1999～2002年玉林市狂犬病流行病学分析

目的 了解玉林市1999～2002年狂犬病流行状况，探讨发病升高的原因。方法 对1999～2002年玉林市狂犬病疫情资料进行统计，分析发病的地区、时间、人群分布；采取个案调查方式，分析传染源、感染途径、伤口处理与疫苗注射情况与发病的关系；采取随机抽样方法，对陆川县进行犬密度调查。结果 1999～2002年发病率分别为0．18／10万、0．35／10万、0．71／10万、1．24／10万，年均发病率为0．63／10万，病死率。100．00％。全年各月均有病例发生，但以秋冬季节较多。发病以农民最多，其次为中小学生。犬是主要的传播动物，暴露后平均潜伏期为40．7天。半数以上患者(51．04％)的伤口未做任何处理，有69．23％的患者未注射狂犬疫苗，30．77％的患者不同程度注射狂犬疫苗仍发病。结论 犬密度较大，犬未经免疫，犬伤者不按要求进行及时彻底的伤口处理，不及时联合注射抗狂犬病血清和狂犬疫苗，注射疫苗后保护抗体未产生前病人已出现症状，是近几年来玉林市狂犬病发病率逐年上升的原因。     

犬类致伤患者狂犬疫苗免疫抗体测定研究

目的分析犬类致伤患者狂犬疫苗免疫后抗体水平,了解犬类咬伤人群接种狂犬疫苗后抗体产生的免疫效果。方法选取2012年2月至2013年9月在狂犬病门诊注射狂犬疫苗的犬类致伤患者924例,全程接种五针疫苗后抽取静脉血采用酶联免疫法进行狂犬病毒抗体检测。结果 924例接种狂犬疫苗后抗狂犬病毒抗体水平阳性率为95.6%,其中男性狂犬病毒抗体阳性率为94.6%,女性为96.6%,不同性别、不同产地疫苗之间狂犬病抗体阳性率无显著差异(P0.05);50岁以上组狂犬病毒抗体阳性率显著低于其余各组(P0.05)。结论通过全程接种狂犬病疫苗,绝大部分患者抗狂犬病毒抗体水平合格,但仍有一部分患者尤其是年龄较大的患者抗体水平低于保护阈值,需要进一步加强接种。     

荆门市被犬咬伤者接种狂犬疫苗后抗体检测结果分析

狂犬病毒感染机体后 ,可以迅速地侵入人的神经组织 ,引起一系列临床症状 ,发病凶险 ,病死率几乎 10 0 %。为了解接种狂犬疫苗的免疫效果 ,对 1～ 6月份 715人被犬咬伤者接种狂犬疫苗后进行抗体测定 ,报告如下。1　方法715人中 6 77人按 0、3、7、14、30天全程免疫注射了狂犬疫苗 (浓缩人用狂犬疫苗≥ 2 .5 IU) ,注射部分为上臂三角肌 ,肌注每次 2 m l。其余 38人因咬伤头面部伤口较深大 ,在2 4小时内注射了抗狂犬病毒血清 ,以后按程序注射狂犬疫苗 ,715人都是在全程免疫后间隔 10天采静脉血 1ml,用酶联免疫法检测抗狂犬病抗体 ,抗体阴性者…     

惠州市1186例狂犬病疫苗接种者免疫效果分析

目的分析惠州市人狂犬病疫苗暴露后免疫的抗体水平,及时了解和观察本市犬咬伤人群接种狂犬病疫苗后（IgG）抗体产生的免疫效果,评价目前本市使用的狂犬病疫苗质量,为今后的狂犬病疫苗预防接种工作及制订科学完善的防患措施提供科学依据。方法惠州市人狂犬病疫苗暴露后（咬伤后）,抽取全程接种五针疫苗1个月后自愿进行狂犬病毒抗体检测人员静脉血,按酶联免疫法检测抗狂犬病毒抗体。结果惠州市1186例接种狂犬疫苗后抗狂犬病毒抗体水平检测阳性率为96.1%。其中男性97.2%,女性94.5%。不同年龄组抗狂犬病毒抗体阳性率有随着年龄的增长而呈下降的趋势。不同厂家狂犬疫苗免疫效果相当,差异无统计学意义。结论通过0、3、7、14和28d全程接种狂犬疫苗后,96.1%以上的患者抗狂犬病毒抗体水平合格,还有3.9%的患者抗体水平低于保护阈值,需进一步加强接种。     

