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墨西哥人类狂犬病的新面貌:在消灭犬类狂犬病之后,下一步该做什么

The New Face of Human Rabies in Mexico, What's Next After Eradicating Rabies in Dogs.

机构信息

Laboratorio de Rabia, Departamento de Virología, Instituto de Diagnóstico y Referencia Epidemiológicos, Secretaría de Salud, Álvaro Obregón, Ciudad de México, México.

Unidad de Investigación en Inmunología, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Cuauhtémoc, Ciudad de México, México.

出版信息

Vector Borne Zoonotic Dis. 2022 Feb;22(2):69-75. doi: 10.1089/vbz.2021.0051.

DOI:10.1089/vbz.2021.0051
PMID:35175137
Abstract

In pre-Hispanic Mexico, dogs were not identified as an important source of rabies. We know from codexes and chronicles of the conquerors that at that time, rabies cases in humans and domestic animals were caused by local wildlife species such as bats. Canine-rabies virus variant seems to have arrived with Europeans. The first documented case of canine rabies in the Americas is found in Mexico in the (16th century). During Mexico's independence, cases were frequently reported. In the 19th century the first attempts to control human rabies were made through sanitary measures such as elimination of rabid dogs and applying postexposure vaccination. During the first half of the 20th century, the efficacy of canine vaccination to prevent human rabies was established. However, in Mexico, despite reports of numerous human cases (>70/year), canine vaccination did not have enough coverage. It was only during the 1990s that Mexico made a serious commitment to eliminate dog-transmitted human rabies. Since the beginning, vaccination campaigns have been free and massive. Coverage increased from 7,100,000 doses in 1990 to more than 18,000,000 since 2017. This culminated in the elimination of dog-mediated human rabies cases since 2006. Subsequently, the epidemiology of rabies had changed. Nowadays, it is wildlife species (mainly bats and skunks) that are the source of human rabies. As a mega-biodiverse country Mexico has numerous wildlife species with potential to transmit rabies virus. Thus it is paramount to remain vigilant with respect to canine vaccination campaigns and to promote rabies research in wildlife.

摘要

在西班牙征服前的墨西哥,狗并没有被认为是狂犬病的重要传染源。我们从征服者的抄本和编年史中得知,当时人类和家畜的狂犬病病例是由当地的野生动物物种(如蝙蝠)引起的。犬狂犬病病毒变异株似乎是随着欧洲人一起到来的。美洲有记录的首例犬狂犬病病例是在墨西哥(16 世纪)发现的。在墨西哥独立期间,经常有病例报告。19 世纪,人们首次通过卫生措施尝试控制人类狂犬病,例如消灭狂犬病犬和进行暴露后疫苗接种。20 世纪上半叶,犬接种疫苗预防人类狂犬病的功效得到了确立。然而,在墨西哥,尽管有大量的人类病例报告(每年>70 例),但犬接种疫苗的覆盖率仍然不足。直到 20 世纪 90 年代,墨西哥才认真致力于消除由犬传播的人类狂犬病。从一开始,疫苗接种活动就是免费的和大规模的。覆盖率从 1990 年的 710 万剂增加到 2017 年的 1800 多万剂。这最终导致自 2006 年以来消除了由犬传播的人类狂犬病病例。随后,狂犬病的流行病学发生了变化。如今,野生动物(主要是蝙蝠和臭鼬)是人类狂犬病的源头。作为一个拥有丰富生物多样性的国家,墨西哥有许多潜在的携带狂犬病病毒的野生动物物种。因此,必须保持警惕,继续开展犬类疫苗接种活动,并促进对野生动物的狂犬病研究。

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