西安市6635例狂犬病暴露者流行病学调查  

Epidemiological analysis on 6 635 patients exposed to rabies in Xi'an,China

作　　者：郭敏锋 曹华梁[1] 赵军杰[1] 徐海煜 范永志 鱼军[1] GUO Min-feng;CAO Hua-liang;ZHAO Jun-jie;XU Hai-yu;FAN Yong-zhi;YU Jun(Xi’an Central Hospital,Xi’an 710004,China)

机构地区：[1]西安市中心医院,西安710004

出　　处：《中国人兽共患病学报》2018年第9期850-854,共5页Chinese Journal of Zoonoses

摘　　要：目的分析西安市2016-2017年来6 635例狂犬病暴露者流行特征,探讨相关危险因素,为狂犬病的防治提供依据。方法对狂犬病暴露者按年龄、性别、职业、暴露时间、暴露地点、暴露动物、暴露部位、暴露级别和处置及发病情况等进行统计分析。结果 6-10月为狂犬病暴露高发季节,共暴露4 038例,占60.86%;犬和猫为主要致伤动物,占66.25%和30.49%;暴露男女比为1∶1.19;20～岁及10～岁年龄组暴露最多,占33.56%和16.38%;暴露者以自由职业者、学生及服务业从业者居多,分别占总26.36%、21.75%和15.33%;暴露地点主要在家中,占67.94%;暴露部位以上、下肢为主,分别占43.48%和38.63%;以Ⅲ级暴露为主,占80.24%;暴露后规范处置率达100%,狂犬病疫苗接种率达100%,疫苗全程接种率为99.83%,Ⅲ级暴露后被动免疫制剂注射率为52.95%。结论西安市面临着严峻的狂犬病防控压力,其狂犬病暴露流行病学特征与周边地区及陕西省全省不尽相同,有自己的特点,应重点加强宠物犬猫的免疫与管理,消灭流浪犬猫;针对不同人群特点加强狂犬病预防及处置知识的健康教育,提高其预防意识和认知水平;进一步加强犬伤处置门诊规范化建设。We analyzed the epidemic characteristics and related risk factors on 6 635 patients exposed to rabies in Xi’an in recent 2 years,in order to provide scientific evidence for the prevention and control of rabies.According to age,gender,occupation,and exposure date,exposure place,attacking animal,wounded areas,level of exposure,medical treatment and incidence,statistical analysis was proceeded to population exposed to rabies.Results showed that the peak incidence month segments of the rabies exposure were June to October with a total of 4 038 cases,accounting for 39%;the attacking animals were mostly dogs and cats,accounting for 66.25%and 30.49%;the ratio of male to female was 1∶1.19;the most two susceptible age segments were adults of 20-29 years old and students of 10-19 years old,accounting for 33.56%and 16.38%;the most susceptible occupation were freelance,students and service practitioners,accounting for 26.36%,21.75%and 15.33%;the attack mostly occurred at home,accounting for 67.94%;upper limbs and lower limbs were most vulnerable to exposure,accounting for 43.48%and 38.63%;exposure classification was given priority to level III exposure,accounting for 80.24%;standardized disposal rate and rabies vaccine injection rate were 100%,injection rate of whole way was 99.83%,and rabies immunoglobulin utilization rate of level III patients was 52.95%.Xi’an is facing severe challenges of rabies prevention and control.The epidemiological characteristics of rabies exposure are different from the ones in surrounding area as well as the whole Shaanxi Province.The emphasis should be put on immunity and management of pet dogs and cats,and elimination of abandoned dogs and cats.To improve the awareness and cognitive level,education of rabies prevention should be strengthened according to different characteristic of populations.Standardized construction of outpatient service of the treatment of dog bite wounds should be further improved.

关 键 词：狂犬病 暴露 流行病学 

分 类 号：R373.9[医药卫生—病原生物学]