平顶山市一孕产妇狂犬病暴露后死亡案例分析

目的通过一起产妇狂犬病死亡案例流行病学调查,探讨疫情发生原因,为更好防治狂犬病提供客观依据。方法查阅病案资料,采用现场流行病学调查方法对平顶山市2013年网络直报的一起狂犬病案例进行调查。分析案例暴露后处理情况及发病临床表现及发病因素。结果该产妇在孕期4个月时被家犬咬伤脚部,暴露后属高危人群,伤口没有规范处理,没有接种狂犬疫苗和抗狂犬血清,伤后潜伏期为5个月,在分娩时发病,通过剖腹产下婴儿。经对密切接触者及新生儿接种狂犬疫苗和抗狂犬血清后,观察密切接触者至今无人发病。结论胎盘对狂犬病毒具有屏障保护作用。建议加强农村居民狂犬病防控知识健康教育,政府应将狂犬疫苗和血清免疫纳入医保或农合。确保暴露人群及时得到保护,是预防狂犬病发病的根本措施。

Analysis of a death of pregnant woman after exposed to rabies in Pingdingshan City

Objective To investigate the epidemiology characteristics of a pregnant woman died of rabies so as to provide the evidence for rabies prevention.Methods The data of medical record of a pregnant woman died of rabies reported on the network in 2013 was collected using the method of field epidemiology.The treatment situation after exposure,clinical manifestation and disease cause were analyzed.Results The right foot of the patient was bitten by a domestic dog at the 4th gestational month.The wound after exposure was not treated normally,and no rabies vaccine and antiserum were given.After the incubation period of five months,disease attacked during the delivery.Infant was delivered by caesarean section.Rabies vaccine and rabies immunoglobulin was given to the infant and close contact,and so far no rabies cases were found.Conclusion Placental barrier can prevent rabies virus.Education health on rabies prevention be strengthened in rural residents.Rabies vaccine and antiserum be included in rural medical insurance.