湖南省2009年狂犬病监测分析

目的分析湖南省2009年狂犬病监测资料,评价预防处置效果,为预防和控制狂犬病提供依据。方法根据《湖南省狂犬病监测实施方案》,收集全省狂犬病监测资料进行流行病学分析。结果 2009年共报告狂犬病200例,发病率为0.31/10万。Ⅱ级、Ⅲ级暴露者占98.0%,伤口未处理者达65.5%,病例均无暴露前免疫史,暴露后只有13.0%注射了狂犬疫苗,133例Ⅲ级暴露者仅9.77%联合应用了抗狂犬免疫球蛋白或血清。狂犬病门诊监测中,湖南全省共报告267 133例暴露者,Ⅱ、Ⅲ级暴露者占85.60%。暴露者中有94.59%在预防门诊接受伤口处理,97.62%暴露后全程接种了疫苗,Ⅲ级暴露者中42.47%注射了抗狂犬免疫球蛋白或血清。伤人动物主要是犬,全省犬密度为6.309只/100人,兽用疫苗接种率为47.78%,犬只狂犬病毒感染率是0.56%。结论犬密度较高、犬群有较高的感染率,兽用疫苗接种率较低,群众防治意识不强以及暴露后未能得到规范处理是目前狂犬病高发的主要相关因素。加强犬只＂管、免、灭＂,规范暴露后伤口的规范处理,是遏制狂犬病高发行之有效的综合措施。

Rabies surveillance in Hunan province,2009

Objective To investigate rabies epidemics in Hunan province and evaluate the effects of post-exposure prophylaxis.Methods Rabies surveillance data were collected and analyzed per provincial guidelines of rabies prevention.Results 200 human cases of rabies were reported in 2009,and the incidence rate was 0.31/100 000 person-years.98.0% of the human rabies cases had the second or third degree of injuries,65.5% of which were untreated wounds and only 13.0% received post-exposure rabies vaccination.No vaccination history was reported for all the cases before exposure.Only 13（9.77%） cases with the third degree injuries received post-exposure vaccination and anti-rabies immune globulin or serum.For rabies outpatients cnsurveillance,267 133 cases were reported with rabies suspect animal exposure in 2009,of which,85.60% reported for the second or third degree injuries,and 94.59% and 97.62% received wound treatment and post-exposure vaccination,respectively.Pet dogs were the major rabies virus carriers and had a rabies positive proportion of 0.56%.Pet dogs had the density of 6.309 / 100 persons and the current vaccination history of 47.78% only.Conclusion High incidence of human rabies cases was associated with the density of pet dogs,the low vaccination coverage of pets,the low level of the risk awareness and inconsistency with standard post-exposure prophylaxis procedures.