一起学校肢痛症暴发的流行病学调查

Epidemiological survey of an outbreak of erythromelalgia in a school

目的核实和调查一起学生肢痛症暴发的流行情况,探讨和分析疾病流行因素,预防该病在校园内流行。方法采用流行病学调查分析方法对2014年2月顺德区某中学发生的肢痛症进行调查,采用SPSS 17.0统计学软件对调查数据进行统计学分析。结果 410名病例分布于3个年级,高一至高三罹患率分别为12.92%、13.06%和17.39%,高三罹患率高于高一、高二,差异有统计学意义(P<0.01);女生罹患率(22.49%)高于男生罹患率(6.71%),差异有统计学意义(P<0.01);临床表现以肢端疼痛,足趾、足底、足跟、足背痛为主,少数伴有手指疼痛及肢端红斑;2014年2月7日—28日气温从22℃下降至5℃,随后气温回升至21.5℃,短期内气温呈"V"字形变化,随着气温回升,病例数开始增加。对2月10日—28日的每日平均温度和病例数进行相关性分析,结果显示二者呈正相关关系(r=0.46,P<0.05),提示气温骤降骤升是造成该病流行的主要诱因;病例对照研究显示,缺乏体育锻炼(OR=2.71,95%CI:1.69~4.34)和防寒保暖措施不到位(OR=3.81,95%CI:2.35~6.19)为该病的危险因素。结论本次学校肢痛症暴发流行,发病可能与气温急剧变化以及学生缺乏体育锻炼和防寒措施不到位有一定关系,加强宣传教育和体育锻炼,增强学生体质,并注意防寒保暖,可以有效预防该病在校园内流行。

Objective To verify and investigate the epidemic situation of erythromelalgia in students, and exploreandanalyze the epidemic factors, so as to prevent the disease epidemic in schools. Methods The epidemiological investigationmethod was used to investigate an outbreak of erythromelalgia in a middle school in February 2014, and the results wereanalyzed with SPSS17.0 statistical software. Results There were 410 cases that distributed in three grades, and the attackratesin Grade One, Grade Two and Grade Three were 12.92%,13.06%and17.39% respectively.The attack rate of Grade Threewas higher than that of Grade Two and Grade One（P0.01）. The attack rate in the male students was 6.71% and that in thefemale students was 22.49%, and the difference was statistically significant（P0.01）. The clinical manifestations includedmainly the acra pain（toe, pelma, heel, and acrotarsium）. A few patients had finger pain and erythema. From February 7-28,2014, the temperature decreased from 22 ℃ to 5 ℃, and then rose to 21.5 ℃（V change）, and as the temperatures rose, thecases increased. The correlation analysis between the daily average temperature and the cases in that period showed a positivecorrelation（r=0.46, P0.05）, suggesting that the sudden drop and rise of the temperature was the main inducement of theepidemic. The case-control study showed that the lack of physical exercises（OR=2.71, 95%CI： 1.69-4.34） and no perfectmeasures to keep warm（OR=3.81, 95%CI： 2.35-6.19） were the risk factors. Conclusions This erythromelalgia outbreak inthe school may be related to the rapid temperature change, the lack of physical exercises in the students, and no perfectmeasures to keep warm. Therefore, strengthening health education, physical exercises and perfect measures to keep warm caneffectively prevent the disease epidemic in schools.