浙江省兰溪市22993例狂犬病暴露者的流行病学特征

目的 了解浙江省兰溪市狂犬病暴露人群的流行病学特征,为制定控制策略提供依据.方法 对兰溪市2009-2012年全市犬伤门诊暴露人群的个人信息登记表进行回顾性分析,采集暴露者的性别、年龄、职业、暴露时间、程度及处理情况等信息.结果 2009-2012年,全市共报告狂犬病暴露22 993例,各年度报告暴露人数分别为2 602例、4 170例、7 540例和8 681例,年暴露率分别为39.44/万、62.86/万、113.15/万和130.35/万.男女比例为1.19∶1；单月暴露率以7月最高（1 1.99％）,1月最低；年龄组中以0～9岁、40～49岁和50～59岁组暴露人数较多,分别占总数的14.81％、21.54％和16.77％;以农民为主,占54.24％；暴露动物以犬为主,占89.30％.各年龄段暴露部位均以下肢（59.24％）和上肢（33.49％）为主.97.68％的暴露者均由专业的犬伤门诊医师进行伤口处理,99.70％的暴露者接受疫苗接种,但在狂犬病暴露为Ⅲ级的人群中,接种免疫球蛋白的比例仅为20.96％.结论 兰溪市狂犬病暴露报告率近年来有上升趋势,相关部门应加强犬只的预防免疫及管理,降低人群犬伤暴露率,采取适当的措施提高Ⅲ级暴露人群接受免疫球蛋白阻断治疗,预防狂犬病疫情的发生.

Epidemiological characteristics of 22 993 cases with rabies exposure in Lanxi Zhejiang

Objective To describe the epidemiological characteristics of rabies exposure population in Lanxi Zhejiang and to provide scientific basis for rabies control strategy.Methods The personal information of exposed-to-rabies population in outpatient clinic of dog injury from 2009 to 2012 in Lanxi were retrospectively analyzed,including person＇s gender,age,occupation,exposure time and processing.Results During the period,a total of 22 993 rabies exposure cases were reported,and the exposure rates for 4 years were 39.44/104,62.86/ 104,113.15/104 and 130.35/104,respectively.The ratio of male to female was 1.19∶1.The cases reported in July accounted for 11.99%,ranked the first in the list,while January had the least cases reported.Age groups in 0-9,40-49 and 50-59 years had larger number of exposures,which accounted for 14.81%,21.54% and 16.77%.Most of the exposed cases were farmers（54.24%）.The main exposure animal was dog（89.30%）.In all age groups,the main exposure position was the lower limbs （59.24%） and upper limbs （33.49%）.Most of the cases （97.68%） were treated by specialists in outpatient clinic of dog injury and 99.70% of them received a whole course rabies vaccine inoculation.The treatment rate of anti-rabies immunoglobulin was low to 20.96% in cases with grade Ⅲ exposure.Conclusions The reporting rates of rabies exposure have risen in recent years in Lanxi Zhejiang.The relevant departments should strengthen the immune prevention and management in dogs to reduce rabies exposure,and take appropriate measures to enhance immunoglobulin blocking treatment in grade Ⅲ expose cases to prevent the occurrence of rabies.