Surveillance of human rabies in Shandong province, 2010

Objective To understand the epidemiological characteristics and incidence trend of human rabies in Shandong in 2010 and provide scientific evidence for the prevention and control of the disease. Methods The descriptive epidemiological analysis and statistical analysis were conducted on the incidence data of human rabies in 2010 in Shandong, which were collected from national disease reporting information system and the rabies clinics conducting surveillance in Shandong. Results A total of 74 rabies cases were reported in 2010. The majority of cases were farmers (77.03%). Up to 93.24% of cases were caused by dog bites, and 34.38% did self wound treatment. The incidences in children and elder people were high. The vaccination rate after exposure was 13.04%, the full series vaccination rate was 5.8%, the injection rate of rabies immunoglobulin (RIG) was 1.45% and the vaccination rate after exposures in rabies clinics was 95.70%. Up to 87.90% of the people visiting rabies clinics was due to dog bites. The self wound treatment rate before seeking medical care was low in all surveillance areas and RIG injection rate was only 20.88% for grade Ⅲ exposure. The differences on exposure grade classification varied obviously in the rabies clinics. The dog density was high and immunization rate was low in some surveillance areas. The viral antigens were detected in brain tissues of 13 suspected rabid dogs by using immunofluorescence test and RT-PCR. Conclusion The incidence of human rabies continued to decline in Shandong in 2010. Most rabies cases were reported in rural area. Dogs were still the major animal hosts. The main related factors on the incidence of human rabies included poor dog management, inadequate post-exposure prophylaxis and treatment (PEP/PET) and non standard and timely vaccination after exposure. It is necessary for health department to strengthen the training on PEP/PET after exposure and health education about rabies prevention. Close attention should be paid to suspected rabid dogs biting more than one person.