Epidemiological analysis on rabies surveillance in China from 2006 to 2008

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.