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目的综合处置一起一犬伤13人的狂犬病暴露事件,评价预防处置措施效果,为规范化处置一犬伤多人事件提供依据。方法根据《狂犬病暴露后预防处置工作规范(2009版)》对一犬伤13人事件中的13人进行伤口清洗、狂犬病疫苗和/或狂犬病免疫球蛋白接种;分别采用RT-PCR方法和RFFIT方法进行伤人犬的实验室诊断和狂犬病暴露后处置人群免疫效果评价。结果伤人犬被打死、焚烧后深埋处理。犬脑组织标本经RT-PCR检测狂犬病病毒N、L基因均有特异性条带出现。13例伤者均为Ⅲ级暴露,均在24 h内主动至当地狂犬病预防处置门诊进行暴露后预防处置,其全程免疫后第15 d的血清抗狂犬病病毒中和抗体水平均>0.5 IU/mL。结论伤人犬为狂犬病病犬,13例狂犬病暴露后免疫人群全程免疫后血清中和抗体均达到保护性水平。及时、有效的多部门合作对一犬伤多人事件的处置具有积极意义。
Objective To comprehensively deal with a rabies exposure event involving 13 dogs and 13 dogs and to evaluate the effect of prevention and treatment measures so as to provide basis for standardizing the handling of a multi-person incident involving a dog. Methods Thirteen of 13 dogs with canine wounds were subjected to wound cleaning, rabies vaccine and / or rabies immunoglobulin inoculation according to the “Code of Practice for the Prevention and Treatment of Post-exposure Exposure to Rabies (Version 2009)”. RT-PCR and RFFIT The laboratory diagnosis of rabbits and rabies patients exposed to post-exposure evaluation of the immune effect. As a result, the injured dog was killed and burned for burial treatment. Canine brain tissue samples by RT-PCR detection of rabies virus N, L gene specific bands appear. All the 13 injured patients were grade Ⅲ, and all of them were actively exposed to the local rabies prevention and treatment post-exposure treatment within 24 hours. The levels of serum anti-rabies virus neutralizing antibodies on the 15th day after immunization were all> 0.5 IU / mL . Conclusion Rabbit dogs were rabies dogs, and the serum neutralizing antibodies reached the protective level after immunization of 13 rabies patients. Timely and effective multi-sectoral cooperation is of positive significance to the handling of a multi-person incident involving a dog.