广州市白云区86例狂犬病流行病学分析

目的 对广州市白云区狂犬病病例进行流行病学分析，以掌握其流行规律及防制措施，为控制狂犬病发病提供科学依据。方法 对白云区1980～1991年因被动物咬伤发病致死的狂犬病病例个案调查表进行描述流行病学分析。结果 1980～1991年共发生狂犬病86例，1987年发病率最高为1．81／10万。发病年龄以10～14岁为多，丘陵地区占55.81％，全年各月均有病例发生，以9月份为高。犬咬伤致病占91．86％，咬伤头面部及上肢占58．12％，未进行伤口处理占94．19％。潜伏期最短8d，最长2557d。86例患者全程注射狂犬疫苗仅1例。结论 1989年前对犬“管、免、灭”措施不落实，狂犬病发病率上升，1989年后全面落实有关措施，1992年至今无狂犬病发生。     

狂犬疫苗接种后抗体检测分析

狂犬病是人类至今未能征服的疾病之一，目前对该病缺乏特效疗法，发病后病死率极高。动物咬伤后尽早注射狂犬疫苗是预防狂犬病的有效措施之一，因此免后抗狂犬病毒抗体水平对控制狂犬病的发生有极重要的作用。为了解现行的地鼠肾组织培养狂犬疫苗对患者的保护作用及其影响...     

2007-2010年台山市狂犬病流行病学分析

[目的]分析台山市狂犬病流行特征,探讨防控对策。[方法]对2007-2010年台山市狂犬病相关资料进行分析。[结果]2007-2010年台山市共报告狂犬病病例23例,死亡23例,平均年发病率为0．58／10万。2007-2010年年发病率（／10万）分别为0．20、0．81、0．71、0．61;年均发病率较高的镇有三合镇（3．19／10万）,端芬镇（2．54／10万）,广海镇（1．12／10万）。23例病人中,男性占65．22％,女性占34．78％;本地农民占65．22％,外来农民工占17．39％,学生及学前儿童占17．39％;4-16岁占17．39％,36-59岁占56．52％;5-10月发病数占全年总数的69．270．4。致伤动物为犬的占86．96％。致伤后,69．57％未对伤口作任何处理,100．00％未注射抗狂犬病毒血清或免疫球蛋白,及时接种狂犬病疫苗者占4．35％,全程接种狂犬病疫苗的为0。[结论]农民、儿童少年是预防狂犬病的重点人群,暴露后未处理伤口、未接种狂犬病疫苗和抗狂犬病毒血清或抗狂犬病免疫球蛋白是发病的主要原因。     

1868例狂犬疫苗接种者免疫后抗体检测结果分析

狂犬病是人类目前尚未征服的传染性疾病之一,廉价有效的预防方法是给动物咬伤、抓伤者注射狂犬疫苗、抗狂犬病毒血清、狂犬病免疫球蛋白和正确处理伤口。为了解高邮市动物咬伤人群注射狂犬疫苗后抗体产生情况,笔者对2005年年度1868例狂犬疫苗接种者进行免疫后抗体检测结果分析。     

1 868例狂犬疫苗接种者免疫后抗体检测结果分析

狂犬病是人类目前尚未征服的传染性疾病之一,廉价有效的预防方法是给动物咬伤、抓伤者注射狂犬疫苗、抗狂犬病毒血清、狂犬病免疫球蛋白和正确处理伤口。为了解高邮市动物咬伤人群注射狂犬疫苗后抗体产生情况,笔者对2005年年度1868例狂犬疫苗接种者进行免疫后抗体检测结果分析。     

