臺灣博碩士論文加值系統

　　本研究為評估台中地區對狂犬病的防疫狀況，及對台灣目前進口的狂犬病疫苗進行施打後抗體維持的評估。從1998年6月到1999年5月間共收集家犬及流浪犬血清檢體各500個，以酵素連結免疫吸附法檢測其抗體；結果家犬血清抗體呈陽性的佔49%，這顯示台中地區犬隻注射疫苗以防止狂犬病爆發的政策並未徹底的執行，以及畜主對狂犬病的防疫觀念仍舊不足。流浪犬狂犬病抗體呈陽性的佔27%，而目前台灣的流浪犬眾多，因而更曝露出流浪犬在公共衛生上已形成狂犬病防治上的嚴重漏洞。
　　另一疫苗實驗則共使用24隻健康犬隻，其中20隻分成四組，分別施打四種目前進口的狂犬病疫苗，另外4隻則做為對照組，結果在四個受測試的巿售狂犬病疫苗中，C品牌狂犬病疫苗明顯的能較迅速的刺激抗體之產生及維持較高較久之抗體力價。此外，在施打後第二個月起，開始有實驗犬隻抗體呈陰性。目前狂犬病疫苗的注射規定是一年補強一次，在本次實驗中發現在施打後半年即有45%的實驗犬隻抗體呈陰性；在家犬的注射記錄分析上也發現，只注射一劑狂犬病疫苗的犬隻，抗體能維持一年以上的只佔62%；這顯示目前狂犬病疫苗施打率偏低的情形下，即使在短期內進行疫苗的施打，在施打後半年至下次疫苗施打前則可能出現整體狂犬病抗體陽性率不足以抵抗狂犬病入侵的情形，因此建議在初次疫苗施打後一個月即進行第二劑之補強，以儘速提高及維持整體抵抗狂犬病入侵的能力。
　　根據本次研究結果，為要有效的控制及預防狂犬病的侵入端賴政府單位與相關專業機構在以下幾個方面進行努力：一、流浪犬的清除及飼養寵物的管理，二、犬隻的免疫以阻斷狂犬病的傳播，三、監控評估狂犬病防疫上的成效，四、公共衛生觀念的教育課程以確保民眾的合作性。本次調查結果除了確切的了解目前台中地區的防疫況狀，疫苗施打後抗體維持試驗之結果亦可提供緊急時防疫之參考。

　　This research is to evaluate the immune status of dogs in Taichung to rabies virus, a total of 1000 serum samples were collected form domestic dogs（500） and stray dogs（500） in June 1998 to May 1999, and tested for antibodies with the ELISA. 49% of domestic dogs had antibodies against rabies virus and 27% of stray dogs had antibodies against rabies virus, indicating that the vaccination strategy for preventing rabies outbreaks in dogs is incompletely practiced in Taichung. And owners in Taichung have an insufficient concept to epidemic prevention of rabies. Furthermore, there are 1300 thousand stray dog in Taiwan. 48% people in Taichung have been seen stray dog on the street. It''s to show that stray dogs have caused a serious public health problem in controling rabies.
　　Another research is to test how long the protection of antibody titer in serum can keep after injected with the rabies vaccine. A total of twenty-four dogs were used for this study. Twenty dogs were divided four grouping and injected with different rabies vaccines that have been imported in Taiwan. The remainder dogs were infected aseptic saline for contrast. The result of the survey showed that the "C" brand of rabies vaccine can rapidly stimulate antibody production, and keep high and long timing antibody titer. Two months after injecting rabies vaccine, the experimental dog''s antibody had begun to change to negative in this experiment. As a result of this experiment, suggest to booster rabies vaccine again after one month of the first vaccination to enhance the immune state to rabies virus.
For valid control and prevent rabies, there is a need for comprehensive, professionally organized, and publicly supported agencies in the following areas: 1. stray dogs elimination and control of the raised of pet; 2. immunization of dogs, so as to break the chains of virus transmission; 3. surveillance, to measure the effectiveness of all control measures; and 4. public education programs to assure cooperation.

表次------------------------------------------------------------------------------III
圖次------------------------------------------------------------------------------IV
中文摘要------------------------------------------------------------------------V
英文摘要------------------------------------------------------------------------VII
第一章 前言--------------------------------------------------------------------1
第二章 文獻探討--------------------------------------------------------------3
　第一節 狂犬病的簡介----------------------------------------------------3
　　一、 狂犬病的歷史----------------------------------------------------3
　　二、 狂犬病的病原----------------------------------------------------3
　　三、 傳染途徑----------------------------------------------------------4
　　四、 致病機轉----------------------------------------------------------5
　　五、 臨床症狀----------------------------------------------------------6
　　六、 狂犬病的治療----------------------------------------------------7
　第二節 狂犬病診斷在防疫上的意義--------------------------------8
　　一、 抗原診斷上的意義---------------------------------------------8
　　　(一) 活體診斷--------------------------------------------------------9
　　　(二) 病理學檢查---------------------------------------------------10
　　　(三) 免疫螢光法---------------------------------------------------11
　　　(四) 接種實驗------------------------------------------------------11
　　　(五) 反轉錄聚合酵素連鎖反應-------------------------------12
　　二、 抗體診斷上的意義-------------------------------------------12
　　　(一) 快速螢光抑制試驗-----------------------------------------13
　　　(二) 間接免疫螢光試驗-----------------------------------------13
　　　(三) 酵素連結免疫吸附法--------------------------------------14
　第三節 狂犬病的疫情及控制----------------------------------------14
　　一、 台灣地區過去的疫情記錄----------------------------------14
　　二、 我國目前的防疫政策----------------------------------------15
　　三、 國外狂犬病流行及防疫模式------------------------------16
　　　(一) 美國犬型狂犬病的流行及防疫模式------------------18
　　　(二) 墨西哥蝙蝠型狂犬病的流行及防疫模式------------19
　　四、 目前狂犬病防疫上的隱憂----------------------------------20
第三章 材料與方法---------------------------------------------------------24
　第一節 實驗材料---------------------------------------------------------24
　第二節 實驗方法---------------------------------------------------------26
第四章 結果-------------------------------------------------------------------33
　第一節 台中地區流浪犬血清狂犬病抗體調查結果------------33
　第二節 台中地區家犬血清狂犬病抗體調查結果---------------33
　第三節 巿售狂犬病疫苗抗體維持試驗結果---------------------34
第五章 討論-------------------------------------------------------------------44
　第一節 研究背景討論---------------------------------------------------44
　第二節 台中地區流浪犬血清狂犬病抗體調查討論------------45
　第三節 台中地區家犬血清狂犬病抗體調查討論---------------46
　第四節 巿售狂犬病疫苗抗體維持試驗討論----------------------49
　第五節 面對狂犬病的因應對策--------------------------------------50
參考文獻-----------------------------------------------------------------------51

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