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目的通过对2009年浙江省金华市狂犬病门诊暴露人群监测结果进行分析,为狂犬病暴露后的正确处置及控制狂犬病的流行提供参考。方法通过在全市犬伤门诊建立的狂犬病暴露人群监测系统,收集首次就诊人群的暴露和处置信息,采用描述性流行病学方法对收集的资料进行分析。结果 2009年金华市共计报告狂犬病暴露病例54 942例,暴露率为1080.37/10万。病例的时间分布呈现“春末上升,夏季高峰,秋季回落”的特点,病例以青壮年为主,20～59岁病例占总数的59.57%,病例职业以农民为最多,占总数的57.56%。伤人动物最多的为犬,占91.17%;其次为猫,占4.87%。暴露程度Ⅰ级17.96%、Ⅱ级71.24%、Ⅲ级10.81%,受伤部位以小腿为最多,占总数的40.89%。就诊人群狂犬疫苗全程接种率为99.85%,Ⅲ级暴露被动免疫制剂接种率为26.56%。结论近年来金华市的狂犬病疫情呈上升趋势。加强行政领导,规范犬只管理,切实落实“管、免、灭”的措施;加强宣传教育;将疫苗和被动免疫制剂纳入农村医保,降低经济负担等是今后防制工作的重点。
OBJECTIVE: To analyze the surveillance results of outpatients exposed to rabies in Jinhua City, Zhejiang Province in 2009 so as to provide reference for proper treatment after rabies exposure and control of rabies epidemic. Methods A surveillance system of rabies exposure in the city’s dog clinic was set up to collect information on the exposure and treatment of the first-time visiting population and the descriptive epidemiological method was used to analyze the data collected. Results In 2009, a total of 54 942 cases of rabies exposure were reported in Jinhua City, with an exposure rate of 1080.37 / 100,000. The time distribution of the cases showed the characteristics of “rising in late spring, peak in summer and falling back in autumn”. The cases were mainly young and middle-aged, accounting for 59.57% of the total cases in the age range of 20 ~ 59 years. Cases occupations accounted for the largest number of peasants, accounting for 57.56 %. Dogs with the most wounding animals accounted for 91.17%, followed by cats accounting for 4.87%. Grade I was 17.96%, grade II was 71.24%, grade III was 10.81%. The most affected area was the calf, accounting for 40.89% of the total. The vaccination rate of rabies vaccine in the treatment group was 99.85%, and the immunization rate of passive immunization in class Ⅲ was 26.56%. Conclusion The epidemic rate of rabies in Jinhua City has been on the rise in recent years. Strengthen the administrative leadership, standardize dog management, and effectively implement “control, avoid, destroy ” measures; strengthen publicity and education; the vaccine and passive immune agents into the rural medical insurance, reduce the economic burden is the focus of prevention and control work in the future.