| 周航,李昱,牟笛,殷文武,余宏杰.中国2012年狂犬病流行特征分析[J].Chinese journal of Epidemiology,2015,36(3):205-209 |
| 中国2012年狂犬病流行特征分析 |
| Analysis of epidemiological features of human rabies in China, 2012 |
| Received:November 14, 2014 |
| DOI：10.3760/cma.j.issn.0254-6450.2015.03.004 |
| KeyWord: 狂犬病 监测 流行特征 |
| English Key Word: Rabies Surveillance Epidemiological features |
| FundProject: |
| Author Name | Affiliation | E-mail | | Zhou Hang | Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Li Yu | Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Mu Di | Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Yin Wenwu | Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Yu Hongjie | Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China | yuhj@chinacdc.cn |
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| Abstract: |
| 目的 根据2012年全国狂犬病监测数据,分析我国狂犬病流行病学特征与趋势,探讨相应防治对策建议。方法 利用2012年“传染病疾病监测信息报告管理系统”和6省监测点监测上报的数据,进行回顾性描述分析。结果 2012年全国共27个省731个县(区)报告狂犬病1 425例,报告死亡1 361人,报告发病率为0.11/10万,报告死亡率为0.10/10万。报告发病率和死亡率分别较2011年下降26.0%和27.9%。我国狂犬病疫情仍主要分布在南方地区,其次为中东部地区,广西、广东、湖南、贵州和河南分别位居报告发病数的前五位,病例数占病例总数的49.6%。病例仍以农民、学生和散居儿童为主,分别占病例总数的70.9%、8.3%和5.8%。病例男女性别比为2.6:1。2012年共收集到294例狂犬病病例个案调查表,致伤动物仍以犬为主(92.1%),其次为猫(6.8%)。病例潜伏期M=70 d。62.4%的病例为上肢暴露,暴露后疫苗接种率仅为6.9%,Ⅲ级暴露者的被动免疫制剂注射率为2.9%。暴露预防处置门诊监测显示,伤人动物以犬为主(81.7%),7.0%的就诊者为Ⅰ级暴露,50.5%为Ⅱ级暴露,42.5%为Ⅲ级暴露。各监测点的暴露分级构成存在差异。结论 2012年我国狂犬病发病例数继续下降,但疫情波及县(区)数下降相对缓慢,并有向西部和北部地区扩散的趋势;病例多发于农村,儿童和老年人仍是风险较大人群,犬仍是狂犬病主要的宿主动物;病例暴露后伤口处理、疫苗和被动免疫制剂的使用率低是其发病的直接原因。 |
| English Abstract: |
| Objective To analyze epidemiological characteristics and trends of rabies and explore control and prevention measures based on the rabies surveillance data of 2012 in China. Methods Data of 2012 from China's infectious disease surveillance reporting and management system and sentinel surveillance systems in 6 provinces were used,for a retrospective analysis in descriptive epidemiological methods. Results 1 425 cases were reported in 731 counties of 27 provinces in 2012 and 1 361 deaths were reported due to rabies,with the rabies incidence rate and mortality rate of 0.11/100 000 and 0.10/100 000 respectively,decreasing by 26.0% and 27.9% respectively from 2011. Rabies epidemic was mainly found in southern regions,followed by middle and eastern regions in China. 49.6% of total rabies cases were found in Guangxi,Guangdong,Hunan,Guizhou,and Henan province,which were the top five provinces. The rabies cases were mainly peasants,students and scattered children,accounting for 70.9%,8.3% and 5.8% of total cases respectively. The male-female ratio in rabies cases was 2.6:1. In 2012,294 epidemiological questionnaires were collected,revealing that 92.1% of the exposure was caused by dogs and 6.8% by cats. The median of latent period was 70 days. 62.4% of the cases were exposed in upper limb,and only 6.9% of such cases were vaccinated after exposure while the proportion of passive immunity biological vaccination was 2.9% for cases with exposure of category Ⅲ. Surveillance data from PEP (post-exposure prophylaxis) clinics showed that 81.7% of the visitors were hurt by dogs and the exposure categories Ⅰ,Ⅱ and Ⅲ accounted for 7.0%,50.5% and 42.5% respectively. The proportion of of the exposure categories varied by PEP surveillance clinics. Conclusion Despite continuing decrease of rabies cases in China in 2012,the number of counties (districts) affected falled relatively slow,with a tendency of rabies spreading to the western and northern regions in China. There were more rabies cases in rural areas than urban ones,and children and elderly people constitute the high-risk population. Animal reservoir of rabies was still dogs as before. Poor PEP and insufficient use of vaccination and passive immunity preparations were main causes for onset of human rabies. |
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