以面神经麻痹为主的莱姆病（血清流行病学调查及2例报道）

本文报道莱姆（Ｌｙｍｅ）病血清流行病学调查结果，１２０份蚌埠市区居民血清中未查出莱姆病抗体，而在７０份面神经麻痹患者血清中则检出２例莱姆病抗体阳性，证明平原地区也有莱姆病感染。     

以面神经麻痹为主的莱姆病：（血清流行病学调查及2例报告）

本文报道莱姆（Ｌｙｍｅ）病血清流行病学调查结果。１２０份蚌埠市区居民血清中未查出莱姆病抗体，而在７０份面神经麻痹患者血清中则检出２例莱姆病抗体阳性，证明平原地区也有莱姆病感染。     

山西长治地区就诊人群莱姆病血清学初步调查

目的：确定长治地区莱姆病的存在以及莱姆病感染者的来源。方法：收集附属医院就诊196人的血样，用ELISA方法检测人群血清莱姆病抗体阳性率。结果：196个血样中，莱姆病血清莱姆病抗体阳性血样7份，阳性率3．5％，莱姆病血清阳性感染者均来自当地农村，男性，年龄在30岁-45岁之间。结论：长治地区存在人群莱姆病的自然感染。     

新疆喀什市不同人群蜱传莱姆病血清流行病学调查

目的了解莱姆病在新疆喀什市不同人群中流行和感染的状况。方法采用酶联免疫吸附试验法对从新疆喀什市不同人群中采集的1500份血清样本进行抗莱姆病螺旋体IgG抗体检测,对所有样本采用巢式PCR方法扩增莱姆病螺旋体rrf(5S)～rrl(23S)rRNA间隔区片段,检测血清样本莱姆病螺旋体的阳性率,实验数据采用SPSS19.0软件进行统计学分析。结果 1500份被检血清中62份抗莱姆病螺旋体IgG抗体阳性,阳性率为4.13%,不同年龄人群均有莱姆病螺旋体感染,其中,20～50岁人群的感染率明显高于20岁以下和50岁以上人群,差异有统计学意义(χ~2=11.426,P=0.008);莱姆病螺旋体感染在性别和族别间差异无统计学意义(χ~2=1.875,P=0.492;χ~2=1.693,P=0.483),巢式PCR未检测到莱姆病螺旋体阳性的样品。结论新疆喀什市人群存在蜱传莱姆病感染。     

盈江县 2004 -2013 年狂犬病流行与防控效果分析

目的了解盈江县狂犬病流行态势及防治效果,为控制狂犬病提供科学依据。方法应用描述流行病学方法对盈江县狂犬病疫情及防控资料进行统计分析。结果2004—2013年盈江县发生动物狂犬病疫情21起,在犬伤人群中发生人间狂犬病病例15例,年均发病率0．51／10万;检验犬类脑组织标本52份,检出狂犬病毒抗原和核酸2份,阳性率3．85％。实施狂犬病综合防治措施后疫情得到了遏制。结论盈江县狂犬病自然疫源地有扩散蔓延趋势,要加强监测和落实各项防控措施。     

某市3所医院护理人员莱姆病相关知识问卷调查分析

目的了解某市医院临床护理人员对莱姆病相关知识的知晓情况,为莱姆病临床护理工作提供科学依据。方法自行设计问卷调查表,随机抽取3所医院护理人员,对提前设定好的问卷调查表限时作答上交,汇总分析。结果本次调查发放调查表280份,有效问卷回收率100. 00%;问卷结果仅0. 71%护理人员卷面回答全部正确,知晓率较高的相关知识是莱姆病神经损害型临床表现(67. 50%)和眼型临床表现(59. 64%),而在临床工作中仅0. 71%工作人员接触过莱姆病病例,其余人员对莱姆病相关知识知晓欠缺。结论某市3所医院临床护理人员总体对莱姆病相关知识知晓欠缺,直接影响莱姆病临床护理质量和治疗效果。     

迭部林区莱姆病、野兔热、恙虫病和Q热复合感染的调查研究

目的调查了解甘肃省迭部林区人群莱姆病、野兔热、恙虫病、Q热等4种病的自然感染、分布特征和复合感染状况。方法血清学检测。结果调查采集迭部林区人群703份血清样本,检测出莱姆病、野兔热、恙虫病、Q热血清抗体阳性率分别为5．83％、4．41％、1．42％和2．42％,4种病的复合感染率0．85％,其中莱姆病与野兔热复合感染率0．14％,莱姆病与恙虫病复合感染率0．14％,莱姆病与Q热复合感染率0．43％,莱姆病、野兔热与Q热三病复合感染率0．14％。结论甘肃省迭部林区人群中存在莱姆病、野兔热、恙虫病和Q热的复合感染,为诊断和防治提供了科学依据。     

