Groupe de recherche en épidémiologie des zoonoses et santé publique, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada.
Ecole de santé publique, Université de Montréal, Montréal, Quebec, Canada.
BMC Public Health. 2020 Apr 29;20(1):584. doi: 10.1186/s12889-020-08606-8.
In Nunavik, Arctic rabies is still endemic due to a spillover from wildlife to dogs. The prevention of human exposure and the management of potential exposure is a significant public health concern in this region.
This study retrospectively describes cases of potential exposure to rabies in humans as reported to the Nunavik Public Health Board through their registry of reported cases. We used multi-correspondence analysis as well as univariable and multivariable regression models to test for differences between children and adults in reported cases, and to examine the contexts of exposure to dogs and dog attacks.
From 2008 to 2017, 320 cases of potential exposure to rabies were reported, 92% of which were linked to dogs. The annual incidence rate was 2.5 per 1000 people. The incidence increased significantly during the study period, although the reasons for this are unclear. Fifteen cases of exposure were with rabid animals, mostly dogs (9 of 15). No human cases of rabies occurred thanks to adequate medical case management. Two specific profiles for potential exposure to rabies were identified based on age and gender. The first was children (< 15 y/o), male or female, who were more likely to be exposed through playing with dogs and were more often injured in the head and/or neck. The second was young male adults (aged 15 to 34 y/o), who were more involved with wildlife than other age groups and mostly injured in the upper limbs and as a result of a reaction by the animal.
Rabies is a real public health threat in Nunavik. Potential human exposure needs to be prevented, and prevention measures should be tailored to the two risk profiles identified based on age, gender and animal species involved.
由于野生动物向犬类溢出，努纳武特地区仍然存在北极地区狂犬病。预防人类接触和管理潜在暴露是该地区一个重大的公共卫生关注点。
本研究通过努纳武特公共卫生局的报告病例登记处，回顾性描述了向该机构报告的人类潜在暴露于狂犬病的病例。我们使用多元对应分析以及单变量和多变量回归模型，检验报告病例中儿童和成人之间的差异，并检查与犬类接触和犬类攻击的情况。
2008 年至 2017 年期间，报告了 320 例潜在的狂犬病暴露病例，其中 92%与犬类有关。年发病率为每 1000 人 2.5 例。尽管原因尚不清楚，但在此期间发病率显著增加。15 例暴露是与狂犬病动物接触，主要是犬类（15 例中有 9 例）。由于适当的医疗病例管理，没有发生人类狂犬病病例。根据年龄和性别确定了两种潜在的狂犬病暴露特定的特征。第一种是儿童（<15 岁），男性或女性，更有可能在与犬类玩耍时接触到，更可能在头部和/或颈部受伤。第二种是年轻男性成年人（15 至 34 岁），他们比其他年龄段更多地接触野生动物，而且大多数上肢受伤，是动物的反应所致。
狂犬病在努纳武特是一个真实的公共卫生威胁。需要预防潜在的人类暴露，并且预防措施应根据年龄、性别和涉及的动物种类，针对确定的两种风险特征进行调整。
