广西2004-2008年狂犬病高发因素分析

目的分析广西2004-2008年狂犬病流行病学特征和2006--2008年健康犬脑带毒检测结果，探讨广西狂犬病高发因素及相关性。方法收集分析2004--2008年广西疾病监测信息系统和全国狂犬病监测系统资料，DFA和RT-PCR法检测2006--2008年健康犬脑标本。结果2004—2008年间广西共报告狂犬病2463例，年发病率0．98／10万。疫情波及95个县，高发县数量减少，低发县数量增多，中西部地区疫情增长迅速。病例四季没有显著高峰。高发人群为农民、儿童和散居儿童，〈20岁和≥40岁发病较多。病例犬伤占83．79％；病例多为Ⅲ级暴露，占78．5％；受伤部位上下肢占83．17％，头面颈部占10．56％。67．88％的病例未处理暴露伤口，18．31％注射狂犬疫苗，3．63％Ⅲ级暴露病例注射被动免疫制剂；潜伏期的中位数为60d。2006--2008年健康犬脑狂犬病毒RT—PCR检测阳性率分别为1．92％、0．93％和0．89％。结论暴露后处置未能规范实行、地域内存在大量的狂犬病毒感染的健康犬是广西狂犬病高发的两个重要因素。

Analysis of human rabies high-occurrence factors in Guangxi from 2004 to 2008

Objective Analysis the epidemiological characteristics on rabies cases occurred in Guangxi from 2004 to 2008 and summarize the result of healthy-dog infection rabies virus investigation from 2006 to 2008.Exploring the high-occurrence and correlated factors on rabies in Guangxi.Methods Data collected from the National Disease Surveillance System and the National Active Surveillance System for Rabies from 2004 to 2008 and Data of healthy-dog infection rabies virus investigation from 2006 to 2008 were analyzed.Results The total rabies cases were 2463 in Guangxi from 2004-2008 and average incidence rate was 0.98 per 100 thousand per year.There were 95 counties had rabies case reported,anyway more than 10 cases occurred county number was declined while less than 5 cases rose year by year.The rabies case incidence area was expanded and the cases in middle and west area of Guangxi rose significantly.Rabies cases were reported whole year and no seasonal peak.Human rabies eases mainly were farmers,students and children.Yanger than 20 years old and elder 40 years old were the highest age groups in the population of the investigation,83.79% cases were attacked by dogs.78.5% cases classification category Ⅲ.83.17% cases had exposed on the upper and lower limbs,10.56% exposed to the head,face or neck.But 67.88% cases did not received any PEP and only 18.31% cases vaccinated and 3.63% category Ⅲ exposure cases combined administration of RIG.The incubation median was 60 days.The rabies virus infection rate among randomly collection healthy-dog brain samples from 2006 to 2008 was 1.92%,0.93% and 0.89%.Conclusion Unsuccessful and inadequate PEP of patients were the main factors leading to the high-occurrence of human rabies in Guangxi.And there axe a lot of infection rabies virus healthy-dogs alive in Guangxi also as a high-occurrence factor.