ABSTRACT
Objective To analyze the epidemic characteristics and causes of post-exposure immunization failure of rabies in Hubei Province from 2015 to 2021, and to provide evidence for the prevention and control of rabies in Hubei Province. Methods The investigation data of rabies cases in Hubei Province from 2015 to 2021 were collected, and descriptive epidemiological methods were used for data analysis. Results A total of 127 cases of rabies were reported in Hubei Province from 2015 to 2021, with an average annual incidence of 0.31/million, showing a downward trend. The male to female ratio was 1.70:1. Farmers accounted for 82.67% of the total cases, and the 50-79 years old group accounted for 75.59%. The incidence was mainly concentrated in Xiangyang, Shiyan, Yichang and Jingmen, accounting for 77.17%. Most of the cases were concentrated in summer and autumn. Exposure of grade Ⅱand Ⅲ accounted for 24.79% and 75.21%, respectively. Hands, lower limbs below knee, head, arms and lower limbs above knee accounted for 46.15%, 25.21%, 9.40%, 8.55% and 7.69% of the exposed parts, respectively. Dogs, cats and wild animals accounted for 95.73%, 3.42% and 0.85% of the exposed animals, respectively. Stray animals, domesticated animals, neighbors' animals and wild animals accounted for 41.88%, 37.61%, 19.66% and 0.85% of animal sources, respectively. Neither the neighbors’ animals nor domesticated animals were vaccinated against veterinary rabies virus. After exposure, 8.55% of patients went to medical institutions for standard treatment of wounds, 9.40% were vaccinated with human rabies vaccine, and 4.55% of patients with grade III exposure were injected with rabies virus immunoglobulin. The incubation period within 6 months, from 6 months to 1 year, and over 1 year accounted for 72.22%, 14.74%, and 12.04%, respectively. The exposure degree (Z=-1.98, P 2=10.91, P 2=15.73, P < 0.05) had statistically significant effects on the incubation period. Among the 11 cases of post-exposure immunization failure, all were grade Ⅲ exposure, 63.63% were exposed to the head and face, 81.81% were not fully vaccinated with human rabies virus vaccine, 63.63% were not immunized with immunoglobulin, and 27.27% were inappropriate wound treatment. Conclusion The key to rabies prevention and control is to standardize dog management, strengthen rabies education, standardize post-exposure wound treatment, timely vaccinate against rabies virus, and inject rabies virus immunoglobulin when necessary.
ABSTRACT
Objective To analyze the immunization failure factors of 18 exposed rabies.Methods A statistical analysis factors is based on processing the exposed local wounds, the application of anti-serum, vaccines, wound area, incubation period, and compared to immune cases. Results Eighteen people, exposed immunization failure cases, scattered in the rural area(town). Thire age distribution is in all age groups during 2~83 years old and sex ratio of the men and women is 1:0.8.The short incubation period(28 days) accountered for 77.8%(14/18);Among by 61.5% people was bitten in neck accounter for 91.7%(10/12);Nine cases went to the village and town hospital to deal with the wound ,but only one case used rabies virus serums. Vaccines made in China are rat kidney(five cases) and refined Vero(8 cases), at the sane time the other five types made in China were unkown. Conclusions The most effective way to reduce the incidence of short incubation period is to strengthen management and immunization of animals such as dog, and to apply exposed former immunization in the epidemic area. At the same time, the key to reduce exposed immunization failure is exposed dealing in right ways, the muscle injection with anti-virus serums or immune globulin, and application of vaccine.