Animal bite epidemiology and surveillance for rabies postexposure prophylaxis
Animal bite epidemiology and surveillance for rabies postexposure prophylaxis
复制标题
DOI：
10.2460/javma.2000.217.190
复制
发表时间：
2000-07-15
期刊：
影响因子：
--
通讯作者：
Miles, T
中科院分区：
文献类型：
--
作者：
Moore, DA;Sischo, WM;Miles, T
目的-了解动物咬伤和暴露的流行病学，评估动物暴露报告系统用于狂犬病暴露后预防（PEP）的监测，并确定减少PEP的机会。设计期患病率调查。研究人群-1995年宾夕法尼亚州居民。程序-1995年宾夕法尼亚州县卫生办公室动物咬伤报告的数据进行了总结。计算了州、县、不同年龄组和不同人口密度的动物咬伤发生率。动物物种，治疗，伤口的位置，和PEP的建议进行了评估exposs.Results-More的16,000动物相关的潜在狂犬病暴露在宾夕法尼亚州的67个县的65。发病率最高的是5岁以下儿童（324/10万）。在75%需要伤口治疗的受害者中，50%接受了抗菌药物治疗，29%接受了破伤风环治疗，19%的伤口缝合、入院或转诊接受整形手术，尽管75%的接触是狗，但接触猫的受害者接受PEP的可能性是其他受害者的6倍（相对危险度，6.1; 95%置信区间，5.1 - 7.4）。在556次PEP中，30%用于狗的暴露，44%用于猫，7%用于浣熊，4%用于蝙蝠，2.5%用于松鼠，2.1%用于土拨鼠，2%用于狐狸，8%用于其他物种。59%的养狗接种了最新的狂犬病疫苗，而养猫的这一比例为41%。结论-干预措施，例如狗咬伤预防教育、为宠物接种狂犬病疫苗、适当使用PEP以及减少野猫数量，应该在社区中建立、加强或更好地执行。
Objectives-To understand the epidemiology of animal bites and exposure, evaluate the animal exposure reporting system for surveillance of rabies postexposure prophylaxis (PEP), and identify opportunities to reduce PEP.Design-Period prevalence survey.Study Population-Pennsylvania residents in 1995.Procedure-Data from animal bite reports from Pennsylvania county health offices were summarized for 1995. Animal bite incidences for the state, counties, various age groups, and various population densities were calculated. Animal species, treatment, location of wounds, and PEP recommendations were evaluated for exposures.Results-More than 16,000 animal-related potential rabies exposures were reported from 65 of 67 counties in Pennsylvania. The highest incidence was in children less than 5 years old (324/100,000). Of the 75% of victims requiring wound treatment, 50% received antimicrobials, 29% received-a tetanus toroid, and 19% had wounds sutured, were admitted to hospitals, or were referred for plastic surgery, Although 75% of exposures were to dogs, victims exposed to cats were 6 times as likely to receive PEP (relative risk, 6.1; 95% confidence interval, 5.1 to 7.4). Thirty percent of 556 PEP were given for exposures to dogs, 44% for cats, 7% for raccoons, 4% for bats, 2.5% for squirrels, 2.1% for groundhogs, 2% for foxes, and 8% for exposures to other species. Fifty nine percent of owned dogs were up-to-date on rabies vaccinations compared with 41% of owned cats.Conclusion-Interventions, such as dog bite prevention education, vaccination of pets against rabies, appropriate use of PEP, and reduction of feral cat populations, should be instituted, enhanced, or better enforced in communities.