Objective Analysis of the characteristics of grade Ⅲ exposure cases in rabies clinic in Jiaxing city, to understand the decision of immunoglobulin injection and knowledge of prevention and control of rabies, and to provide baseline data for the prevention and control of rabies. Methods Individual of grade Ⅲ rabies exposure cases were collected at the clinics affiliated to Jiaxing Center for Disease Control and Prevention(CDC) to establish the rabies surveillance database. Besides, from 2015 June to December, 437 grade Ⅲ rabies exposure cases from the clinics were investigated about their immunoglobulin injection and knowledge of prevention and treatment. Logistic regression is used to deal with the data, and R language is used to achieve statistical analysis. Results A total of 22 327 grade Ⅲ rabies exposure cases were treated at clinic during 2011-2016.The grade Ⅲ rabies exposure mainly occurred in people aged >20 years old,accounting for 21.26%. Local farmers accounted for 31.52%. The peak of rabies exposure was during July to August, and 77.35% of the grade Ⅲ exposure cases were caused by dog biting. 3.55% of the cases were exposed by the head and face, and the 0-old group accounted for 46.85%. Up to 74.72% of grade Ⅲ exposures were treated within 24 h. The combined injection of rabies immunoglobulin accounted for 32.24% of the total number of injections at grade Ⅲ exposure cases. In the survey of 437 cases with grade Ⅲ exposure, 53.88% chose to inject combined rabies immunoglobulin. The injection rate was related to body weight, rabies vaccine experience within 3 years and the exposure site (P=0.020, 0.016, 0.020, respectively). Only 11.44% had a clear picture as for "Why should I need rabies immunoglobulin injection?". Conclusion Grade Ⅲ rabies exposures increase every year in Jiaxing city.It is necessary to strengthen the management and immunization of dogs, especially in rural areas. And it is needed to improve the knowledge of public rabies prevention and controlfocusing on the young age children, the elderly and other high-risk groups. After exposure to rabies, it is necessary to treat the wound in time and inoculate the rabies vaccine. Rabies immunoglobulin should be used correctly for grade Ⅲ exposure.
MAO Rong, JIN An-bao, GU Wei-ling
. Analysis on characteristics and influence factors of prevention and treatment of grade Ⅲ rabies exposure population at rabies clinic of Jiaxing Zhejiang during 2011-2016[J]. Chinese Journal of Vector Biology and Control, 2018
, 29(4)
: 373
-378
.
DOI: 10.11853/j.issn.1003.8280.2018.04.014
[1] 周航,李昱,陈瑞丰,等.狂犬病预防控制技术指南(2016版)[J].中华流行病学杂志,2016,37(2):139-162.
[2] 扈荣良.狂犬病理论、技术与防治[M].北京:科学出版社, 2007:1-377.
[3] 中华人民共和国国家卫生和计划生育委员会.狂犬病暴露预防处置工作规范(2009年版)[EB/OL].(2009-12-17)[2018-01-11].http://www.nhfpc.gov.cn/zwgkzt/wsbysj/200912/45090.shtml.
[4] 中国疾病预防控制中心.狂犬病暴露预防处置操作指南(2007)[EB/OL].(2017-12-26)[2018-01-11].http://www.chinacdc.cn/n272442/n272530/n3479265/n3479308/21441.html.
[5] Hampson K,Coudeville L,Lembo T,et al.Estimating the global burden of endemic canine rabies[J].PLoS Negl Trop Dis, 2015,9(4):e0003709.DOI:10.1371/journal.pntd.0003709.
[6] Knobel DL,Cleaveland S,Coleman PG,et al.Re-evaluating the burden of rabies in Africa and Asia[J].Bull World Health Organ,2005,83(5):360-368.
[7] 张翔,王辉,阴秀峰.浙江省兰溪市22993例狂犬病暴露者的流行病学特征[J].国际流行病学传染病学杂志,2014,41(1):38-40.DOI:10.3760/cma.j.issn.1673-4149.2014.01.009.
[8] 张煌辉,刘宏伟.2011-2015年广东省珠海市斗门区17066例狂犬病暴露者流行病学特征分析[J].医学动物防制, 2017,33(6):596-599.
[9] 隋庆梅,林少倩,许华茹,等.济南市2007-2013年狂犬病暴露人群监测分析[J].中国公共卫生管理,2016,32(1):90-91.DOI:10.19568/j.cnki.23-1318.2016.01.030.
[10] 周冰,彭素标.北京市门头沟区2010-2013年狂犬病监测结果分析[J].中国媒介生物学及控制杂志,2015,26(3):299-302.DOI:10.11853/j.issn.1003.4692.2015.03.020.
[11] 黄海洪,曾世培,覃宁,等.1782例狂犬病暴露人群流行病学特征及处置情况分析[J].中国公共卫生管理,2017,33(3):354-356.DOI:10.19568/j.cnki.23-1318.2017.03.020.
[12] 邱波,梁纪伟,辛化雷,等.青岛市2009-2013年狂犬病暴露处置监测分析[J].中国媒介生物学及控制杂志,2014,25(6):563-565.DOI:10.11853/j.issn.1003.4692.2014.06.021.
[13] 扈荣良,张守峰,刘晔.我国狂犬病预防和控制建议[J].中国人兽共患病学报,2012,28(5):487-491.DOI:10.3969/j.issn.1002-2694.2012.05.020.
[14] 林君芬,孙继民,柴程良.浙江省犬伤门诊服务现况与规范化探讨[J].中国媒介生物学及控制杂志,2010,21(2):166-168.
[15] 王玮,林君芬,柴程良,等.浙江省2011年犬伤门诊规范化建设现况调查分析[J].中国媒介生物学及控制杂志,2013,24(6):531-534.DOI:10.11853/j.issn.1003.4692.2013.06.016.
[16] 刘淑清,陶晓燕,于鹏程,等.中国2015年狂犬病流行特征分析[J].中华实验和临床病毒学杂志,2016,30(6):537-540.DOI:10.3760/cma.j.issn.1003-9279.2016.06.009.
[17] 闻栋.湖州市狂犬病暴露人群流行特征与暴露预防处置现状分析[J].中国高等医学教育,2015(5):129,139.DOI:10.3969/j.issn.1002-1701.2015.05.068.