1996～2003年桂阳县狂犬病流行特征分析

目的分析1996～2003年狂犬病流行特征，为有效控制狂犬病提供科学依据，以便制定相应的防治对策。方法对近8年来全县各医疗卫生机构报告的狂犬病报告卡及狂犬病个案调查表进行统计分析。结果1996～2003年共报告狂犬病55例（死亡55例），年平均发病率为0．89／10万；无明显的季节性；98．18％的病例发生在农村；人群分布以20岁以下的青少年为多，占50．9l％；致伤动物犬类占90．91％（50／55）；85．45％的病例无暴露后免疫史。结论加强犬类管理，加大健康教育力度，提高人群自我保健意识，及时规范处理伤口、迅速全程接种狂犬疫苗及抗狂犬病毒血清（抗狂犬病毒免疫球蛋白）的联合应用以及为广大居民提供廉价高效的免疫制品，加强对乡镇防疫医生的培训等是预防控制狂犬病的有效措施。     

Economic impact of implementing decennial tetanus toxoid,reduced diphtheria toxoid and acellular pertussis (Tdap) vaccination in adults in the United States

BackgroundIn the United States, persons ≥11 years are recommended to receive one dose of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine, followed by decennial tetanus- and diphtheria-toxoid (Td) boosters. Many providers use Tdap instead of Td. We evaluated epidemiologic and economic impacts of replacing Td boosters with Tdap.MethodsWe used a static cohort model to examine replacing Td with Tdap over the lifetime of 4,386,854 adults ≥21 years. Because pertussis is underdiagnosed and true incidence is unknown, we varied incidence from 2.5 cases/100,000 person-years to 500 cases/100,000 person-years. We calculated vaccine and medical costs from claims data. We estimated cost per case prevented and per quality-adjusted life year (QALY) saved; sensitivity analyses were conducted on vaccine effectiveness (VE), protection duration, vaccine cost, disease duration, hospitalization rates, productivity loss and missed work. We did not include programmatic advantages resulting from use of a single tetanus-toxoid containing vaccine.ResultsAt lowest incidence estimates, administering Tdap resulted in high costs per averted case ($111,540) and QALY saved ($8,972,848). As incidence increased, cases averted increased and cost per QALY saved decreased rapidly. With incidence estimates of 250 cases/100,000 person-years, cost per averted case and QALY saved were $984 and $81,678 respectively; at 500 cases/100,000 person-years, these values were $427 and $35,474. In multivariate sensitivity analyses, assuming 250 cases/100,000 person-years, estimated cost per QALY saved ranged from $971 (most favorable) to $217,370 (least favorable).ConclusionsOur findings suggest that replacing Td with Tdap for the decennial booster would result in high cost per QALY saved based on reported cases. However, programmatic considerations were not accounted for, and if pertussis incidence, which is incompletely measured, is assumed to be higher than reported through national surveillance, substituting Tdap for Td may lead to moderate decreases in pertussis cases and cost per QALY.     

Human rabies exposures and postexposure prophylaxis in South Carolina, 1993-2002

OBJECTIVES: South Carolina mandates reporting of animal bites and manages distribution of biologics for rabies postexposure prophylaxis (PEP). Incidence and epidemiologic characteristics of potential human rabies exposures and preventive treatment in South Carolina from 1993 through 2002 were examined to help assess the burden of PEP in the state and determine if the incidence of rabies exposures has changed over time. METHODS: Data on animal exposure investigations and PEP administration at the state and county level were examined, and the annual incidences of potential rabies exposures and human PEP courses were calculated. RESULTS: The incidence of animal exposures for which investigations were initiated was 297.9 per 100,000 population per year, and the incidence of PEP was 10.6 per 100,000 population per year. At the county level, the incidence of PEP appeared inversely correlated with the population density. Most courses of PEP were administered following exposures to domestic species, although these animals accounted for only a small proportion of rabid animals in the state. The annual PEP incidence was similar throughout the study period, but it was markedly higher than estimates from 1981 (< 5/100,000 population per year). CONCLUSIONS: The incidence of PEP in South Carolina is higher than previously thought, and these findings suggest that incidence extrapolations for other states and at the national level may be underestimated. An accurate estimation of the incidence of PEP and an understanding of rabies epidemiology is important at the state level to allow for better public health planning.     

