周航, 满腾飞, 李群, 殷文武. 2009年中国狂犬病监测分析[J]. 疾病监测, 2010, 25(12): 934-937,957. DOI: 10.3784/j.issn.1003-9961.2010.12.003
引用本文: 周航, 满腾飞, 李群, 殷文武. 2009年中国狂犬病监测分析[J]. 疾病监测, 2010, 25(12): 934-937,957. DOI: 10.3784/j.issn.1003-9961.2010.12.003
ZHOU Hang, MAN Teng-fei, LI Qun, YIN Wen-wu. Surveillance of human rabies in China, 2009[J]. Disease Surveillance, 2010, 25(12): 934-937,957. DOI: 10.3784/j.issn.1003-9961.2010.12.003
Citation: ZHOU Hang, MAN Teng-fei, LI Qun, YIN Wen-wu. Surveillance of human rabies in China, 2009[J]. Disease Surveillance, 2010, 25(12): 934-937,957. DOI: 10.3784/j.issn.1003-9961.2010.12.003

2009年中国狂犬病监测分析

Surveillance of human rabies in China, 2009

  • 摘要: 目的 根据2009年全国狂犬病监测数据,分析中国狂犬病流行病学特征与趋势,探讨相应的对策建议。 方法 利用2009年传染病疾病监测信息报告管理系统和6省上报的哨点监测数据,进行回顾性描述分析。 结果 2009年全国24个省份的892个县(区)报告发病数2213例,报告死亡2131例。报告发病数和死亡数较2008年分别下降10.3%和10.2%。中国狂犬病疫情仍主要分布在南方地区,其次为中东部地区,报告发病数较多的省份为广东、广西、贵州、湖南和河北省(自治区),报告病例数占全国病例总数的56.6%。病例仍以农民、学生和散居儿童为主,分别占病例总数的69.3%、10.6%和7.4%。病例男女性别比为2.34 ∶ 1。儿童和老年人的发病率较高。监测点报告的539例病例中,病例的致伤动物仍以犬为主,占87.9%;其次为猫,占5.8%。潜伏期在半年内的居多,占总病例的75.2%。病例暴露后疫苗注射率为15.2%(62/408),其中,Ⅲ级暴露者的被动免疫制剂注射率为6.3%(21/334)。监测点暴露预防处置门诊的疫苗接种率均达到99%以上,伤人动物以犬为主,占84.0%;其次是猫,占10.5%。各省份监测门诊合计的就诊者伤口自行处理率较低,Ⅲ级暴露者的抗狂犬病血清/人免疫球蛋白注射率均不高。各监测点监测门诊的暴露分级构成差异依然存在,这可能与各地就诊者暴露特点不同有关,也提示各监测门诊的分级标准不统一。 结论 2009年狂犬病疫情继续下降,但疫情县(区)数占所有县(区)总数的比例在有所升高,并有向西部和北部扩散的趋势。病例多发于农村,儿童和老年人仍是风险较大的人群,犬和猫仍是中国狂犬病主要的宿主动物。病例中的暴露后伤口处理、疫苗和被动免疫制剂的使用情况都极差,成为患者发病的直接原因。狂犬病的防控,需多部门联防联控,卫生部门应做好健康教育和暴露预防处置等工作。

     

    Abstract: 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.

     

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