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目的通过了解北京市怀柔区2011—2014年狂犬病暴露人群流行病学特征及预防处置情况,为更有效地开展怀柔区人狂犬病防控工作提供依据。方法对怀柔区2011—2014年狂犬病免疫预防门诊上报的13 743例狂犬病暴露者个案登记资料进行描述流行病学分析。结果怀柔区2011—2014年每年狂犬病暴露例数年均3 436例。动物致伤5—8月达到高峰,男女性别比1.30∶1,40~59岁组、20~29岁组及0~9岁组为狂犬病暴露高发年龄段,农民、在职人员、学龄前儿童为狂犬病暴露高危人群,致伤部位以下肢为主,其次手部。就诊的暴露者以Ⅱ级暴露为主(73.63%),Ⅲ级暴露25.30%,Ⅲ级暴露中狂犬病免疫被动制剂使用率为49.73%。伤人动物中犬类占到91.65%,有主犬只伤人时1年内接种过狂犬疫苗的仅占24.19%。结论有效防控疫情,需针对重点人群,重点季节开展广泛的宣传动员。进一步规范狂犬病暴露预防处置工作,提高Ⅲ级暴露判定比例,提高Ⅲ级暴露者中狂犬病免疫被动制剂使用率。加强犬类管理,做好养犬登记,所有犬只均应进行强制性免疫。
Objective To understand the epidemiological characteristics and prevention and treatment of rabies exposure in Huairou District of Beijing from 2011 to 2014 so as to provide basis for more effective prevention and control of rabies in Huairou District. Methods Epidemiological analysis of 13 743 rabies exposure cases reported by the rabies immunization clinic in Huairou district from 2011 to 2014 was performed. Results In 2011-2014, annual average number of rabies cases in Huairou District was 3 436 cases. Animal injury peaked from May to August, male to female ratio of 1.30:1, 40 to 59 years old group, 20 to 29 years old group and 0 to 9 years old group were rabies-exposed age, peasant, working staff, preschool children Rabies exposed to high-risk groups, injured parts of the lower limbs, followed by the hand. Exposed to the treatment of Ⅱ level exposure (73.63%), Ⅲ grade exposure 25.30%, Ⅲ level exposure rabies immunization passive agent utilization rate was 49.73%. Dogs accounted for 91.65% of the animals in the wounding system, while in the case of the main dog, only 24.19% of rabies vaccines were inoculated within 1 year. Conclusion Effective prevention and control of the outbreak need to focus on the crowd, the key season to carry out a wide range of advocacy mobilization. Further standardize the prevention and treatment of rabies exposure to improve the grade Ⅲ exposure to determine the proportion of exposure to increase the level of rabies immunization passive agent utilization. Strengthen dog management, do dog registration, all dogs should be mandatory immunity.