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狂犬病风险:法属圭亚那两个偏远村庄聚集性蝙蝠咬伤病例管理过程中遇到的困难

Rabies Risk: Difficulties Encountered during Management of Grouped Cases of Bat Bites in 2 Isolated Villages in French Guiana.

作者信息

Berger Franck, Desplanches Noëlle, Baillargeaux Sylvie, Joubert Michel, Miller Manuelle, Ribadeau-Dumas Florence, Spiegel André, Bourhy Hervé

机构信息

Institut Pasteur de la Guyane, Cayenne, French Guiana.

出版信息

PLoS Negl Trop Dis. 2013 Jun 27;7(6):e2258. doi: 10.1371/journal.pntd.0002258. Print 2013 Jun.

Abstract

In French Guiana, from 1984 to 2011, 14 animal rabies cases and 1 human rabies case (2008) were diagnosed. In January 2011, vampire-bat attacks occurred in 2 isolated villages. In mid-January, a medical team from the Cayenne Centre for Anti-Rabies Treatment visited the sites to manage individuals potentially exposed to rabies and, in April, an anti-rabies vaccination campaign for dogs was conducted. Twenty individuals were bitten by bats in 1 month, most frequently on the feet. The median time to start management was 15 days. The complete Zagreb vaccination protocol (2 doses on day 0 and 1 dose on days 7 and 21) was administered to 16 patients, 12 also received specific immunoglobulins. The antibody titration was obtained for 12 patients (different from those who received immunoglobulins). The antibody titers were ≥0.5 EU/mL for all of them. The serology has not been implemented for the 12 patients who received immunoglobulins. Accidental destruction of a vampire-bat colony could be responsible for the attacks. The isolation and absence of sensitization of the populations were the main explanations for the management difficulties encountered. Sensitization programs should be conducted regularly.

摘要

在法属圭亚那,1984年至2011年期间,共诊断出14例动物狂犬病病例和1例人类狂犬病病例(2008年)。2011年1月,两个偏远村庄发生了吸血蝙蝠袭击事件。1月中旬,卡宴抗狂犬病治疗中心的一个医疗团队前往事发地点,对可能接触狂犬病的人员进行处理,并于4月开展了一次犬类抗狂犬病疫苗接种活动。一个月内有20人被蝙蝠咬伤,咬伤部位大多为足部。开始处理的中位时间为15天。16名患者接受了完整的萨格勒布疫苗接种方案(第0天接种2剂,第7天和第21天各接种1剂),其中12人还接受了特异性免疫球蛋白。对12名患者(与接受免疫球蛋白的患者不同)进行了抗体滴定。他们所有人的抗体滴度均≥0.5 EU/mL。对接受免疫球蛋白的12名患者未进行血清学检测。吸血蝙蝠群落的意外破坏可能是袭击事件的原因。人群的隔离和缺乏防范意识是遇到处理困难的主要原因。应定期开展防范意识宣传活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b6e/3694830/9a957ea04f29/pntd.0002258.g001.jpg

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