森林脑炎与莱姆病的血清学对比观察

莱姆病是林区近几年发现的蜱媒螺旋体病,可与森林脑炎同时发生,近5年本院检查804份血清标本,森林脑炎抗体阳性133例,占16.4％,莱姆病抗体阳性96例,占11.94％,其中16例抗体双阳性     

云南省某大学新生中莱姆病和恙虫病的血清流行病学调查

目的 分析云南省某大学新生莱姆病和恙虫病感染情况,间接了解两种虫媒传染病在云南省的分布.方法 采集来自云南滇中及滇东北2地区大学新生血样标本,以ELISA方法检测莱姆病和恙虫病IgG抗体,计算抗体阳性率.结果 共检测大学新生血清标本42份,检出莱姆病IgG抗体阳性率为2.4％;恙虫病IgG抗体阳性率为4.8％.结论 云南省存在莱姆病和恙虫病散发,应进一步加强对这2种虫媒传染病的监测与控制.     

莱姆病神经系统损害72例临床分析

莱姆病的神经系统损害又称神经莱姆病，以神经系统损害表现多样化且无特异性为特点，现将我院近几年收治的有神经系统损害的莱姆病72例总结如下。     

Babesiosis in Wisconsin. A new focus of disease transmission

A confirmed case of human babesiosis was identified in August 1983 in a 54-year-old asplenic Wisconsin resident. Babesia microti was identified as the causative agent by blood smear morphology and hamster inoculation techniques. The patient's wife had clinically confirmed Lyme disease in 1981 and had serologic evidence (immunofluorescent antibody to a B microti titer of 1:1,024) of recent Babesia infection in August 1983. Mice (Peromyscus species) trapped on the patients' property and elsewhere in their Wisconsin county of residence were infected with B microti. Lyme disease and babesiosis have the same tick vector and animal reservoir; serum samples from 116 Wisconsin and Minnesota residents with clinically confirmed Lyme disease between 1980 and 1983 were tested, and none were found to have concurrent Babesia infection. This area of Wisconsin is identified as a new focus for babesiosis transmission, but the risk of transmission seems to be low.     

Role of serology in the diagnosis of Lyme disease.

Numerous concerns regarding the potential for misdiagnosis of Lyme disease using commercial assays have been voiced by the US Food and Drug Administration (FDA). We attempted to clarify the clinical value of serologic testing for Lyme disease using the results of commonly marketed assays for detecting antibody to Borrelia burgdorferi, the organism that causes Lyme disease. We reviewed published studies on B burgdorferi test performance published through 1998, package insert labeling from FDA-cleared test kits for B burgdorferi, and Lyme Disease Survey Set LY-A from the College of American Pathologists. We assessed the sensitivity and specificity of commercial serologic tests (enzyme-linked immunosorbent assay [ELISA], immunofluorescence antibody [IFA], and immunodot) for diagnosis of Lyme disease. To reduce this risk of misdiagnosis, it is important that clinicians understand the performance characteristics and limitations of these tests. These tests, in common use in clinical or commercial laboratories, should be used only to support a clinical diagnosis of Lyme disease, not as the primary basis for making diagnostic or treatment decisions. Serologic testing is not useful early in the course of Lyme disease because of the low sensitivity of tests in early disease. Serologic testing may be more useful in later disease, at which time sensitivity and specificity of the test are improved. Positive or equivocal results on an ELISA, IFA, or immunodot assay requires supplemental testing with a Western blot assay. A negative result on the Western blot or ELISA indicates that there is no serologic evidence of infection by B burgdorferi at the time the sample was drawn.     

盈江县2012年麻疹流行病学调查及分析

目的分析盈江县麻疹控制后复燃的影响因素,为推进消除麻疹进程提供科学依据。方法采用描述流行病学方法对盈江县2012年麻疹流行及相关资料进行统计分析。结果盈江县2012报告疑似麻疹病例16例,确诊7例,其中缅甸输入4例、县内发生3例。患者均无免疫史,均为散发。结论盈江县麻疹复燃原因是境外输入麻疹传染源,应针对流行原因采取相对应的防控措施。     

