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[2012年中国人间狂犬病流行病学特征分析]

[Analysis of epidemiological features of human rabies in China, 2012].

作者信息

Zhou Hang, Li Yu, Mu Di, Yin Wenwu, Yu Hongjie

机构信息

Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China; Email:

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2015 Mar;36(3):205-9.

Abstract

OBJECTIVE

To analyze epidemiological characteristics and trends of rabies and explore control and prevention measures based on the rabies surveillance data of 2012 in China.

METHODS

Data of 2012 from China's infectious disease surveillance reporting and management system and sentinel surveillance systems in 6 provinces were used, for a retrospective analysis in descriptive epidemiological methods.

RESULTS

1 425 cases were reported in 731 counties of 27 provinces in 2012 and 1 361 deaths were reported due to rabies, with the rabies incidence rate and mortality rate of 0.11/100 000 and 0.10/100 000 respectively, decreasing by 26.0% and 27.9% respectively from 2011. Rabies epidemic was mainly found in southern regions, followed by middle and eastern regions in China. 49.6% of total rabies cases were found in Guangxi, Guangdong, Hunan, Guizhou, and Henan province, which were the top five provinces. The rabies cases were mainly peasants, students and scattered children, accounting for 70.9%, 8.3% and 5.8% of total cases respectively. The male-female ratio in rabies cases was 2.6 : 1. In 2012, 294 epidemiological questionnaires were collected, revealing that 92.1% of the exposure was caused by dogs and 6.8% by cats. The median of latent period was 70 days. 62.4% of the cases were exposed in upper limb, and only 6.9% of such cases were vaccinated after exposure while the proportion of passive immunity biological vaccination was 2.9% for cases with exposure of category III. Surveillance data from PEP (post-exposure prophylaxis) clinics showed that 81.7% of the visitors were hurt by dogs and the exposure categories I, II and III accounted for 7.0%, 50.5% and 42.5% respectively. The proportion of of the exposure categories varied by PEP surveillance clinics.

CONCLUSION

Despite continuing decrease of rabies cases in China in 2012, the number of counties (districts) affected fall relatively slow, with a tendency of rabies spreading to the western and northern regions in China. There were more rabies cases in rural areas than urban ones, and children and elderly people constitute the high-risk population. Animal reservoir of rabies was still dogs as before. Poor PEP and insufficient use of vaccination and passive immunity preparations were main causes for onset of human rabies.

摘要

目的

基于2012年中国狂犬病监测数据,分析狂犬病的流行病学特征及流行趋势,探索防控措施。

方法

利用中国传染病监测报告与管理系统2012年的数据以及6个省份的哨点监测系统数据,采用描述性流行病学方法进行回顾性分析。

结果

2012年,27个省份的731个县共报告1425例狂犬病病例,报告死亡1361例,发病率和死亡率分别为0.11/10万和0.10/10万,较2011年分别下降26.0%和27.9%。狂犬病疫情主要集中在南方地区,其次是中部和东部地区。广西、广东、湖南、贵州和河南5省报告病例数占全国总病例数的49.6%,位列前5。狂犬病病例主要为农民、学生和散居儿童,分别占总病例数的70.9%、8.3%和5.8%。狂犬病病例男女比例为2.6∶1。2012年共收集294份流行病学调查问卷,结果显示暴露于犬类的占92.1%,暴露于猫类的占6.8%。潜伏期中位数为70天。62.4%的病例上肢暴露,其中仅6.9%的此类病例暴露后接种了疫苗,Ⅲ级暴露者中被动免疫生物制品接种比例为2.9%。暴露后预防(PEP)门诊监测数据显示,81.7%的就诊者被犬致伤,Ⅰ、Ⅱ、Ⅲ级暴露分别占7.0%、50.5%和42.5%。不同PEP监测门诊的暴露分级比例有所不同。

结论

2012年中国狂犬病病例数虽持续下降,但受影响的县(区)数量下降相对缓慢,且有向西部和北部地区蔓延的趋势。农村地区狂犬病病例多于城市,儿童和老年人为高危人群。狂犬病的动物宿主仍然主要是犬类。暴露后预防措施不力、疫苗及被动免疫制剂使用不足是导致人狂犬病发病的主要原因。

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