摘要目的 分析2017年我国狂犬病的流行病学特征,掌握疫情变化规律,为防控策略的调整提供科学依据.方法 收集2017年“传染病疾病监测信息报告管理系统”和6个省份(湖南省、广西壮族自治区、安徽省、贵州省、江苏省和山东省)监测点以及国家统计局上报的数据资料,采用描述性流行病学方法对资料进行统计、分析.结果 2017年全国27个省份共报告狂犬病病例516例,报告死亡502例,报告发病率为0.037/10万,报告死亡率为0.036/10万.报告发病数和死亡数分别较2016年下降19.88％(128/644)和15.20％(90/592).我国狂犬病疫情分布仍以南部和中部地区为主,报告发病数居前5位的省份依次为湖南省(71例)、河南省(52例)、广西壮族自治区(41例)、安徽省(39例)和湖北省39例,占全国报告发病总数的46.90％ (242/516).高发季节为夏秋季,病例仍以农民、学生和散居儿童为主.病例男女性别比为2.46∶1(367∶149).各年龄段均有发病,中老年发病多于青少年.共收集186例狂犬病病例个案调查表,致伤动物仍以犬为主,占94.89％(167/176).暴露程度以Ⅲ级暴露为主,占68.86％ (115/167).暴露后疫苗接种率仅为6.02％(10/166).病例潜伏期中位数为72 d.结论 2017年我国狂犬病疫情持续下降,南方病例仍然高于北方,高发省份出现下降趋势,低发省份出现上浮波动.病例主要分布于农村地区,以男性和农民为主.病例暴露后伤口处置率、疫苗接种率和被动免疫制剂注射率低仍是发病的直接因素.应加强狂犬病的监测力度,以农村地区为重点,加大狂犬病暴露后预防处置的宣传力度,提高犬只免疫率.

abstractsObjective To understand epidemiological characteristics of human rabies in China in 2017 and provide evidence for the development of strategy of human rabies control and prevention.Methods The descriptive epidemiological analysis was conducted based on the epidemic data from Chinese Infectious Disease Surveillance Reporting System,sentinel surveillance system in 6 provinces (Hunan,Guangxi,Anhui,Guizhou,Jiangsu and Shandong) and National Bureau of Statistics in 2017.Results A total of 516 human rabies cases,including 502 deaths,were reported by 27 provinces in 2017 with the morbidity rate and mortality rate of 0.037/100 000 and 0.036/100 000,respectively.The case number and death number decreased by 19.88％ (128/644) and 15.20％ (90/592) respectively compared with 2016.Rabies epidemics were mainly found in southern and central areas.The first 5 provinces reporting high case numbers were Hunan (71 cases),Henan (52 cases),Guangxi (41 cases),Anhui (39 cases) and Hubei (39 cases),their cases accounted for 46.90％ (242/516) of the total reported cases in China.Rabies mainly occurred in summer and autumn,and the majority of patients were farmers,students and children outside child care settings.The male to female ratio of the cases was 2.46 ∶ 1 (367 ∶ 149).Cases was reported in all age groups,and more cases occurred in middle aged and old adults than in adolescents.Questionnaires survey was conducted for 186 cases,the results indicated that 94.89％ (167/176) of exposures were caused by dog bites.The exposure degree was mainly category Ⅲ,accounting for 68.86％ (115/167),and only 6.02％ (10/166) of cases were immunized after exposure.The median of latent period of these cases was 72 days.Conclusions By 2017,the human rabies incidence in China had declined consecutively for ten years,more cases were reported in southern area than in northern area.The case number showed downward trends in provinces with high incidences and fluctuant increase in provinces with low incidence.Rabies cases mainly occurred in rural areas,and most cases were men and farmers.Low rate of post exposure prophylaxis,low rates of vaccination and passive immunization product injection were main causes for the onset of human rabies.It is necessary to strengthen the surveillance for human rabies,especially in rural areas,health education about treatment after rabies exposure and expend the coverage of canine immunization.