上海市狂犬病流行病学分析及预防控制策略

目的 分析1950～2000年上海市狂犬病流行病学特征和评价预防控制策略。方法 开展病例流行病学调查，死亡病例病毒分离和间接荧光法测狂犬病毒IgG。结果 上海市狂犬病发病率1950年的1.98/10万为最高，1958～1988年无本地内源性感染病例，1989年至今共发生19例狂犬病病例。1985～2000年9月报告的20例狂犬病病例平均潜伏期66.37d，平均病程4.55d。其中705未经任何医疗预防处理。194例阳性犬咬伤者经及时全程医疗预防处理后，均未发病。结论 严格的犬类管理，及时伤口处理，注射狂犬病疫苗和抗狂犬病血清可以预防狂犬病和降低发病率。

A study on the epidemiological characteristics and the preventive measures of rabies in Shanghai

Objective To analyze the epidemiological characteristics and the preventive measures of rabies in Shanghai from 1950 to 2000. Methods Suspected cases of rabies were investigated epidemiologically and collection of samples to isolate the virus. Results The most highest morbidity of rabies was 1.98 / 100 000 in 1950. There had been neither case of rabies, nor the rabies virus positive identified in dogs between 1958 and 1988. The morbidity of rabies was 0- 0.03 / 100 000 from 1989 to 2000. According to the data of 20 reported cases from 1985 to Sept.2000, the mean incubation was 66.37 days, except one case of 14 years. The mean course of diseases was 4.55 days. Seventy percent of the cases did not receive any preventive measure. A hundred and ninety four persons who were bitten by rabies virus positive dogs were timely treated and all of them survived. In recent years, there has been more than 50 000 persons bitten by dogs every year in Shanghai. The rate of rabies vaccine immunization was over 95%. The rate of anti rabies serum immunization was over 20%. Conclusion Rabies is a preventable disease even when persons were bitten by dogs with rabies virus positive. The important measure is to treat the wound timely, giving vaccine and anti rabies serum injection. According to the regulation of dog control in Shanghai, the number of dogs be kept at the lowest level, immunizing all the registration dogs,and destroying the none registration dogs are the most essential measures to be taken.