Paez Andrés, Polo Luis, Heredia Damaris, Nuñez Constanza, Rodriguez Milena, Agudelo Carlos, Parra Edgar, Paredes Andrea, Moreno Teresa, Rey Gloria
Laboratorio de Virología, Laboratorio de Patología, Subdirección de Vigilancia y Control en Salud Pública, Instituto Nacional de Salud, Bogotá, Colombia.
Rev Salud Publica (Bogota). 2009 Dec;11(6):931-43. doi: 10.1590/s0124-00642009000600009.
A sylvatic rabies outbreak during March 2008 caused two human deaths in the town of Santander de Quilichao in Cauca, Colombia. This article describes the diagnostic laboratory techniques used, the field investigation and focus control used, as well as this outbreak's epidemiological significance and implications for public health.
Rabies was diagnosed by direct immunofluorescence, biological tests involving inoculating mice, histopathology and immunohistochemistry and then typed by using monoclonal antibodies. Field investigation focused on searching for human and animal contacts, identifying suspicious cases and conducting an institutional search for rabid accidents. Focus control consisted of post-exposure treatment of the exposed population, vaccinating dogs and cats, collecting and eliminating stray animals and educating the community.
Two human rabies cases were confirmed in the laboratory and another was inferred in a cat by epidemiological nexus. Antigenic variant 3 was isolated from the human cases. 11,369 dogs, 3,325 cats and 217 humans were vaccinated.
This study confirmed that rabies in the wild represents a threat for humans. The outbreak described here originated in vampire bats and was transmitted to humans by a cat, pointing out the nexus between wild rabies and the urban ecosystem which cats represent, thereby becoming a target for rabies' control and prevention activities. This study underlines the urgency of implementing and maintaining rabies control and prevention activities in the wild to minimise its impact on humans.
2008年3月,哥伦比亚考卡省圣安东尼奥 - 德基利乔镇爆发的野生动物狂犬病疫情导致两人死亡。本文介绍了所采用的诊断实验室技术、现场调查和疫源地控制措施,以及此次疫情的流行病学意义和对公共卫生的影响。
通过直接免疫荧光法、接种小鼠的生物学试验、组织病理学和免疫组织化学方法诊断狂犬病,然后使用单克隆抗体进行分型。现场调查重点是寻找人与动物的接触情况、识别可疑病例并对狂犬病发病事故进行机构性搜索。疫源地控制包括对暴露人群进行暴露后治疗、给狗和猫接种疫苗、收集和清除流浪动物以及对社区进行教育。
实验室确诊两例人间狂犬病病例,通过流行病学关联推断另有一例发生在猫身上。从人间病例中分离出抗原变异体3型。为11369只狗、3325只猫和217人接种了疫苗。
本研究证实野生动物狂犬病对人类构成威胁。此处描述的疫情起源于吸血蝙蝠,并通过猫传播给人类,指出了野生动物狂犬病与猫所代表的城市生态系统之间的联系,因此猫成为狂犬病防控活动的目标。本研究强调了在野生动物中实施和维持狂犬病防控活动以尽量减少其对人类影响的紧迫性。