臺灣北部某醫學中心實行狂犬病疫苗接種分析

Rabies Vaccinations Administered in a Medical Center in Northern Taiwan

目標：本研究使用台灣某醫學中心接受暴露前及暴露後狂犬病疫苗接種個案之資料分析，目的在於提醒往返於狂犬病流行國家，需要採取更多的警覺及預防。方法：本研究為2005年8月到2007年9月間，至該醫院家庭醫學科旅遊門診就醫的資料，包括暴露前預防性接種25例及暴露後治療性接種95例。結果：暴露前的狂犬病疫苗預防性接種為25例，百分之百完成率高達92%。在95例暴露後的狂犬病疫苗治療性接種中，有51位男性(54%)和44位女性(46%)；主要意外發生地點為工作場所或居住地點，共79位(83%)；最常攻擊的動物為狗(78%)。需接種五劑疫苗的個案很少，只有4%；實際於該院完成的疫苗數以完成一劑的個案最多27人(28%)。其中在中國被狗咬傷高達56例(59%)。結論：回顧歷史，狂犬病預防政策使臺灣成為世界上七個“非狂犬病流行”國家之一。如果預防措施可以不斷的警覺與更新，保持嚴密追蹤，相信狂犬病在將來可被正式地宣佈在臺灣絕跡，成為臺灣在公共衛生的一大成就。

Objectives: This study is undertaken to assess data on rabies vaccinations administered to both pre-exposure and post-exposure groups. The primary objective of this study is to warn travelers of the need to take extra precautions when visiting countries that are known to have rabies epidemics, with a particular focus on China. Methods: This study uses descriptive statistics to analyze the data obtained from a travelers' clinic in a medical center in Northern Taiwan between August 2005 and September 2007. The data relate to rabies vaccinations administered to both pre-exposure travelers (25 cases) and postexposure patients (95 cases). Results: In the 25 cases of pre-exposure vaccination, the completion rate reached a high of 92%. Of the total of 95 patients with post-exposure to rabies, 51 (54%) were male, and 44 (46%) were female. The primary settings where the incidents took place were workplaces and residences (79 cases, 83%). Amongst all cases of bites by animals, dogs ranked the highest (78%). The proportion of patients requiring five shots of vaccine was very low, at about 4%, as compared to the actual vaccine shot completion, where 27 patients (28%), which was the largest proportion, completed just one shot. Of the total number of incidents 59% (56 cases) involved patients who had been bitten by dogs in China, where five cases were also reported of patients having been bitten by cats. Conclusions: Looking back through the history of Taiwan, the rabies prevention policy which was adopted on the island led to it becoming one of only seven non-epidemic areas throughout the whole world. If prevention can continue to be meticulously promoted in the future, it is believed that rabies can be officially declared extinct in Taiwan, which will represent another great achievement for the island's public health record.