CAJ | 학술논문

目的分析中国2013年狂犬病病例流行病学特征与趋势,探讨相应防治对策建议.方法利用2013年“传染病报告信息管理系统”和6省监测点监测上报的数据,进行回顾性描述分析.结果 2013年我国28个省共报告狂犬病1172例,较2012年下降17.75％.病例主要分布在南方地区,报告发病数居前5位的省份依次为广西(161例)、广东(140例)、贵州(84例)、湖南(83例)和河南(81例),占全国报告发病总数的46.84％.高发季节为夏秋季,病例以农民、学生和散居儿童为主.病例男女性别比为2.27∶1.40-64岁组报告病例最多,其次为0-14岁组.共收集到319例狂犬病病例个案调查表,致伤动物仍以犬为主(占93.83％),其次为猫(占5.48％).病例潜伏期中位数为67天.暴露程度以Ⅲ级暴露为主,占64.36％.暴露后疫苗接种率为11.86％,但疫苗全程接种率仅1.36％,Ⅲ级暴露者的被动免疫制剂注射率为5.91％.结论 2013年全国狂犬病疫情总体继续呈下降趋势,南方病例仍然多于北方,但北方地区疫情有上升和扩散的趋势.病例主要分布于农村地区,病例职业以农民、学生、散居儿童为主.病例的伤口自行处理与医疗机构处理率、疫苗接种率与被动免疫制剂注射率均很低.应加强狂犬病监测工作,以农村地区为重点,加强狂犬病暴露后预防处置宣传.
목적 분석중국2013년광견병병례류행병학특정여추세,탐토상응방치대책건의.방법 이용2013년“전염병보고신식관리계통”화6성감측점감측상보적수거,진행회고성묘술분석.결과 2013년아국28개성공보고광견병1172례,교2012년하강17.75％.병례주요분포재남방지구,보고발병수거전5위적성빈의차위엄서(161례)、엄동(140례)、귀주(84례)、호남(83례)화하남(81례),점전국보고발병총수적46.84％.고발계절위하추계,병례이농민、학생화산거인동위주.병례남녀성별비위2.27∶1.40-64세조보고병례최다,기차위0-14세조.공수집도319례광견병병례개안조사표,치상동물잉이견위주(점93.83％),기차위묘(점5.48％).병례잠복기중위수위67천.폭로정도이Ⅲ급폭로위주,점64.36％.폭로후역묘접충솔위11.86％,단역묘전정접충솔부1.36％,Ⅲ급폭로자적피동면역제제주사솔위5.91％.결론 2013년전국광견병역정총체계속정하강추세,남방병례잉연다우북방,단북방지구역정유상승화확산적추세.병례주요분포우농촌지구,병례직업이농민、학생、산거인동위주.병례적상구자행처리여의료궤구처리솔、역묘접충솔여피동면역제제주사솔균흔저.응가강광견병감측공작,이농촌지구위중점,가강광견병폭로후예방처치선전.
Objective To analyze epidemiological features and trend of rabies in China,and correspondingly discuss prevention and control strategies.Methods Based on the data from Chinese Infectious Disease Surveillance Reporting System and sentinel surveillance system in 6 provinces in 2013,we made a retrospective analysis using descriptive epidemiological methods.Results A total of 1172 cases were reported by 28 provinces which decreased by 17.75％ compared with those of 2012.Rabies mainly occurred in southern China,and the top five provinces of reported cases were Guangxi,Guangdong,Hunan,Guizhou,and Henan,which account for 46.84％ of total rabies cases.The rabies occurred commonly in summer and fall,and the cases were mainly composed of farmers,students and scattered children.The ratio of male to female was 2.27∶ 1.There were two peaks of case numbers in 0-14 age group and 40-64 age group.The 319 epidemiological questionnaires that were collected showed that 93.83％ of exposure was caused by dogs and 5.48％ by cats.The median of latent period was 67 days.64.36％ of cases with exposure of category Ⅲ,and 11.86％ of cases received vaccine after exposure.Only 1.36％ of cases received full immunization.5.91％ of cases with exposure of category Ⅲ received passive biological immunity.Conclusions Rabies cases continued to decrease in 2013,the cases of south still more than north,the reported provinces did not decrease,indicating a trend of increase in northern areas.Cases occurred commonly in rural areas,and were mainly farmers,students and scattered children.All of the proportions of voluntary and medical treatment,vaccination,passive biological immunity were low.It should continue to strengthen the national rabies surveillance.Attach great importance to the propaganda and education of rabies,focusing on rural areas,strengthen the propaganda education of treatment after rabies exposure.