PDF《中国疾病预防控制中心文件》

102206 中国疾病预防控制中心病毒病预防控制所(唐青)

130122 中国人民解放军军事医学科学院(扈荣良)

100050 中国食品药品检定研究院(董关木,俞永新)

430060 武汉生物制品研究所(严家新)

1 摘要 狂犬病是由狂犬病病毒感染引起的一种动物源性传染 病,临床大多表现为特异性恐风、恐水、咽肌痉挛、进行性 瘫痪等.近年来,狂犬病报告死亡数一直位居我国法定报告 传染病前列,给人民群众生命健康带来严重威胁. 为指导基层疾控机构做好狂犬病的预防控制工作,尤其 是暴露后的预防处置,降低狂犬病所致死亡,中国疾病预防 控制中心组织专家,参考世界卫生组织和美国疾控中心的技 术指南,以及国内外最新研究进展,制定了《狂犬病预防控 制技术指南 (2016 版) 》 . 本指南系统回顾了狂犬病的病原学、 临床学、实验室诊断、流行病学、疫苗和被动免疫制剂的种 类、机理、效果、安全性和不良反应监测与处置,以及暴露 预防处置方法等内容的科学证据,在此基础上对狂犬病暴露 前和暴露后预防处置的伤口处置、疫苗接种和被动免疫制剂 使用等技术给出了推荐建议. 本指南适用于从事狂犬病防控工作的各级各类疾病预 防控制机构、狂犬病暴露预防处置门诊、医疗机构感染科和 急诊科等专业人员.根据狂犬病的国内外研究进展,本指南 今后将不断更新、完善.

2 Abstract Rabies, caused by the infection of rabies virus, is a zoonotic infectious disease. Its major clinical manifestations are presented as specific hydrophobia, aerophobia, pharyngospasm, and progressive paralysis. Reports on the deaths of rabies have continuously remained the top ones, among all the notifiable infectious diseases in China, which pose serious threats to the health of the Chinese people. In order to promote the prevention and control programs on rabies in our country, to regulate the prevention and disposition of rabies and to reduce the deaths caused by rabies, the Chinese Center for Disease Control and Prevention has organized a panel of experts, in the reference with Guidelines issued by WHO, American Advisory Committee on Immunization Practices, and the latest research progress from home and abroad, and compiled this document-- Technical Guidelines for Human Rabies Prevention and Control (2016) . The Guidelines conducted a systematic review on the etiology, clinical characteristics, laboratory diagnosis, epidemiology of rabies and provided evidence on varieties, mechanisms, effects, side-effects and security of rabies vaccine, as well as on other preparations

3 on passive immunity of its kind, on methods related to prevention and disposition of exposure etc, finally to have come up with the recommendation on the above mentioned various techniques. The guidelines will be used by staff working on prevention and control of rabies from the Center for Disease Control and Prevention at all levels, from the departments of outpatient and divisions of infection and emergency control in all the medical institutions. The guidelines will be updated and revised, following the research progress from home and abroad.

4 前言 狂犬病(Rabies)是由狂犬病病毒(Rabies virus)感染 引起的一种动物源性传染病.狂犬病病毒主要通过破损的皮 肤或粘膜侵入人体,临床大多表现为特异性恐风、恐水、咽 肌痉挛、进行性瘫痪等.近年来,狂犬病报告死亡数一直位 居我国法定报告传染病前列,给人民群众生命健康带来严重 威胁. 暴露后处置是暴露后预防狂犬病的唯一有效手段.世界 卫生组织认为,及时、科学和彻底的暴露后预防处置能够避 免狂犬病的发生.为指导基层疾控机构做好狂犬病预防控制 工作,尤其是暴露后的预防处置,降低狂犬病所致死亡,中 国疾病预防控制中心组织专家,参考世界卫生组织和美国疾 控中心的技术指南,以及国内外最新研究进展,制定了《狂 犬病预防控制技术指南(2016 版) 》 . 本指南适用于从事狂犬病防控工作的各级各类疾病预 防控制机构、狂犬病暴露预防处置门诊、医疗机构感染科和 急诊科等专业人员.根据使用中反馈的问题和狂犬病的国内 外研究最新进展,本指南今后将不断更新、完善.