Mumps in Poland in 2003

In 2003, 87,336 cases of mumps were reported in Poland. The incidence (228,7 per 100,000) was higher then in 2002(104.6), which corresponds to a periodical increase of mumps incidence. According to the natural periodicity the peak incidence would be expected to take place in 2002. The increase of mumps incidence in 2003, still lower however then the previous peaks, can be attributed to the prolongation of the epidemics cycle usually occurring with growing vaccine coverage. Even though the mumps vaccine was not included into the national immunization program, the coverage in 3-year old children in 2003 reached 39.6%. Approximately 4.6% of cases were hospitalized (4,056) and no mumps deaths were reported. Children 5-9 year old constituted the most affected age group (incidence 2,133.1 per 100,000). In Poland the MMR vaccine was recommended on voluntary basis in place of measles vaccine for children in their 2nd and 7th year of age. Immunization of 2-years old children is mandatory beginning in 2004.     

Measles in Poland in 2002

In Poland 34 measles cases were registered in 2002 (0.09 per 100,000 population)--99 cases less than in the preceding year. Eleven (32%) cases occurred in unvaccinated persons, 9 (27%) in persons who had received only one dose of the vaccine and 14 (41%) in those vaccinated with two doses. The number of cases among the vaccinated population--23, including one case of vaccine associated measles--together with high vaccination coverage after 1975, indicates high effectiveness of measles vaccines used in Poland. Fifteen cases (44%) were confirmed serologically (IgM). Across the voivodeships the number of cases ranged from 0 in four voivodeships to 5 in the ?laskie voivodeship. In none of the voivodeships, however, did the incidence exceed 0.2 per 100,000. The most affected were infants (incidence 0.85 per 100,000), children in their second year of life (incidence 1.09) and children aged 5 and 6 years--incidence of 0.72 and 0.69 respectively. According to the immunization schedule these were children who should receive their first or subsequent dose of vaccine during the year 2002. Cases among children and adolescents below 15 years of age (26 cases) constituted 77% of all reported cases. Out of all reported cases 13 (38%) were hospitalized. There were no deaths due to measles in Poland in 2002.     

Mumps in Poland in 2002

In 2002, 39,978 cases of mumps were reported in Poland. The incidence (104.6 per 100,000) was higher then in 2001 (43.3), which corresponds to a periodical increase of mumps incidence occurring in Poland every 3-4 years. This year's peak is much lower than the previous ones, which can be attributed to the growing vaccine coverage. Even though the mumps vaccine was not included into the national immunization program, the coverage in the 3-year old children reached in 2002 35.5%. Approximately 3.5% of cases were hospitalized (1400) and no mumps deaths were reported. Children 5-9 years old constituted the most affected age group (incidence 965.2 per 100,000). In Poland the MMR vaccine was recommended on voluntary basis in place of measles vaccine for children in their 2nd and 7th year of age. Immunization of 2-years old children is mandatory beginning in 2004.     

