Chen Fengling, Shao Zhaoming, Liang Chaobin, Wang Xiangbo, Yang Xueyuan, Yao Guizhong, Zhao Shuqing, Wang Lili, Ou Zhongying, Zhang Lijie, Luo Huiming
Chancheng Center for Disease Control and Prevention of Guangdong Province, Foshan 528000, China.
Xuanwu Hospital, Capital Medical University.
Zhonghua Liu Xing Bing Xue Za Zhi. 2015 Jun;36(6):629-33.
To identify the cause of an outbreak of foot pain syndrome among students from a senior high school in Foshan.
We defined a suspect case as onset of foot pain/numbness with unknown reason among students and teachers in a school of Foshan city, from February 10 to March 16, 2014. A suspect case was noticed as having both food pain and numbness. All the cases were searched through reviewing medical records in the nearby hospitals and school's clinic, also the records of absenteeism in school. Clinical information was collected from all the students, using a standardized questionnaire. Daily temperature was collected from all the students, between January 1 and March 31, 2014. A 1 : 2 individual matched case-control study was conducted to identify related risk factors on this epidemic. We interviewed all the cases and controls on their diet, physical activities and measures used for warming.
A total of 407 case-students were identified, with an attack rate (AR) as 26.5%. The AR was 37.3% in girls, compared to 12.9% in boys. The difference was statistically significant (χ² = 115.1, P < 0.01). Boarding students had a higher AR (31.8%) than the commuting students (16.2%). The difference was statistically significant (χ² = 43.2, P < 0.01). In girls, boarding students had higher AR (46.1%) than those commuting students (18.5%). The difference was statistically significant (χ² = 61.4, P < 0.01). No statistically significant difference was found between boarding or commuting students in boys. Outdoor temperature was coming down from 23 °C on February 6 to 6 °C on February 13, but gradually rose to 23 °C on February 28. There was a positive relationship (r = 0.65, P = 0.002) noticed between daily maximum temperature and the number of cases during February 13-28. Results from this case-control study showed that factors as lacking physical activities (OR = 2.8, 95% CI: 1.5-5.6), feeling cold in bed (OR = 3.0, 95% CI: 1.3-7.0) and having experienced similar symptoms (OR = 3.4, 95% CI: 1.1-11.0) could increase the risk of this disease.
This outbreak was possibly caused by the abrupt fluctuation of temperature within a short period.
确定佛山市某高中学生足部疼痛综合征暴发的原因。
我们将2014年2月10日至3月16日期间佛山市某学校学生和教师中原因不明的足部疼痛/麻木发作定义为疑似病例。疑似病例表现为足部疼痛和麻木。通过查阅附近医院和学校医务室的病历以及学校的缺勤记录来搜索所有病例。使用标准化问卷收集所有学生的临床信息。收集2014年1月1日至3月31日期间所有学生的每日体温。进行1:2个体匹配病例对照研究以确定此次疫情的相关危险因素。我们就病例和对照的饮食、体育活动及保暖措施进行了访谈。
共确定407例学生病例，罹患率为26.5%。女生罹患率为37.3%，男生为12.9%。差异有统计学意义（χ² = 115.1，P < 0.01）。寄宿学生的罹患率（31.8%）高于通勤学生（16.2%）。差异有统计学意义（χ² = 43.2，P < 0.01）。在女生中，寄宿学生的罹患率（46.1%）高于通勤学生（18.5%）。差异有统计学意义（χ² = 61.4，P < 0.01）。在男生中，寄宿学生和通勤学生之间未发现统计学上的显著差异。室外温度从2月6日的23℃下降到2月13日的6℃，但在2月28日逐渐回升至23℃。2月13日至28日期间，日最高气温与病例数之间呈正相关（r = 0.65，P = 0.002）。该病例对照研究结果显示，缺乏体育活动（比值比[OR] = 2.8，95%可信区间[CI]：1.5 - 5.6）、睡觉时感觉寒冷（OR = 3.0，95%CI：1.3 - 7.0）以及有类似症状（OR = 3.4，95%CI：1.1 - 11.0）等因素会增加该病的发病风险。
此次暴发可能是由短期内气温的突然波动引起的。
