来狂犬病流行特征，为该县的疾病控制提供科学依据。方法收集、统计和分析该县1999—2012年狂犬病疫情资料。结果该县在过去的14年中共出现176例狂犬病病例，人群年均发病率为1．60／10万，死亡率为100％。9、10、11月份病例数占38．64％，0～5岁幼儿病例占病例数的11．93％，40～65岁占61．36％，农民被感染者占80．68％。该县狂犬病病例主要集中在该县的两个区域六个乡镇，占全县总人口数的47．85％，而病例数占总病例数的62．50％。176例狂犬病死亡病例有173例未及时进行狂犬病疫苗接种，3例未完成疫苗全程接种所致。结论本世纪以来该县狂犬病病例与上世纪80—90年代相比病例在数量增加，其防制任务仍然严重。     

2010-2011年绵阳市犬密度及犬只狂犬病病毒带毒调查报告

目的了解绵阳市犬只密度和狂犬病病毒带毒感染状况,为防制狂犬病提供科学依据。方法北川、平武未报告过狂犬病,随机抽取2个村进行调查;在其余7个报告狂犬病病例的县市区分别抽取1个报病村和1个未报病村进行调查。调查内容包括犬密度、免疫和拴养等情况。在9个县市区采集50份犬脑组织检测狂犬病毒抗原。结果共调查9个县市区18个村,平均犬密度为0.41只/户,免疫率为81.9%,拴养率67.55%。报病村,其免疫率和拴养率均较未报病村低,但差异无统计学意义。50份犬脑组织未发现狂犬病毒抗原阳性者。结论绵阳市犬只密度较高,免疫率和拴养率低,需加强犬只管理和免疫,有效预防和控制狂犬病的发生。     

上海市2001~2005年狂犬病流行病学特征分析

[目的]分析2001~2005年上海市狂犬病流行病学特征和评价预防、控制策略。[方法]开展病例流行病学调查和间接荧光法测狂犬病毒IgG。[结果]2001~2005年上海市人狂犬病发病仍处于较低水平,共发生内源性病例3例,较前5年(1996~2000年)总计8例下降62.5%,发生外源性病例6例。2001~2005年报告的9例狂犬病病例平均潜伏期84.7 d,平均病程3.6 d,其中88.9%未经任何医疗预防处理。288例可疑犬咬伤者经及时全程医疗预防处理后,均未发病。[结论]严格的犬类管理、及时伤口处理、狂犬病疫苗和抗狂犬病血清注射可以预防狂犬病和降低发病率。     

人狂犬病免疫制剂及其使用研究进展

人狂犬病是致死性疾病,预防免疫显得尤为重要。在过去的一个世纪里,狂犬病疫苗研制及使用取得了巨大进步,先后经历了神经组织培养疫苗、禽胚疫苗和细胞培养疫苗的发展阶段。抗狂犬病血清及免疫球蛋白不断得到纯化。人暴露前及暴露后正确免疫能明显减少发病。新的免疫制剂和新的免疫程序不断出现,这减少了疫苗使用量,提高了免疫效果,为扩大免疫范围提供了可能性。