2006-2014年青岛市疑似狂犬咬伤人事件调查处置  

Investigation and management of personal injury events caused by suspect rabid dog bites in Qingdao from 2006 to 2014

作　　者：邱波[1] 姜法春 邱晓菲[2] 韩雅琳[1] 梁纪伟[1] 

机构地区：[1]青岛市疾病预防控制中心,山东青岛266033 [2]山东大学公共卫生学院,山东济南250012

出　　处：《现代预防医学》2016年第4期736-738,共3页Modern Preventive Medicine

基　　金：青岛市2014年度医药科研指导计划项目(2014-WJZD160)

摘　　要：目的掌握青岛市疑似狂犬咬伤人事件的特点与处置方法。方法接到疑似狂犬咬伤人事件报告后,即对其发生经过和人员受伤等情况进行调查,告知暴露者立即到狂犬病暴露处置门诊就医,并定期随访。采集伤人疑似狂犬脑样品,分别用直接免疫荧光(DFA)和RT-PCR方法检测狂犬病毒抗原和核酸。用描述流行病学方法对资料进行分析。结果 2006-2014年,全市共报告和处置疑似狂犬咬伤人事件23起,其中14起同时咬伤家养动物,19起发生于黄岛区。共有103人被咬伤,Ⅲ级暴露人数是Ⅱ级的6.36倍。农民占66.99%。所有暴露者均进行了伤口处理,102人注射了狂犬病疫苗,82.02%的Ⅲ级暴露者使用了狂犬病免疫球蛋白。随访至今,均未发生狂犬病。5个伤人疑似狂犬脑样品中,3个狂犬病毒阳性。结论近年来,青岛市疑似狂犬咬伤人事件反复出现,其伤人犬狂犬病毒阳性率较高。应采取措施,降低狂犬病毒在犬中的传播,并加强暴露后的规范预防。Objective The aim of this study was to master the characteristics and management methods of personal injury events caused by suspect rabid dog bites in Qingdao. Methods The process of injury, injured person and other related information were investigated as Soon as the report of personal injury event caused by suspect rabid dog bites was received. All the injured persons were advised to immediately go to rabies post-exposed prophylaxis clinics to see doctors and were followed up at regular intervals. Brain samples were collected from the suspect rabid dogs mentioned above and identified for rabies virus antigens and nucleic acids by direct immunofluorescent assay （DFA） and RT-PCR, respectively. All data were analyzed using descriptive epidemiology. Results From 2006 to 2014, a total of 23 personal injury events caused by suspect rabid dog bites were reported and managed. Fourteen cases were found with concurrently bitten domestic animals and 19 occurred in Huangdao district. A total of 103 persons were injured. The persons with category III exposures were 6.36 times as many as those with category II exposures. 66.99% were peasants. All exposed persons had their wounds treated and 102 received a complete rabies vaccine series. 82.02% of persons with category III exposure administered rabies immunoglobulin. Follow-up showed that no one had as yet gotten rabies among all exposed persons. Three of five brain samples from the suspect rabid dogs stated above were positive for rabies virus. Conclusion In recent years, the personal injury events caused by suspect rabid dog bites occurred time after time in Qingdao. The suspected dogs had high carriage rate of rabies viruses. Measures should be taken to reduce the transmission of rabies virus among dogs and strengthen rabies post-exposure prophylaxis.

关 键 词：狂犬病 疑似狂犬 犬咬伤 狂犬病毒 暴露后预防 

分 类 号：R183[医药卫生—流行病学]