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巴西野生狂犬病的流行病学概况(2002 - 2012年)

Epidemiological Profile of Wild Rabies in Brazil (2002-2012).

作者信息

Rocha S M, de Oliveira S V, Heinemann M B, Gonçalves V S P

机构信息

Unidade Técnica de Vigilância de Zoonoses da Coordenação Geral de Doenças Transmissíveis, Departamento de Vigilância das Doenças Transmissíveis da Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasilia, Brasil.

EpiPlan, Faculdade de Agronomia e Medicina Veterinária, Universidade de Brasília, Brasilia, Brasil.

出版信息

Transbound Emerg Dis. 2017 Apr;64(2):624-633. doi: 10.1111/tbed.12428. Epub 2015 Oct 1.

Abstract

Rabies is one of the most important zoonosis in the world with high impact on public health. Studies report the presence of Lyssavirus in reservoirs of the wild cycle, highlighting the role of wild canines, marmosets, and vampire and non-vampire bats as potential vectors of the disease to domestic animals and human beings. Therefore, the reintroduction of rabies in urban environments from reservoirs of the wild cycle is a matter of concern. This study describes the profile of rabies cases documented in Brazil from 2002 to 2012, with emphasis on the wild transmission cycle of the disease. We carried out a descriptive study using records with information on the time of infection, persons with infection and location of confirmed cases of rabies in humans and animals, as well as data on anti-rabies treatments obtained from the Information System of Notifiable Diseases (Sinan) database. Within the study period, 82 cases of rabies transmitted by wild animals to humans were reported, predominantly in rural areas of the northern and north-eastern regions. Of the cases in humans, 72% did not receive post-exposure prophylaxis. Among wild mammals, vampire bats were the most frequent vectors of the disease. In the north-east region, 460 terrestrial wild mammals were reported with confirmed rabies. Over the study period, 1703 bats were reported to carry the rabies virus. In the south-east region, the most frequently reported carriers of the virus were non-vampire bats. The midwest and northern regions presented a lower number of records of rabies cases among terrestrial wild mammals. However, the high number of rabies cases among bovines reflects the role of the vampire bat as a maintainer of the rabies virus in the rural cycle. The present results are key to adjust the planning of rabies control in Brazil to the current epidemiological trends.

摘要

狂犬病是世界上最重要的人畜共患病之一,对公共卫生影响巨大。研究报告称,野生传播循环宿主中存在狂犬病病毒,强调了野生犬科动物、狨猴、吸血蝙蝠和非吸血蝙蝠作为该疾病向家畜和人类传播的潜在媒介的作用。因此,狂犬病从野生传播循环宿主重新引入城市环境是一个令人担忧的问题。本研究描述了2002年至2012年巴西记录的狂犬病病例概况,重点关注该疾病的野生传播循环。我们进行了一项描述性研究,使用了有关感染时间、感染者以及人类和动物狂犬病确诊病例地点的信息记录,以及从法定传染病信息系统(Sinan)数据库获得的狂犬病治疗数据。在研究期间,报告了82例野生动物传播给人类的狂犬病病例,主要发生在北部和东北部地区的农村。在人类病例中,72%未接受暴露后预防。在野生哺乳动物中,吸血蝙蝠是该疾病最常见的传播媒介。在东北地区,报告有460只陆生野生哺乳动物确诊感染狂犬病。在研究期间,报告有1703只蝙蝠携带狂犬病病毒。在东南部地区,报告的该病毒最常见携带者是非吸血蝙蝠。中西部和北部地区陆生野生哺乳动物狂犬病病例记录数量较少。然而,牛群中大量的狂犬病病例反映了吸血蝙蝠在农村传播循环中作为狂犬病病毒宿主的作用。目前的结果对于根据当前的流行病学趋势调整巴西狂犬病控制规划至关重要。

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