Estimating human rabies mortality in the United Republic of Tanzania from dog bite injuries

OBJECTIVE: To make quantitative predictions about the magnitude of underreporting of human rabies deaths in the United Republic of Tanzania. METHODS: Human rabies deaths were estimated by using a series of probability steps to calculate the likelihood of rabies developing after the bite of a suspected rabid dog, incorporating field data on the incidence of animal bite injuries, the accuracy of rabies recognition, the distribution of bite wounds, and post-exposure treatment. FINDINGS: Predicted human rabies mortality was estimated to be (a) 1499 deaths per year (95% confidence interval 891-2238), equivalent to an annual incidence of 4.9 (2.9-7.2) deaths/100,000, when active surveillance data on bite incidence were used, and (b) 193 deaths per year (32-409), corresponding to an annual incidence of 0.62 (0.1-1.32) deaths/100,000, when national bite statistics were used. The annual mean number of rabies deaths officially recorded for the same period was 10.8 (7.7-14.0). CONCLUSION: In the United Republic of Tanzania, cases of rabies in humans have been greatly underreported. Dog bite injuries are an accessible source of epidemiological data that may be used to estimate the public health burden of rabies and to monitor epidemiological trends in developing countries.     

天台县2001-2005年狂犬病疫情分析

目的分析天台县2001—2005年狂犬病流行情况,探讨其流行因素。方法收集2001—2005年天台县狂犬病疫情资料。结果2001—2005年天台县共发病11例,年平均发病率为0.4/10万,年发病率最高为1.07/10万。一年四季均有病例发生,发病最多的是每年的2～4月份。伤人动物均为犬类,咬伤后72.72%的患者伤口未作任何处理,90.90%未注射狂犬病疫苗。结论犬类养殖增加,患者暴露后未及时、规范处理伤口,未注射或未全程注射狂犬病疫苗等因素是导致天台县狂犬病疫情上升的原因。     

2002-2011年周口市狂犬病流行因素分析

目的分析2002-2011年周口市狂犬病流行特征及流行影响因素,为制定狂犬病防控策略和防控措施提供科学依据。方法对2002-2011年周口市狂犬病网络报告和个案调查资料进行统计分析。结果周口市10年共报告狂犬病183例,年平均发病率0.17/10万。患者年龄最小6个月,最大75岁,夏季发病率较高。狂犬病病人3级暴露者169例,占92.3%,患者被咬伤后只有5例(2.7%)病人伤口进行规范化处理,。只有4例(2.2%)患者在暴露后接种了狂犬疫苗。结论应进一步加强狂犬病防治知识宣传,提高市民狂犬病防治知识知晓率,提高犬及宠物狂犬病免疫率,提高狂犬病暴露人群伤口规范化处理及狂犬疫苗、狂免蛋白注射比例。     

河北省2013—2017年疑似预防接种异常反应监测分析

目的 了解河北省2013—2017年疑似预防接种异常反应(adverse events following immunization,AEFI)的发生特征,评价所用疫苗的安全性和预防接种服务工作质量。方法 采用描述性流行病学方法分析河北省2013—2017年AEFI数据。结果 河北省2013—2017年报告AEFI病例57 028例,年均报告发生率为44.48/10万剂。男女性别比为1.33∶1,集中在1岁年龄组,报告时间集中在夏、秋两季;绝大多数AEFI报告已痊愈或好转,约85%的不良反应报告发生在接种后24 h内。一般反应、异常反应报告分别占97.56%、2.00%。AEFI报告发生率较高的疫苗是无细胞百白破联合疫苗(diphtheria,tetanus and acellular pertussis combined vaccine,DTaP)(189.91/10万剂)、23价肺炎球菌多糖疫苗(23-valent pneumococcal polysaccharide vaccine, PPV23)(182.45/10万剂)和无细胞百白破-灭活脊灰-b型流感嗜血杆菌联合疫苗(diphtheria,tetanus and acellular pertussis, inactivated poliomyelitis and Haemophilus influenza type b conjugate combined vaccine, DTaP-IPV-Hib)(150.67/10万剂)。过敏性皮疹(5.48/10万剂)是报告发生率最高的异常反应类型。结论 河北省2013—2017年AEFI监测工作质量逐年提高,所用疫苗安全性良好。