“攻击性”在犬类狂犬病监测和临床诊断中的作用与价值评估
章域震,杨卫红,张海林,冯云,潘虹,杨丽芬,王娟,张云智
云南省地方病防治所,大理 671000
Role of aggression as a typical sign of canine rabies in clinical diagnosis and in surveillance or monitoring of rabies-suspected dogs
ZHANG Yu-zhen, YANG Wei-hong, ZHANG Hai-lin, FENG Yun,PAN Hong, YANG Li-fen, WANG Juan, ZHANG Yun-zhi
Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
摘要 目的 评估“攻击性”作为犬类狂犬病典型症状在监测和临床诊断中的作用与意义。方法 2011-2017年,从云南省收集到可疑狂犬病犬脑组织标本239份,使用DFA检验。将攻击性定义为咬人和动物总数≥2,并按可疑犬咬人和动物数,将可疑病犬分为“0”,“1”,“2”,“3”和“≥4”共5类。结果 239只可疑犬,总阳性率为64.02%;当咬人和动物数=0,1,2,3和≥4时,可疑犬阳性率分别为21.57%、61.76%、73.34%、77.50%和88.37%。当咬人和动物数≥2时,阳性率为78.57%。统计学分析显示:“1”类可疑犬阳性率与“2”和“3”类无统计学差异。结论 本研究结果支持WHO关于“攻击性”定义示例说明(咬两人或更多人或者动物和/或无生命物体),并为犬伤风险评估提供了参考数据。本研究建议未来犬类狂犬病监测项目的策划者和实施者在采用WHO目前关于“攻击性”的定义时,并关注咬人或动物数=1的可疑犬,如肇事犬死亡或逃逸,应深入调查其是否有吞食或咬或攻击异物(如石头、木块、移动车辆等)等异常行为。
关键词 :
狂犬病 ,
攻击性 ,
疑似病犬 ,
监测 ,
临床诊断
Abstract :This study aims to evaluate the role of aggressive dogs in surveillance or monitoring of rabies-suspected dogs. During 2011-2017, 239 brain tissue samples of rabies-suspected dogs were collected in Yunnan Province and examined by direct immunofluorescence assay (DFA). Aggressive dogs were defined as those that had bitten two or more people or/and animals. According to the number of the subjects each of the rabies-suspected dogs had inflicted, the implicated dogs were divided into 5 cohorts, i.e. 0, 1, 2, 3 and ≥4. The positive rates for these cohorts were 21.57%, 61.76%, 73.34%, 77.50% and 88.37%, respectively. For the dogs with aggression as defined in this study, positive rate was 78.57%. However, statistical analysis showed that there was no significant difference between the cohort 1 and 2 or 3. This study supports the exemplificative definition of aggression by WHO, that is, to classify the dogs biting two or more people or animals and/or inanimate objects as “suspected case”. This study provided quantified data for risk assessment of patients bitten by dogs. For the planners and implementers of canine rabies surveillance or monitoring, especially in China.
Key words :
rabies
aggression
rabies-suspected dogs
canine rabies surveillance
clinical signs
收稿日期: 2019-01-03
基金资助: 徐建国院士工作站(No.2018IC155)
通讯作者:
杨卫红,Email: yangwh0604@163.com; ORCID: 0000-0003-2348-7504
引用本文:
章域震, 杨卫红, 张海林, 冯云, 潘虹, 杨丽芬, 王娟, 张云智. “攻击性”在犬类狂犬病监测和临床诊断中的作用与价值评估[J]. 中国人兽共患病学报, 2019, 35(8): 774-778.
ZHANG Yu-zhen, YANG Wei-hong, ZHANG Hai-lin, FENG Yun,PAN Hong, YANG Li-fen, WANG Juan, ZHANG Yun-zhi. Role of aggression as a typical sign of canine rabies in clinical diagnosis and in surveillance or monitoring of rabies-suspected dogs. Chinese Journal of Zoonoses, 2019, 35(8): 774-778.
