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目的通过一起产妇狂犬病死亡案例流行病学调查,探讨疫情发生原因,为更好防治狂犬病提供客观依据。方法查阅病案资料,采用现场流行病学调查方法对平顶山市2013年网络直报的一起狂犬病案例进行调查。分析案例暴露后处理情况及发病临床表现及发病因素。结果该产妇在孕期4个月时被家犬咬伤脚部,暴露后属高危人群,伤口没有规范处理,没有接种狂犬疫苗和抗狂犬血清,伤后潜伏期为5个月,在分娩时发病,通过剖腹产下婴儿。经对密切接触者及新生儿接种狂犬疫苗和抗狂犬血清后,观察密切接触者至今无人发病。结论胎盘对狂犬病毒具有屏障保护作用。建议加强农村居民狂犬病防控知识健康教育,政府应将狂犬疫苗和血清免疫纳入医保或农合。确保暴露人群及时得到保护,是预防狂犬病发病的根本措施。
Objective To investigate the epidemiological investigation of rabies by maternal epidemiology and provide an objective basis for better prevention and control of rabies. Methods Investigate the medical record data and investigate the case of a rabies case of Pingdingshan in 2013 online direct report by means of field epidemiological survey. Case analysis of post-exposure treatment and clinical manifestations and incidence of factors. Results The pregnant woman was bitten by domestic dogs at 4 months of pregnancy. After exposure, her pregnant women were at high risk. The wounds were not regulated and rabies vaccine and anti-rabies serum were not vaccinated. The incubation period was 5 months, Cesarean birth. After close contacts and newborns were vaccinated rabies vaccine and anti-rabies serum, the observed close contacts so far no one disease. Conclusion The placenta has barrier protection against rabies virus. Proposed to strengthen the knowledge and training of rabies prevention and control of rural residents, the government should include rabies vaccine and serum immunization into health insurance or rural cooperative. Ensuring the timely protection of exposed populations is a fundamental measure to prevent the onset of rabies.