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目的调查广东省深圳市某小学暴发皮炎疫情的致病因子、致病途径和危险因素,为及时采取有效的控制和预防措施提供依据。方法开展病例搜索、个案调查、危险因素调查、病例对照研究,现场捕获毒蛾幼虫饲养及成蛾种属鉴定。结果本次研究共调查病例89例,患者主要临床症状为裸露部位皮肤出现斑丘疹,男女罹患率分别为32.79%(60/183)和27.62%(29/105),二者差异无统计学意义(χ2=0.83,P﹥0.05)。经鉴定本次捕获的毒蛾幼虫为鳞翅目毒蛾科黄毒蛾属漫星黄毒蛾幼虫。病例对照研究表明,学生在幼虫寄主树下活动(OR=5.88,95%CI:2.73~12.69)、校内曾经接触幼虫(OR=3.31,95%CI:1.57~7.01)、衣物防护不好(OR=2.36,95%CI:1.07~5.22)为本次皮炎疫情的危险因素。结论本研究首次报道了由漫星黄毒蛾幼虫引起的皮炎暴发疫情,并查明疫情为学生裸露皮肤接触到幼虫及其脱落的刚毛所致的过敏性皮炎,建议进行科学预防,以保证学生及居民的个人健康。
Objective To investigate the pathogenic factors, pathogenic pathways and risk factors of outbreaks of dermatitis in a primary school in Shenzhen, Guangdong Province, so as to provide basis for prompt and effective control and preventive measures. Methods To carry out case search, case investigation, risk factor investigation, case-control study, site capture of moth larvae and moth species identification. Results A total of 89 cases were investigated in this study. The main clinical symptoms of this study were rash on the bare skin. The prevalence rates of male and female were 32.79% (60/183) and 27.62% (29/105) respectively, with no significant difference between the two groups (χ2 = 0.83, P> 0.05). It was identified that the larvae of the captured moth larvae were lepidopteran moths. Case-control studies showed that students were active in larval host trees (OR = 5.88, 95% CI: 2.73-12.69), had contact with larvae in school (OR = 3.31, 95% CI: 1.57-7.01), poor clothing protection = 2.36, 95% CI: 1.07 ~ 5.22) were the risk factors of this dermatitis epidemic. Conclusions This study reports for the first time the outbreak of dermatitis caused by the larvae of D. virgiforme and the outbreak of allergic dermatitis caused by exposing students to exposed larvae and their falling bristles. It is recommended that scientific prevention should be conducted to ensure that students and Residents’ personal health.