链接本文:
http://www.rsghb.cn/CN/10.3969/j.issn.1002-2694.2019.00.143 或 http://www.rsghb.cn/CN/Y2019/V35/I8/774
[1] Thiptara A, Atwill ER, Kongkaew W, et al. Epidemiologic trends of rabies in domestic animals in Southern Thailand, 1994-2008[J]. Am J Trop Med Hyg, 2011, 85(1): 138-145. DOI: 10.4269/ajtmh.2011.10-0535 [2] Tepsumethanon V, Wilde H, Meslin FX. Six criteria for rabies diagnosis in living dogs[J]. J Med Assoc Thai, 2005, 88(3): 419-422. [3] Tepsumethanon V, Lumlertdacha B, Mitmoonpitak C, et al. Survival of naturally infected rabid dogs and cats[J]. Clin Infect Dis, 2004, 39: 278-280. DOI: 10.1086/421556 [4] Jackson AC, Wunner WH. Rabies[M]. London: Elsevier, 2001. [5] 胡秋凌, 胡海梅, 章域震, 等. 楚雄州一犬伤多人事件监测系统分析[J]. 医学动物防制, 2016, 32(9): 1005-1007. [6] 任江萍, 王玮, 王欣莹, 等. 浙江省2011-2013年一犬伤多人事件调查分析[J]. 中国媒介生物学及控制杂志, 2015, 26(2): 168-171. DOI: 10.11853/j.issn.1003.4692.2015.02.015 [7] 陆朝国, 杨金芝, 李学, 等. 贵阳市15起一犬伤多人事件调查[J]. 现代预防医学, 2009, 36(23): 4569-4570. DOI: 10.3969/j.issn.1000-744X.2007.05.046 [8] 李幸乐, 李凤丽, 周瑞清, 等. 一起一犬伤13人狂犬病暴露事件的综合处置及效果评价[J]. 河南预防医学杂志, 2017, 28(1): 4-7. [9] 伍红亚, 孙德伦. 独山县狂犬病防治一犬伤多人事件流行病学调查效益分析[J]. 临床心身病杂志, 2015, 21: 328. [10] Meslin FX, Kaplan MM, Koprowski H, editors. Laboratory techniques in rabies[M]. 4th Ed. Geneva: World Health Organization; 1996: 9-27. [11] 杨浩, 邓志红, 孙倩莱, 等. 2013-2017年湖南省一犬伤多人事件分析[J]. 热带病与寄生虫学, 2018, 16(2): 86-89. DOI: 10.3969/j.issn.1672-2302.2018.02.007 [12] Kitala PM, McDermott JJ, Kyule MN, et al. Community-based active surveillance for rabies in Machakos District, Kenya[J]. Prev Vet Med, 2000, 44(1/2): 73-85. [13] Wallace RM, Reses H, Franka R, et al. Establishment of a canine rabies burden in Haiti through the implementation of a novel surveillance program[J]. PLoS Negl Trop Dis, 2015, 9(11): e0004245. DOI: 10.1371/journal.pntd.0004245 [14] da Silva LH, Bissoto CE, Delbem AC et al, Canine rabies epidemiology in Araatuba and neighborhood, northwestern S?o Paulo State-Brazil[J]. Rev Soc Bras Med Trop, 2004, 37: 139-142. DOI: 10.1590/S0037-86822004000200005 [15] Siwasontiwat D, Lumlertdacha B, Polsuwan C, et al. Rabies: Is provocation of the biting dog relevant for risk assessment?[J]. Transact Royal Soc Trop Hyg, 1992, 86: 433. DOI: 10.1016/0035-9203(92)90262-B [16] Ly S, Buchy P, Heng NY, et al. Rabies situation in Cambodia[J]. PLoS Negl Trop Dis, 2009, 3(9): e511. DOI: 10.1371/journal.pntd.0000511 [17] World Health Organization. WHO expert consultation on rabies: third report[M]. Geneva: WHO Press,2018:7-8. [18] Casey C, Vellozzi C, Mootrey GT, et al. Surveillance guidelines for smallpox vaccine (vaccinia) adverse reactions[J]. MMWR Recomm Rep, 2006, 55(RR-1): 1-16. [19] Rupprecht CE. A tale of two worlds: public health management decisions in human rabies prevention[J]. Clin Infect Dis, 2004, 39: 281-283. DOI: 10.1086/421563 [20] Yao HW, Yang Y, Liu K, et al. The spatiotemporal expansion of human rabies and its probable explanation in mainland China, 2004-2013[J]. PLoS Negl Trop Dis, 2015, 9(2): e0003502. DOI: 10.1371/journal.pntd.0003502 [21] Mitmoonpitak C, Tepsumethanon V, Wilde H. Rabies in Thailand[J]. Epidemiol Infect, 1998, 120: 165-169. DOI: 10.1017/S0950268897008601
[1]
刘天, 童叶青, 刘漫, 吴杨, 姚梦雷, 侯清波, 黄继贵, 罗曼, 陈红缨. 2004——2017年全国肾综合征出血热变化趋势分析 [J]. 中国人兽共患病学报, 2022, 38(6): 515-522.
