Surveillance of human rabies in China, 2009

Objective To understand the epidemiological characteristics and epidemic trend of human rabies in China in 2009, discuss the prevention and control of the disease. Methods The data of human rabies epidemic in 6 provinces in China were collected from national disease reporting information system and national rabies sentinel surveillance system to conduct descriptive analysis. Results A total of 2213 rabies cases and 2131 rabies deaths were reported in 892 counties (districts) in China in 2009, which declined by 10.3% and 10.2% respectively compared with the previous year. The disease mainly occurred in southern and middle eastern parts of China, the cases reported in Guangdong, Guangxi, Guizhou, Hubei and Hebei provinces accounted 56.6% of the total. The cases were mainly farmers (69.3%), students (10.6%) and children outside child care settings (7.4%). The male to female ratio of the cases was 2.34 ∶ 1. The incidences in children and elder people were high. Of 539 cases reported through national rabies sentinel surveillance system, 87.9% were caused by exposure to dogs and 5.8% by exposure to cats. The incubation period of most cases (75.2%) lasted for half year. The vaccination rate after exposure was 15.2% (62/408), the injection rate of rabies immunoglobulin (RIG) and anti-serum for category Ⅲ exposure was 6.3% (21/334). The vaccination rates after exposures in rabies clinics in surveillance areas were more than 99% .The animals causing exposure were mainly dog (84.0%) and cat (10.5%). The self wound treatment rates before seeking medical care were low in all provinces. RIG and anti-serum were not widely injected for category Ⅲ exposures. The differences on exposure classification were observed in different rabies clinics, reflecting the different characteristics of exposure and indicating the different classification standard. Conclusion The human rabies cases continued to decline in China in 2009, but more counties (districts) were affected and the epidemic began to spread to western and northern parts. Children and elder people in rural area were the high-risk population. Dog and cat were still the main animal hosts. Most rabies cases died due to none or inadequate post-exposure prophylaxis and treatment (PEP and PET). Rabies prevention needs multi-sectoral cooperation, and health department should pay more attention on PEP, PET and health education.