2004-2006年全国狂犬病监测分析

目的 介绍中国2004-2006年狂犬病监测工作,总结狂犬病疫情特征,分析疫情上升的原因.方法 搜集2004-2006年全国疾病监测信息系统和2005、2006年全国狂犬病主动监测系统的资料进行分析.结果 2004-2006年期间,中国狂犬病年均增加病例429例,广西、湖南、贵州和广东四省2004-2006年合计病例占全国病例总数的61.5%.2006年疫情已波及839个县区,表现出明显的地域蔓延性,呈现出西南、华北和华南三地同时增长、华东及江西持续下降的格局.农村地区居民病例占92.5%、发病率形成儿童和老年人2个高峰.2006年,监测点病例的伤口处理率为32.0%、疫苗注射率和疫苗全程注射率为13.7%和3.2%、Ⅲ级暴露者的被动免疫制剂注射率为6.1%;农村地区犬密度为14.1只/100人、免疫率为6.0%;监测门诊暴露就诊者的暴露分级构成比分别为19.9%、45.1%和35.1%;暴露就诊者中自行处置伤口比例为27.0%、疫苗接种和全程接种率为99.6%和93.4%、Ⅲ级暴露者的被动免疫制剂注射率31.2%,结论2004-2006年中国狂犬病疫情加速上升.疫情主要波及南方地区并呈地域蔓延性扩散,目前呈现出西南、华北和华南三地同时增长格局.农村地区犬密度高而免疫率低,病例暴露后预防处置状况极差是疫情上升的重要原因.

Investigation of surveillance on rabies in China from 2004 to 2006

Objective The present study was conducted to introduce the surveillance on rabies in China from 2004 to 2006,summarize the characteristics of the rabies epidemic situation,and analyze the reason why the rabies epidemic has been increasing.Methods Data collected from the National Disease Surveillance System from 2004 to 2006 and the National Active Surveillance System for Rabies in 2005 and 2006 were analyzed.Results From 2004 to 2006,there was an annual increase of 429 rabies cases on average.The total cases in the four provinces,Guangxi,Hunan,Guizhou and Guangdong,accounted for 61.5% of the total cases in the whole country.In 2006,839 counties and districts were involved in the epidemic situation,which took on an obvious regional spread,appearing that the cases increased in the Southwest,Huabei,and Huanan areas at the same time while the epidemic in Huadong area and Jiangxi Province was in a steady decrease.The number of the cases in rural areas accounted for 92.5% of the total.There were 2 peaks of incidence among the children and the elderly.In 2006,the rate of wound management in rabies cases at the surveillance sites was 32.0%, with the rate of vaccination and the whole-process vaccination being 13.7% and 3.2% respectively. The rate at which grade-Ⅲ-exposed patients received passive immunization was 6.1%.In rural areas, there was an average of 14.1 dogs per 100 persons and the immunization rate of the dogs was 6.0%.In the outpatient department under surveillance,the component ratio of exposure grades among the post- exposed patients was 19.9%,45.1% and 35.1%,respectively.Among the post-exposed patients,27.0% attempted to manage the wounds by themselves,and there were 99.6% and 93.4% of them using vaccine and using vaccine for the whole process,respectively.The rate at which the grade-Ⅲ-exposed patients received passive immunization was 31.2%.Conclusion From 2004 to 2006,the epidemic situation of rabies rapidly increased in China.The southern areas were mainly involved in the epidemic situation and it assumed a regional spreading.At present,there is a trend that the epidemic increased in the Southwest,Huabei,and Huanan areas simultaneously.In rural areas,the high density of dogs,the lower rate of immunization and poor preventive management after exposure have been important reasons for the increase in the number of rabies cases in China.