[2]
石磊泰, 李玉华. Vero细胞在人用狂犬病疫苗中的研究和应用进展 [J]. 中国人兽共患病学报, 2022, 38(3): 260-265.
[3]
刘天, 郝海波, 姚梦雷, 侯清波, 黄继贵, 吴杨, 刘漫, 胡兵. 2017-2020年湖北省荆州市肾综合征出血热宿主动物监测分析 [J]. 中国人兽共患病学报, 2022, 38(2): 128-134.
[4]
夏炉明, 杨显超, 龚国华, 王建, 刘健, 鞠厚斌, 吴秀娟, 陶田谷晟, 于讳茹, 李凯航, 卢军, 李增强, 朱晓英, 陈伟锋, 常晓静, 吴嘉文, 赵洪进. 2011-2020年上海地区犬只狂犬病本底状况回顾性分析 [J]. 中国人兽共患病学报, 2021, 37(8): 757-762.
[5]
刘茜, 朱武洋. 狂犬病治疗方法及抗病毒药物应用的研究进展 [J]. 中国人兽共患病学报, 2021, 37(5): 444-449.
[6]
杨卫红, 杨鹤飞, 冯云, 章域震, 潘虹, 王娟. 云南省2008-2018年人间狂犬病流行特征及狂犬病病毒基因分析 [J]. 中国人兽共患病学报, 2021, 37(4): 339-345.
[7]
余慧燕, 许可, 黄昊頔, 祁贤, 鲍倡俊. 2014-2018年江苏省禽类外环境禽流感病毒监测结果分析 [J]. 中国人兽共患病学报, 2021, 37(3): 225-229.
[8]
陈楚莹, 王曼, 冯志锋. 2014-2019年中山市H9亚型禽流感监测及病例特征分析 [J]. 中国人兽共患病学报, 2021, 37(2): 122-127.
[9]
石磊泰, 李玉华. 狂犬病mRNA疫苗的应用和研究进展 [J]. 中国人兽共患病学报, 2021, 37(12): 1123-1128.
[10]
张磊, 张玲, 张天喜, 苏克文, 谈思维, 邵吉, 叶海朋, 曹承建, 黄春萍. 狂犬病疫苗接种人群中狂犬病病毒中和抗体水平分析 [J]. 中国人兽共患病学报, 2021, 37(10): 898-902.
[11]
姚光海, 刘英, 黄荷, 胡灿, 王丹, 聂炜, 邹志霆, 李世军. 2009—2019年贵州省人间钩端螺旋体病疫情流行特征研究 [J]. 中国人兽共患病学报, 2021, 37(10): 903-909.
[12]
刘仰青, 付仁龙, 马红梅, 柳小青. 南昌市登革热传播媒介白纹伊蚊密度、抗药性及病原体携带监测研究 [J]. 中国人兽共患病学报, 2020, 36(8): 654-659.
[13]
梅明珠,杨先锋,龙腾,张琼,赵静,田钦,彭娇娇,罗均,姜贺,林颖仪,林志雄,郭霄峰. 狂犬病病毒HEP-Flury M基因重排在小鼠致病性和保护性研究 [J]. 中国人兽共患病学报, 2020, 36(3): 173-177.
[14]
李青, 史永林. 2009-2018年安徽省克-雅病病例监测特征分析 [J]. 中国人兽共患病学报, 2020, 36(2): 130-133.
[15]
宋云, 于鹏程, 朱武洋. 人用狂犬病疫苗肌肉注射免疫程序研究进展 [J]. 中国人兽共患病学报, 2020, 36(2): 158-162.