2004-2008年宁波市狂犬病流行因素分析

目的分析宁波市2004--2008年狂犬病流行因素，探讨有效防制措施。方法通过对宁波市发生的所有狂犬病病例的流行病学个案调查和全市犬密度及犬免疫状况调查；收集全市110家狂犬病门诊（暴露人群监测点）的数据进行分析。结果2004--2008年全市共报告狂犬病病例52例，年平均发病率0．16／10万，病死率为100％；全市8个县（市、区）均有病例报告，以慈溪市发病最多（28例），占全市病例总数的53．85％；发病年龄最大80岁，最小3岁，儿童及青壮年发病较多；病例职业分布以农民（46．15％）为主，伤人动物全部为犬；伤口暴露部位以上肢（67．31％）为主，伤口暴露以Ⅲ度（76．92％）暴露为主，未进行伤口处理35例（67-31％），未接种疫苗42例（80．77％），10例接种疫苗者均未完成全程免疫。门诊暴露监测点显示暴露人群以农民为主；各月均有暴露者，以7—8月最多；最大年龄84岁，最小158d；暴露部位以上下肢为主（68．22％），暴露咬伤程度以Ⅲ度为主（83．05％）；犬密度为42.39只／100户，犬的免疫率为9．62％。结论犬密度高，免疫率低，群众防病意识差，暴露后未进行规范的预防治疗，是宁波市人间狂犬病流行的主要因素。

Analysis of rabies epidemic factors from 2004 to 2008 in Ningbo city

Objective To analyze epidemic factors of rabies from 2004 to 2008 in Ningbo and to explore the effective control measures. Methods It was investigated for epidemic situation of rabies patients and the density and vaccination of the dogs in villages. There were 110 rabies outpatient clinics selected as sentinel site. Results There were 52 cases of human rabies reported from 2004 to 2008. The average annual incidence rate was 0.16/0.1 million. Fatality rate was 100%. The rabies case distributed at eight counties. Cixi county ranked the first, accounted for 53.85% of all cases. Patients aged from 3 to 80 years and the proportion of farmers was the highest with the value of 46.15%. The main wound exposed section was the upper limbs (67.31%). The Ⅲ degree exposure topped all the wound exposure, accounted for 76.92%. There were 35 cases(67.31%) that were not treated, 42 patients(80.77% ) not vaccinated and 10 patients not have the full immunization. The exposure people were mainly farmers from rural areas. The outpatients could occur every month. The oldest was 84 years old. The youngest was only 158 days old. The main exposure section was the upper limb and lower 1imb(68.22%). The main exposure degree was Ⅲ degree(83.05%).The dog density was 42.39 dogs/one hundred houses, the immunization rate of the dogs was 9.62%. Conclusion There were many factors lead to the prevalent of rabies in Ningbo such as high dog density, low immunization rate of dogs, weak prevention awareness among the population and non-standard treatment after exposure.