许真, 刘波, 殷文武, 李群, 冯子健. 2006 - 2008年全国狂犬病流行病学监测分析[J]. 疾病监测, 2010, 25(5): 360-364. DOI: 10.3784/j.issn.1003-9961.2010.05.008
引用本文: 许真, 刘波, 殷文武, 李群, 冯子健. 2006 - 2008年全国狂犬病流行病学监测分析[J]. 疾病监测, 2010, 25(5): 360-364. DOI: 10.3784/j.issn.1003-9961.2010.05.008
XU Zhen, LIU Bo, YIN Wen-wu, LI Qun, FENG Zi-jian. Epidemiological analysis on rabies surveillance in China from 2006 to 2008[J]. Disease Surveillance, 2010, 25(5): 360-364. DOI: 10.3784/j.issn.1003-9961.2010.05.008
Citation: XU Zhen, LIU Bo, YIN Wen-wu, LI Qun, FENG Zi-jian. Epidemiological analysis on rabies surveillance in China from 2006 to 2008[J]. Disease Surveillance, 2010, 25(5): 360-364. DOI: 10.3784/j.issn.1003-9961.2010.05.008

2006 - 2008年全国狂犬病流行病学监测分析

Epidemiological analysis on rabies surveillance in China from 2006 to 2008

  • 摘要: 目的 根据2006 - 2008年全国狂犬病监测结果,总结中国狂犬病疫情流行病学特征,分析疫情变化的原因。 方法 收集2006 - 2008年全国疾病监测信息报告管理系统和全国狂犬病哨点监测系统的报告数据,利用描述性流行病学方法进行分析。 结果 2006 - 2008年,中国狂犬病疫情既往持续10年的增长趋势开始出现停滞甚至下降,但部分重点省份疫情仍然较高。发病仍主要集中在中国南方和中东部地区,广西、贵州、广东和湖南4省(自治区)2006 - 2008年合计病例占同期全国病例总数的52.8%。3年间,有病例报告的县(区)数平均占全国县(区)总数的31.2%。病例中农民、学生和散居儿童三种人群分别占66.2%、14.7%和6.8%,儿童和老年人的发病率形成高峰,40~60岁的中年病例数占病例总数的44.3%。监测点报告的1604例狂犬病病例中,犬和猫暴露所致发病占93.8%,病例暴露后伤口自行处理率为21.8%,疫苗注射率为12.7%。病例中的Ⅲ级暴露者占55.8%,其被动免疫制剂注射率为5.3%。农村地区犬密度中位数为15.0只/100人,有所降低,免疫率为12.0%,有所升高。狂犬病监测门诊暴露就诊者数量大幅增加,因犬和猫暴露就诊者分别占83.0%和12.7%;就诊者在就诊前自行处置伤口的比例为15.7%,在门诊的伤口处理率为85.7%,但有随着自行处理率提高而降低的趋势。绝大部分门诊中,就诊者的疫苗接种率高于95.0%,其中,Ⅲ级暴露者的被动免疫制剂注射率为33.1%。各门诊之间以及同一门诊不同年份之间的就诊者暴露分级构成比存在巨大差异,但差异趋小。 结论 2006 - 2008年,中国狂犬病疫情开始出现10年来增长趋势的下降,南方及中东部地区疫情仍较严重,病例多发于农村地区,儿童和中老年是受危害较大的人群,犬和猫仍是中国主要的狂犬病宿主动物。农村地区犬和猫密度高而免疫率低、暴露后预防处置状况差的情况有所缓解,但仍是中国疫情上升的重要原因。医务人员预防处置技能有所提高,但仍不理想,暴露后处置培训工作是今后卫生部门狂犬病防制工作的重点。

     

    Abstract: Objective To summarize the human rabies epidemiological characteristics and the factors influencing the epidemic by analyzing rabies surveillance data in China from 2006 to 2008. Methods The data of rabies epidemic in China were collected from National Disease Reporting Information System and National Rabies Surveillance System from 2006 to 2008 to conduct descriptive analysis. Results From 2006 to 2008, the increase of rabies incidence in China, which had lasted for 10 years, began to stop and decline despite some provinces still with severe epidemic. The cases mainly occurred in southern and middle eastern parts of China, the rabies cases in Guangxi, Guizhou, Guangdong and Hunan accounted for 52.8% of the national total. In this 3 years, up to 31.2% of the counties (districts) in China reported rabies cases. The cases among farmers, students and pre-school aged children accounted for 66.2%, 14.7% and 6.8% of the total cases respectively. The incidence rates of children and elder people were higher than other age groups, and the cases in age group of 40-60 years accounted for 44.3% of the total. Among the 1604 cases reported through National Rabies Surveillance System, 93.8% were caused by the exposure to dog or cat, 21.8% did self wound care, and 12.7% received vaccination. Totally 55.8% of the cases were classified as grade III exposure and 5.3% of them were administrated rabies immunoglobulin (RIG) or anti-serum. The median of dog density was 15.0/100 persons and immunization rate of dogs was 12.0%. The amount of animal-bite victims visiting the rabies clinics under surveillance was found obviously increased, the people exposed to dog accounted for 83.0% and those exposed to cat accounted for 12.7%. The self wound care rate was 15.7% and the wound care rate in clinics was 85.7%, which decreased as the self wound care rate increased. Over 95.0% of the people exposed received vaccination in most rabies clinics and 33.1% of the people with grade III exposure were administrated RIG or anti-serum. The proportion of exposure grades varied by clinics and years. Conclusion From 2006 to 2008, the increase of the incidence of human rabies in China began to stop and decline, Most rabies cases were reported in rural area, and children and middle-aged people were mostly affected. Dog and cat remained the most important host animals of rabies in China. The high dog density and low immunization rate in rural area and poor post-exposure prophylaxis were the main reasons of high incidence of rabies in China, although the situation was better now, The clinicians ability on post-exposure prophylaxis still needs to be improved. The training on post-exposure prophylaxis remains to be the priority to improve the prevention and control of rabies.

     

/

返回文章
返回