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目的分析宁波市2004-2008年狂犬病流行因素,探讨有效防制措施。方法通过对宁波市发生的所有狂犬病病例的流行病学个案调查和全市犬密度及犬免疫状况调查;收集全市110家狂犬病门诊(暴露人群监测点)的数据进行分析。结果2004-2008年全市共报告狂犬病病例52例,年平均发病率0.16/10万,病死率为100%;全市8个县(市、区)均有病例报告,以慈溪市发病最多(28例),占全市病例总数的53.85%;发病年龄最大80岁,最小3岁,儿童及青壮年发病较多;病例职业分布以农民(46.15%)为主,伤人动物全部为犬;伤口暴露部位以上肢(67.31%)为主,伤口暴露以Ⅲ度(76.92%)暴露为主,未进行伤口处理35例(67.31%),未接种疫苗42例(80.77%),10例接种疫苗者均未完成全程免疫。门诊暴露监测点显示暴露人群以农民为主;各月均有暴露者,以7-8月最多;最大年龄84岁,最小158d;暴露部位以上下肢为主(68.22%),暴露咬伤程度以Ⅲ度为主(83.05%);犬密度为42.39只/100户,犬的免疫率为9.62%。结论犬密度高,免疫率低,群众防病意识差,暴露后未进行规范的预防治疗,是宁波市人间狂犬病流行的主要因素。
Objective To analyze the epidemic factors of rabies from 2004 to 2008 in Ningbo and to explore the effective control measures. Methods The epidemiological investigation of all cases of rabies in Ningbo and the investigation of dog’s density and immunization status in the city were conducted. The data of 110 rabies clinics in the city (monitoring point of exposed population) were collected and analyzed. Results A total of 52 cases of rabies were reported in the city from 2004 to 2008, with an average annual incidence of 0.16 / 100 thousand and a case fatality rate of 100%. Eight cases in the eight counties (cities and districts) in the city were reported with the highest incidence in Cixi City (28 cases ), Accounting for 53.85% of the total number of cases in the city; the onset age was 80 years old, the youngest was 3 years old, the incidence was more in children and young adults; the occupational distribution of cases was dominated by peasants (46.15%), and all the wounding animals were dogs; (67.31%) were upper limbs, the exposure was mainly degree Ⅲ (76.92%), 35 cases (67.31%) were not treated with wounds, 42 cases were unvaccinated (80.77%), and none of the 10 vaccinated persons Complete the whole immune. The outpatient exposure monitoring points showed that the exposed population was dominated by peasants; the average exposure was in July and August, the maximum age was 84 years and the minimum was 158 days. The exposed parts were mostly lower limbs (68.22%). The extent of exposure to bites Ⅲ degree (83.05%); dog density was 42.39 / 100 households, the dog’s immune rate was 9.62%. Conclusions High dog density, low immunization rate, poor awareness of disease prevention and no standardized prevention and treatment after exposure are the main factors of rabies prevalence in Ningbo.