The geographic spread and temporal increase of the Lyme disease epidemic

OBJECTIVE. To describe the temporal and geographic progression of the Lyme disease epidemic in New York State from 1977 through 1989. DESIGN. Communicable disease surveillance system. SETTING. Statewide. MAIN OUTCOME MEASURES. The progression of the epidemic was examined by analyzing trends in Lyme disease cases reported to the state surveillance system, town and county Lyme disease incidence rates, Lyme disease hospital discharge rates, and the distribution of Ixodes dammini ticks obtained from surveillance efforts and submitted for identification. MAIN RESULTS. The number of confirmed Lyme disease cases in New York has increased with concurrent increases in the number of hospital discharges. The number of counties endemic for Lyme disease increased from four to eight between 1985 and 1989. The number of counties with documented I dammini ticks increased from four in 1985 to 22 in 1989. Incidence of the disease also increased within known endemic counties. CONCLUSIONS. Tick surveillance indicated that the range of I dammini has expanded annually into areas up to 384 km from the original known endemic areas of Long Island, NY, and Connecticut. Cumulative data from human surveillance resources document both temporal increases and geographic expansion of the Lyme disease epidemic in New York.     

湘南莽山林区莱姆病心肌损伤的流行病学调查

目的探讨莱姆病心肌损伤流行病学特点。方法采用间接免疫荧光抗体试验（IFA）初步筛查湘南莽山林区莱姆病血清抗体阳性患者,进行莱姆病心肌损伤的诊断和流行病学调查。结果1120名林区居民中,莱姆病患者72例,患病率为6.4%,男女莱姆病患病率分别为6.2%和6.7%,男女患病率间差异无统计学意义（P〉0.05）。不同年龄组居民莱姆病的感染率比较,差异有统计学意义（P〈0.01）。莱姆病心肌损伤患者14例,发生率为19.4%,其中男女心肌损伤比为3∶1。各年龄组莱姆病患者心肌损伤发生率比较,差异无统计学意义（P〉0.05）。心肌损伤出现于红斑后21d（中位数）,以房室传导阻滞常见。结论莱姆病患者心肌损伤发生于早期,心肌损伤有性别差异,损伤类型以传导系统功能障碍为主。     

云南省盈江县蚊虫调查及乙型脑炎病毒分离

1984年及1989年7～8月,在盈江县捕获成年雌性蚊虫7属32种632O只,霜背库蚊、三带喙库蚊和棕头库蚊是农村畜圈的主要蚊种,伪白纹伊蚊和白纹伊蚊是野外竹林区的优势蚊种。对所获蚊虫用C6/36细胞和小白鼠方法分离病毒,从三带喙库蚊和窄翅伊蚊中各分离到1株乙型脑炎病毒。分析认为三带喙库蚊是当地乙型脑淡病毒的主要传播媒介,窄翅伊蚊亦可参与该病毒的传播。     

河北省承德林区莱姆病血清学调查研究

目的:调查承德地区林区动物莱姆病以及当地居民感染莱姆病螺旋体的情况.方法:血清流行病学检测承德林区牛、羊血清IgG抗体和当地居民血清IgG抗体,PCR法检测莱姆病螺旋体.结果:血清流行病学检测结果显示,在承德林区至少有牛、羊两种动物中有莱姆病的感染, 其感染率分别为 23.3%、30%;当地居民也存在莱姆病的感染,感染率为13.3%;PCR检测未查到阳性结果.结论:此次调查证实了牛、羊是承德林区莱姆病的重要贮存宿主;当地居民存在莱姆病的感染.     

中国莱姆病螺旋体PD_(91)重组外膜蛋白C抗原性初步研究

目的　研究中国莱姆病螺旋体 PD91 重组外膜蛋白 C(r Osp C)检测莱姆病特异性抗体Ig M的效果 ,为莱姆病的早期特异性诊断提供依据。方法　 r Osp C经纯化、定量后 ,用于酶联免疫吸附试验 (EL ISA) ,检测早期莱姆病患者和莱姆病疫区工人血清 Ig M,并与其他检测方法比较检测效果。结果　用 r Osp C EL ISA和全菌蛋白 Western blotting方法检测了 12例早期莱姆病患者血清 Ig M,其阳性率分别为 75 %和 6 6 .7% (P>0 .0 5 ) ;r Osp C EL ISA、全菌蛋白 EL ISA检测 98份健康人血清 Ig M,特异度分别为 10 0 %和 96 .94 % (P>0 .0 5 ) ;用 r Osp C EL ISA、全菌蛋白 EL ISA和 IFA检测 2 10例莱姆病疫区工人血清 ,其阳性率分别为 5 .2 4 %、8.5 7%和 7.6 2 % ,3种检测方法间无统计学差异 (P>0 .0 5 )。结论　 r Osp C具有较好的灵敏度和特异性 ,其用于我国早期莱姆病患者的临床检测和莱姆病流行病学调查上有一定的应用价值。