狂犬病是由 Lyssavirus 属病毒引起的病毒性人畜共患病，可感染哺乳动物并导致脑和脊髓进行性、致死性炎症[2][3][4]。该病主要通过受感染动物唾液传播，一旦出现临床疾病，病程通常迅速进展并几乎必然致死[2][3][5]。
疾病概览
狂犬病
Rabies
有证据支持的资料英文 5/7 个适用章节 · 中文 5/7 个适用章节更新于 2026年9月3日
狂犬病是由狂犬病毒引起的可预防人畜共患中枢神经系统病毒性感染，一旦临床发病几乎必然致死[1][2][3]。全球每年估计约59,000人死亡，主要发生在非洲和亚洲，且常被低估[1][2][3]。人类病例约99%与犬传播有关，可通过犬只免疫和暴露后预防等措施预防[1][2][3]。
阅读完整临床与流行病学资料6
早期可出现发热、伤口部位异常刺痛或麻木感[3][5]，随后进入中枢神经系统受累阶段[3][5]。狂躁型可有兴奋、恐水、恐风，并可因心肺功能衰竭在数日内死亡[3]。一旦出现症状，病程通常迅速进展并几乎必然致死[1][2][3][5]。
狂犬病分布于除南极洲以外的所有大陆，全球每年估计约有5.9万例死亡病例，其中95%发生在非洲和亚洲[1][3]。由于报告不足和估计存在不确定性，实际数字可能被严重低估[3][2]。作为一种被忽视的热带疾病，狂犬病主要影响边缘化的农村贫困人群，约有一半病例发生在15岁以下儿童中[3][2]。
狂犬病主要通过感染动物的唾液传播，通常经由咬伤、抓伤或黏膜（眼、口）或开放性伤口直接接触而感染人类[1][2]。犬类是狂犬病最重要的宿主，全球超过99%的人类病例由犬咬伤引起[2]。猫、家畜和野生动物同样易感[1]。在犬传狂犬病已得到基本控制的美洲地区，食血蝙蝠已成为人类感染的主要来源[1]。狐狸、浣熊、臭鼬等野生动物导致的人类死亡极为罕见，啮齿动物咬伤尚无传播狂犬病的记录[1]。通过吸入气溶胶、食用生肉或生奶、器官移植等方式感染的情况极为罕见[1]。
预防策略包括犬只常规疫苗接种以从源头减少病毒储存宿主，以及在暴露后及时进行处置（包括适当的伤口处理、狂犬病免疫球蛋白和疫苗接种）以防止发病[1][3][2]。全球每年有超过2900万人接受狂犬病暴露后预防接种[1]。实现2030年犬传人类狂犬病零死亡目标需要多层面的综合方法，包括政府支持、疾病意识宣传、高风险人群疫苗接种以及最关键的犬类狂犬病控制[3][2]。
- 1World Health Organization. Rabies [Internet]. cited 3 Sept 2026.Available from: https://www.who.int/news-room/fact-sheets/detail/rabies
- 2World Health Organization. Rabies [Internet]. cited 3 Sept 2026.Available from: https://www.who.int/health-topics/rabies
- 3Fooks AR et al. Rabies. Nat Rev Dis Primers. 2017 Nov 30. PMID: 29188797. doi: 10.1038/nrdp.2017.91.PubMed: https://pubmed.ncbi.nlm.nih.gov/29188797/
- 4Hemachudha T et al. Human rabies: neuropathogenesis, diagnosis, and management. Lancet Neurol. 2013 May. PMID: 23602163. doi: 10.1016/S1474-4422(13)70038-3.PubMed: https://pubmed.ncbi.nlm.nih.gov/23602163/
- 5Lacy M et al. Human Rabies Treatment-From Palliation to Promise. Viruses. 2024 Jan 22. PMID: 38275970. doi: 10.3390/v16010160.PubMed: https://pubmed.ncbi.nlm.nih.gov/38275970/
- 6Kumar A et al. Canine rabies: An epidemiological significance, pathogenesis, diagnosis, prevention, and public health issues. Comp Immunol Microbiol Infect Dis. 2023 Jun. PMID: 37229956. doi: 10.1016/j.cimid.2023.101992.PubMed: https://pubmed.ncbi.nlm.nih.gov/37229956/
- 7Wikipedia contributors. Rabies [Internet]. Wikipedia. cited 2 Sept 2026.Available from: https://en.wikipedia.org/wiki/Rabies
- A82
- 1C82
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