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狂犬病作为旅行者面临的一种风险,尤其是在高流行地区。

Rabies as a traveler's risk, especially in high-endemicity areas.

作者信息

Meslin François-Xavier

机构信息

Department of Communicable Diseases, World Health Organization, Switzerland.

出版信息

J Travel Med. 2005 Apr;12 Suppl 1:S30-40. doi: 10.2310/7060.2005.12055.

DOI:10.2310/7060.2005.12055
PMID:16225804
Abstract

Rabies is a viral zoonosis, an animal disease transmissible to humans, caused by rhabdoviruses of the genus Lyssavirus. It is almost invariably fatal in humans. Rabies is widely distributed throughout the world and present in all continents. More than 99.,9 % of human deaths from rabies reported worldwide result from the bite of a rabid dog. Prompt and thorough cleansing of the wound, together with administration of immunoglobulin in cases of severe exposure, and immunization with modern vaccines starting immediately after exposure, virtually guarantee complete protection. When assessing the risk of contracting the disease for a traveller visiting a rabies- affected area, to contract the disease one should consider the probability of: rabies exposure that which is directly related to the incidence of rabies in the area and the probability of contact with an infected rabies- susceptible animals, be it either wild or and domestic animals, especially dogs and cats; being provided with the best possible treatment, which depends upon the availability of modern safe and efficacious rabies vaccines and rabies immunoglobulin, and the rabies awareness of the health care providers in charge of rabies prophylaxis in the area where the exposure occurs. This article,paper using a number of examples and recent data on dog bite incidence and vaccine availability in various parts of the world, provides guidance on how to assess the risk and proposes means to avoid or mitigate this risk.

摘要

狂犬病是一种病毒性人畜共患病,是一种可传染给人类的动物疾病,由狂犬病毒属的弹状病毒引起。它在人类中几乎无一例外是致命的。狂犬病在世界各地广泛分布,各大洲均有出现。全球报告的人类狂犬病死亡病例中,超过99.9%是由疯狗咬伤所致。及时彻底清洗伤口,在严重暴露情况下注射免疫球蛋白,并在暴露后立即开始接种现代疫苗,几乎可以保证完全防护。在评估前往狂犬病疫区的旅行者感染该疾病的风险时,为了感染该疾病,应考虑以下概率:狂犬病暴露,这与该地区狂犬病的发病率直接相关,以及接触受感染的狂犬病易感动物的概率,无论是野生动物还是家畜,尤其是狗和猫;获得尽可能最佳的治疗,这取决于现代安全有效的狂犬病疫苗和狂犬病免疫球蛋白的可获得性,以及暴露发生地区负责狂犬病预防的医护人员的狂犬病防范意识。本文通过使用一些例子以及世界各地狗咬伤发生率和疫苗可获得性的最新数据,提供了如何评估风险的指导,并提出了避免或降低这种风险的方法。

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