1953-2017年陕西省狂犬病的流行特征

目的  分析陕西省1955-2017年狂犬病流行情况及第三流行期流行特征，为科学防控狂犬病提供依据。 方法  收集1953-2003年历史疫情资料、2004-2017年中国疾病预防控制信息系统狂犬病监测资料及2009-2017年狂犬病患者个案调查资料进行统计分析。 结果  1953-2017年，陕西省出现3次人间狂犬病流行。2009-2017年报告人狂犬病病例270例，每月均有狂犬病病例发生。病例主要集中在关中和陕南地区，陕北地区偶有病例报告。男女性别比为2.5：1，职业构成以农民为主（84.4%）。伤人犬中家养犬和流浪犬的构成比为13.1：1，家养犬伤人多发生在农村地区（86.9%）。暴露级别以Ⅲ级为主（84.2%）。超六成病例在伤后未对伤口进行任何处理，狂犬疫苗接种率和免疫球蛋白使用率均较低。 结论  民众对狂犬病的危害认识不足，致伤害后处理不规范甚至不处理，从而引起发病。应加大狂犬病防控知识宣传，并将重点放在农村偏远地区，倡导民众伤后主动就医病合理利用报销政策。

Epidemiological characteristics of rabies in Shaanxi Province from 1953 to 2017

  Objective  To analyze the epidemiological characteristics of rabies in 1955-2016 and the third epidemic period in shaanxi province, and to provide scientific basis for prevention and control of rabies.  Methods  The historical epidemic data from 1853 to 2003, the rabies surveillance data from Chinese diesase prevention and control information system from 2004 to 2017, and the rabies patient case survey data from 2009 to 2017 were collected to conduct the analysis.  Results  From 1953 to 2017, there were three epidemics of human rabies in Shaanxi Province. In 2009-2017, 270 cases of rabies were reported, and rabies cases occurred every month. Cases were mainly concentrated in Guanzhong and southern Shaanxi, and occasional cases were reported in northern Shaanxi. The male-female ratio is 2.51:1, and the occupational composition was dominated by farmers (84.4%). Injured dogs were mainly domesticated dogs, the ratio of domestic and stray dogs was 13.07:1. The exposure level was mainly grade Ⅲ (84.23%). The wounds of 60% cases were not treated after the injury, and the rabies vaccination rate and immunoglobulin utilization rate were both low.  Conclusions  The public's awareness of the dangers of rabies was still insufficient, so that there was no standard treatment after canine bite, which causes disease. It is necessary to increase the publicity of rabies prevention and control knowledge. The focus should be placed on remote areas and rural areas, and the public should be advocated to take the initiative to use the reimbursement policy for medical treatment.