Human rabies in Zhejiang Province, China

OBJECTIVES: To explore the epidemiological characteristics of human rabies in Zhejiang Province, China. METHODS: Descriptive and statistical analyses were performed using data collected through interview with human rabies cases or their relatives during 2007 to 2014. A standardized questionnaire was used to collect the data. RESULTS: Two hundred and one cases of human rabies were diagnosed in Zhejiang Province between 2007 and 2014, with a gradually declining annual incidence. Of the rabies cases identified, 61.2% were aged 40-65 years, and the male to female ratio was 2.30:1; 63.7% of cases occurred in the summer and autumn. The two most reported occupations were farmer (69.2%) and rural laborer (15.4%). Wenzhou, Jinhua, and Huzhou were the three cities with the most reported cases. The majority of cases (92.8%) were attributed to canines, and 71.0% of animal vectors were household animals. Less than half of the cases (41.4%) sought wound treatment after exposure. Post-exposure passive immunization was given to 9.7% and active immunization to 2.3%. Cases with a wound on the head/face only had a significantly shorter incubation than those with wounds at other sites (p<0.05); cases with a wound on the hand only had a significantly shorter incubation than those with a wound on the lower limb below the knee only (p<0.001). Non-resident cases were significantly younger (p<0.001) and had a shorter disease duration (p=0.015) than locally resident cases. CONCLUSIONS: The majority of rabies cases occurred among 40-65-year-old male residents of northern, mid-west, and southeast Zhejiang Province. Further health education is needed to increase the coverage of post-exposure prophylaxis (PEP) in people exposed to possible rabid animals and rabies vaccine use in household animals.