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江苏省盐城市1999-2008年狂犬病流行病学研究

An epidemiological investigation of the rabies between 1999-2008 in Yancheng city,Jiangsu province

摘要:

目的 分析盐城市狂犬病的流行病学特征.方法 收集狂犬病疫情资料,开展犬密度、犬免疫率、犬伤人率及狂犬病处置门诊工作调查;检测犬脑中狂犬病毒并进行相关分子生物学研究.结果 1999-2008年盐城市共报告135例人狂犬病,形成自1958年以来的第二次流行高峰,其中2003年报告40例狂犬病.135例患者中114例为农民.监测点调查发现盐城市犬密度为每100人中约豢养犬3~6只,每年平均100只犬伤人6.37人次,2008年犬的免疫率只有20%,暴露人群狂犬病疫苗接种率为77%.狂犬病处置门诊中抗狂犬病血清(球蛋白)的使用率仅为5%~10%.在采集108份犬脑标本中,4份狂犬病毒阳性,扩增、测序并分析病毒的N和G基因显示,这些病毒为基因Ⅰ型狂犬病毒,与目前使用的狂犬疫苗株CTN同源性最高.结论 盐城市人间狂犬病的持续流行与当地犬的饲养量大、免疫率低以及农村地区群众受动物伤害后的处理不及时规范及处理率低密切相关.

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abstracts:

Objective To better understand the epidemiology of rabies during the past ten years in Yancheng city,Jiangsu province. Methods Data was collected and analyzed on rabies cases in Yancheng. Density and vaccination rate on Canine,Rate of injured people bit by dogs,and the information of post-exposure prophylaxis were studied. Rabies virus in the dog brains,collected around the epidemic areas of Yancheng,were detected and analyzed. Results A total of 135 human rabies cases occurred from 1999 through 2008,and formed the second epidemic peak since 1958. Of these victims,84% (114) were farmers. In general,the rate of people having dogs were 3%-6% per 100 people,and the injured person-times of 100 dogs were 6.37 per year. Notably,the vaccination rate of dogs was only 20%. Of those people injured by dogs and other animals,77% had received post-exposure treatment,and only 5%-10% had been administered anti-rabies serum. Rabies virus antigen was found in 4 (3.6%) of 111 brain specimens among dogs collected from epidemic areas. Genetic analysis of N and G genes,which were amplified from brain specimens,indicated that these viruses belong to genotype Ⅰ rabies and expressing a close relationship with the Chinese vaccine strain CTN. Conclusion The large number of dogs with low vaccination rate among them,together with the incorrect and low post-exposure treatment in rural areas seemed to be responsible for the outbreak of rabies in Yancheng city.

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