1例注射狂犬疫苗后死亡确诊病例的调查  

Investigation of a Confirmed Human Death Case After Injection of Rabies Vaccine

作　　者：陈伯中[1] 刘富强[2] 戴德芳[2] 赵善彬 盘建春 

机构地区：[1]湖南省永州市疾病预防控制中心,湖南永州425000 [2]湖南省疾病预防控制中心

出　　处：《实用预防医学》2008年第5期1445-1446,共2页Practical Preventive Medicine

摘　　要：目的探讨一例狂犬病例疫苗免疫失败原因以及病例确诊方法。方法对病例进行详细的流行病学调查,采集相关组织标本进行狂犬病抗原及核酸检测。结果病例伤口暴露后及时在医疗机构进行了伤口处理,并注射狂犬病疫苗5针后死亡,检测病例海马、脑干、小脑、白质、灰质、脊髓的组织狂犬病抗原阳性和狂犬病毒核酸阳性,而角膜、背皮、咬伤处皮肤狂犬病抗原和狂犬病毒核酸均为阴性。结论该病例属于注射狂犬疫苗后免疫失败,可能与疫苗质量、免疫程序及注射针次有一定的关系。及时采集病例脑组织进行狂犬病抗原及核酸检测可作为病例确诊依据。Objectives To explore the failed reason for rabies vaccine and the methods to confirm human rabies cases. Methods The details of the case were epidemiologically investigated, and the specimens were collected to detect rabies - related antigen and nucleic acid. Results The patient was timely treated after wound exposure. She died after injecting rabies vaccine five times. The specimens were detected positive with rabies- related antigen and nucleic acid of hippocampus. brainstem, cerebellum, white matter, gray matter, and spinal cord tissue, but negative with cornea, dorsal skin, and the skin wound. Conclusions The case belongs to rabies vaccine immunization failure, and the possible reasons are concerned with the quality of rabies vaccine, immunization procedures, and the injection times. It is a useful way to confirm rabies cases with collecting and detecting the brain tissue antigen and nucleic acid timely.

关 键 词：狂犬病 狂犬疫苗 疫苗免疫失败 RT PCR 

分 类 号：R186[医药卫生—流行病学]