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首页> 外文期刊>Online Journal of Public Health Informatics >Increased Seizure Activity in Florida Associated with Hurricane Irma, September 2017
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Increased Seizure Activity in Florida Associated with Hurricane Irma, September 2017

机译：2017年9月与飓风艾玛相关的佛罗里达州癫痫发作活动增加

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Objective Using Florida’s syndromic surveillance data, to describe the increase in seizure activity in the days after Hurricane Irma made landfall in 2017 Introduction On September 10, 2017, Irma made landfall in the Florida Keys as a Category 4 hurricane and subsequently tracked up the west side of the state. Due to the size of the storm, it impacted nearly all of Florida. The Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE-FL), the state’s syndromic surveillance system, captures 98% of the emergency department (ED) visits statewide and has historically served a vital function in providing near real-time ED data that are used to track post-disaster morbidity and mortality. After previous hurricanes and tropical storms, increases in carbon monoxide poisonings, animal bites, and injuries have been documented. During post-Irma surveillance, an additional increase in seizure-related ED visits was observed. Methods Twice-daily Hurricane Irma surveillance reports were produced from Sept 10-22, 2017. In addition to specialized queries specific to storm surveillance, analysis was conducted using ESSENCE-FL’s syndrome and subsyndrome categories. The subsyndrome category of Seizure captures ED visits which list the words seizure or convulsion in the patient chief complaint. Daily number of seizure visits were compared against a 28-day baseline using an exponentially weighted moving average algorithm. Additionally, daily seizure visits as a percentage of total ED visits were calculated and plotted. Results On September 11, 12, and 13, ED visits for seizures were increased above the expected levels. On these dates respectively, 336 visits (270 expected, p 0.01), 349 visits (278 expected, p 0.01), and 306 visits (267 expected, p 0.01) seizure visits occurred statewide. September 10 showed the largest increase in seizure visits as a percent of all visits. Conclusions Routine post-storm surveillance was able to identify an increase in seizure visits at EDs in Florida. This hurricane-related increase, while not detected using our syndromic surveillance system during previous storms, supports findings of increased emergency medical service calls for convulsions and seizures after Hurricanes Katrina and Rita (both in 2005) found by other researchers (Davis et al., 2013). Due to the size, strength, and projected path of Hurricane Irma, stress (a known seizure trigger) is a possible biological explanation for the increase that was observed. A greater understanding of storm-related public health threats allows the Florida Department of Health to better plan for these events and communicate this information to the public and our partners. Post-storm analysis was complicated by large changes in overall ED volumes during and immediately following the hurricane, and further exploration of the association found in this study is encouraged.
机译：目的使用佛罗里达州的症状监测数据描述2017年艾尔玛飓风登陆后几天的癫痫发作活动增加引言2017年9月10日，艾尔玛以4级飓风登陆佛罗里达群岛，随后追踪西侧状态。由于风暴的规模，它几乎影响了整个佛罗里达。该州的症状监测系统-社区流行病的早期预警电子监视系统（ESSENCE-FL）捕获了全州98％的急诊室（ED）的来访，并且在提供近乎实时的服务方面历来起着至关重要的作用ED数据，用于跟踪灾后发病率和死亡率。在先前的飓风和热带风暴过后，一氧化碳中毒，动物叮咬和伤害有所增加。在爱尔玛病后监测期间，观察到癫痫发作相关的急诊就诊进一步增加。方法自2017年9月10日至22日，每天产生两次飓风艾尔玛（Irma）监视报告。除针对风暴监视的专门查询外，还使用ESSENCE-FL的综合征和亚综合征类别进行了分析。癫痫发作的亚综合征类别包括急诊就诊，其中列出了患者主要主诉中的癫痫发作或惊厥。使用指数加权移动平均算法，将每天的癫痫发作次数与28天的基线进行比较。此外，还计算并标绘了每日癫痫发作次数占总ED次数的百分比。结果在9月11日，12日和13日，急诊就诊癫痫病的次数增加到了预期水平之上。在这两个日期分别在全州范围内进行了336次（预期为270次，p <0.01），349次（预期为278次，p <0.01）和306次（预期为267次，p <0.01）癫痫发作。 9月10日，癫痫发作访视人数占所有访视人数的最大百分比。结论常规的暴风雨后监视能够确定佛罗里达州急诊室的癫痫发作次数增加。这种飓风相关的增加虽然在先前的暴风雨中没有使用我们的症状监测系统检测到，但支持了其他研究人员发现卡特里娜飓风和丽塔飓风（均于2005年）后急诊和惊厥的紧急医疗服务需求增加的发现（Davis等， 2013）。由于飓风“艾尔玛”的大小，强度和预计路径，压力（已知的癫痫发作触发器）是观察到的增加的可能生物学解释。对暴风雨相关的公共健康威胁有了更深入的了解，佛罗里达州卫生部可以更好地计划这些事件，并将这些信息传达给公众和我们的合作伙伴。飓风过后和飓风过后，总体ED量发生了巨大变化，从而使风暴后的分析变得复杂，因此鼓励进一步探索本研究中发现的关联。

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