| Objective(s):1)To understand the general situation of the distribution of rabies in our country,analyze the characteristics of rabies cases in National Surveillance Sites,such as exposure,post-exposure prophylactic(PEP)history,the incubation period,explore the factors affecting the incidence of rabies cases in China,and find the existing problems of rabies,so as to provide data support for achieving zero canine rabies deaths in 2030.2)To enrich the population data of rabies in China,to understand the molecular epidemiological features of rabies virus in Hunan Province with high incidence,and to improve the prevention and control effectiveness of rabies in Hunan Province.Methods:1)The time,region and population data of rabies in China from 2006 to 2018 were collected,as well as the case investigation data of rabies cases in National Surveillance Sites,to describe their demographic characteristics,exposure history,post-exposure prophylactic and incubation period.Single factor and multiple factor methods were used to analyze the influencing factors of wound treatment,vaccination and antiserum injection after exposure,and single factor analysis was used to analyze the influencing factors of incubation period.2)The samples of rabies cases in Hunan Province from 2012 to 2017 were tested,and the N gene of the positive samples was amplified and sequenced.3)The N gene and the whole gene sequence of all rabies epidemic strains in China were download from GenBank database,and the N gene database of rabies epidemic strains in China were constructed.4)Software such as ATGC,Clustal X,BioEdit and so on were used to splicing,collating and analyzing the N gene sequences of the-obtained positive samples from Hunan province,so as to construct the N gene germline generation tree.Results:1)The incidence of rabies in China is mostly concentrated in the central and southern regions.In recent years,the incidence of hunan province drops slowly and ranks the first in China.Rabies has a high incidence in summer and autumn all the year round,and the case is common in the 40-60 age group.2)A total of 1872 cases of rabies were included in National Surveillance Sites,mainly male and peasant cases,accounting for 69.02%and 71.31%respectively.The exposure mode was mainly bite,accounting for 79.65%.The injured animals were mainly domestic dogs and stray dogs,accounting for 43.83%and 21.39%,respectively.3)After exposure,8.69%of the cases were treated at a medical institution,10.79%were vaccinated,and only 4.68%were given anti-rabies serological injection.Men and people over the age of 55 are more likely to avoid treatment at a medical facility after exposure.4)The median incubation period was 73 days.Gender,exposure,wound management,vaccination and antiserum injection were the influencing factors of the incubation period.5)58 strains of rabies virus N gene sequence analysis,the evolution is given priority to with China Ⅰ type,54 strains for China Ⅰ type,4 strains for China Ⅱ type in Hunan Province from 2012 to 2017Conclusion(s):1)Dog management is inadequate.Rabies infection and transmission caused by domestic dogs and stray dogs account for a high proportion,so the management of domestic dogs and stray dogs should be strengthened.2)The post-exposure prophylactic rate of rabies is relatively low in China,and the post-exposure prophylactic rate is different in different groups.Therefore,the publicity and education of high-risk groups,especially men and farmers,should be strengthened to improve the post-exposure disposal rate.3)There is a certain proportion of "early death" in rabies cases.Therefore,training and management of post-exposure disposal should be strengthened to improve the professional level of doctors and reduce the failure rate after disposal.4)Rabies virus population mainly for the advantage of traditional China Ⅰ type in high incidence of Hunan Province,therefore,China Ⅰ type in the routine surveillance host at the same time,should also expand the detection rate,to prevent the spread of other species. |
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