上海市闵行区2001-2010年狂犬病防制工作现状分析  

Current status of rabies prevention and control in 2001-2010 in Minhang district of Shanghai

作　　者：杜艳[1] 张莉萍[1] 朱亚明[1] 余峰[1] 金宝芳[1] 李捷[1] 王烨[1] 

机构地区：[1]上海市闵行区疾病预防控制中心,上海201101

出　　处：《中国预防医学杂志》2012年第8期606-610,共5页Chinese Preventive Medicine

摘　　要：目的通过上海市闵行区受动物伤害人群暴露后处置的状况及其效果,为进一步规范狂犬病的防控工作提供依据。方法采用描述性流行病学方法,对2001-2010年闵行区报告的人狂犬病资料、疑似狂犬伤人事件及狂犬病暴露后处置等资料进行描述。结果①2001-2010年期间上海市闵行区共报告3例狂犬病,均死亡,1例为本地病例,2例为传入病例;其中2例未经过任何处置,1例未进行规范性处置。2001-2010年闵行区共发生28起疑似狂犬伤人事件,有24只犬头送检,送检率85.71%,其中3例为阳性,阳性率12.50%;3例阳性犬分别分布在2001、2002及2003年,共咬伤10人,1人因未进行暴露后处置而发病,9人犬咬伤者以及密切接触者进行暴露后处置包括伤口处理、注射狂犬病疫苗和抗狂犬病血清,医学观察至少6个月,无一例发病。②狂犬病暴露以犬伤人为主,占伤人动物总数的88.25%,而无证犬伤人占犬伤总数的78.11%;其中Ⅲ级暴露占暴露总数38.72%,RabAn及HRIG接种数占三级暴露总数的21.08%,且有逐年下降趋势(R2=0.409,P=0.046),回归系数有统计学意义。犬伤率有明显地区集中趋势,不同街道犬伤率比较差异有统计学意义(χ2=5011,P<0.001)。狂犬病暴露时间分布显示无证犬伤人数在5～9月间形成一个高峰,峰顶在7～8月,而有证犬伤人数在12个月中分布比较平稳。③10 339份血清样本检测显示狂犬病暴露处置后人狂犬病全病毒抗体阳性率98.07%。结论上海市闵行区狂犬病防制工作有待加强,今后还需强化规范养犬,提高疑似狂犬送检率,并切实提高三级暴露后被动免疫制剂接种率。Objective To evaluate the current status and effectiveness of post-exposure rabies treatment,to provide scientific evidence for the standardization of rabies control.Methods A descriptive epidemiological study was conducted to analyze the data of human rabies information,suspected rabies dog attacking accidents and post-exposure rabies treatment in Minhang district of Shanghai.Results There were three cases of human rabies reported from 2001 to 2010 and all died.Two of them were imported and one was native.They either underwent no or incomplete post-exposure treatment.A total of 28 suspected rabies dog attacking accidents occurred in the area,24 dog heads were available for the detection of virus and 3 were found positive with the positive rate of 12.50%.Among 10 people who were unfortunately bitten by them.One person developed rabies because of lack of treatment after bitten,the other 9 and their close contacts all received post-exposure treatment such as washing wound thoroughly,injection of rabies immune globulin and rabies vaccine.Therefore none of them developed rabies within 6 months of medical follow-up.Rabies exposure mainly meantbitten by dogs,which accounted for 87.87% of the total attacks by animals,the unlicensed dog attack accounted for 78.01% of the total dog bites.Level III exposure accounted for 38.72% of the total exposures,and of which 21.08% vaccinated with RabAn or HRIG.However,this number decreased annually（R2=0.409,P=0.046）.Dog attack was regional and number of attacks varied in different communities（χ2=5 011,P〈0.001）.The seasonal distribution of rabies exposure showed that May to September was the peak season of unlicensed dog attacks,while the number of attacks by licensed dog within 12 months kept relatively stable.Meanwhile the positive rate of antibody against whole virus after post-exposure treatment could reach as high as 98.07%.ConclusionsRabies prophylaxis still needs to be strengthened in Minhang district.A completed post-exposure treatment is extremely critical to save

关 键 词：狂犬病 防制 工作现状 

分 类 号：R184[医药卫生—流行病学]