豫西地区莱姆病血清学及病原学研究

目的　了解豫西地区有关人群血清中是否存在抗莱姆病螺旋体抗体及可能存在的生物媒介。方法　采用间接或直接免疫荧光技术 ,对人血清相关抗体及蜱中肠带菌情况进行研究。结果　豫西地区人群中存在莱姆病自然感染 ,人群感染率为 13.5 3% ;蜱类调查显示 ,长角血蜱和微小牛蜱的中肠带菌阳性率为 2 6 .0 0 % ,这两种蜱可能为传播媒介 ;并从褐家鼠和黄胸鼠的血清中也检测到莱姆病抗体。结论　初步显示豫西地区存在莱姆病疫源地。     

豫西地区莱姆病血清学及病原学研究

了解豫西地区有关人群血清中是否存在抗莱姆病螺旋体抗体及可能存在的生物媒介，方法采用间接或直接免疫荧光技术，对人血清相关抗体及中蜱中肠带菌情况进行研究。结果豫西地区人群中存在莱姆病自然感染，人群感染率为１３．５３％；蜱类调查显示，长角血蜱和微小牛蜱的中肠带菌阳性率为２６．００％，这两种蜱可能为传播是；并从褐家鼠和黄胸鼠的血清中也检测到莱姆病抗体。结论初步显示豫西地区存在莱姆病疫源地。     

内蒙古大兴安岭莱姆病自然疫源地全沟硬蜱的季节消长调查

1991年4～8月在内蒙古大兴安岭对莱姆传播媒介全沟硬蜱季节消长、带菌及人群自然感染季节分布等进行调查。结果证明全沟硬蜱是当地蜱类的优势种,从5月上旬发现蜱开始活动,6月上旬为蜱密度高峰期,占总捕数的36％,7月末蜱基本消失。用直接荧光抗体法查蜱带菌率,从采集的549只全沟硬蜱中,检出带菌蜱164只,自然带菌率为29.9％。间接荧光抗体法检测63例被蜱叮咬者血清,其中13例抗体阳性,阳性率为20.6％。本次调查表明,内蒙古大兴安岭林区5～6月为莱姆病媒介全沟硬蜱活动繁殖的高峰期。对63例被蜱叮咬者进行流行病学调查,被蜱叮咬季节与全沟硬蜱季节消长曲线相一致。     

哈巴河铁热克提林牧区蜱类调查研究

作者于1999年5月在新疆哈巴河铁热克提林牧区调查莱姆病时,采用布旗法和宿主检蜱法,对当地莱姆病媒介蜱类作了调查研究,捕获蜱类标本3090只,经整理鉴定,共系8种,其中森林革蜱D.silvarum1543,占捕获总数49.94％,银盾革蜱D.niveus1099只,占35.57％,草原草蜱D.nuttalli383只,占12.49％,边缘革蜱D.marginatus58只,占1.88％,嗜群血蜱H.concin-ma、铃头血蜱H.campanulata、全沟硬蜱I.persulcatus和残缘璃眼蜱Hy.detrtum共7只,占0.22％。当地蜱类在不同生境、不同寄主和不同时间内,其种类组成、活动及数量动态各不相同。     

莱姆病性心肌炎病人的护理

莱姆病由媒介昆虫蜱(俗称草爬子)叮咬传播所致疾病.病原体为伯氏疏螺旋体.     

湖北省东北部地区发现莱姆病

应用免疫荧光方法（ＩＦＡ）对湖北省东北部地区的英山县进行了莱姆病的流行病学调查。结果，人群总感染率为８．８％（２４／２７２），其中林区居民及非林区居民感染率分别为１２．８％（２２／１７２）及２．０％（２／１００），两者差异有高度显著性（Ｐ＝０．００５）；共采集蜱４８４只，其中微小牛蜱３０８只，豪猪血蜱１３６只，二棘血蜱４０只。经检测，不同蜱种带菌率为０～１５％。本调查证实湖北省东北部地区存在莱姆病，人群感染菜姆病与环境性蜱暴露有密切关系。     

云南勐腊县磨憨口岸蜱类鼠类分布状况调查

目的调查莱姆病生物媒介蜱和主要宿主鼠类在勐腊县磨憨口岸的分类及分布。方法采用布旗法、捕鼠检蜱法、家畜体表检蜱法及鼠笼和挖洞捕鼠等方法。结果在勐腊县中老边境磨憨口岸尚勇镇和城郊的9个自然村、3块原始森林,采集到蜱类291只,优势种为镰形扇头蜱(R.haemaphysaloides)占78.01%(227/291)(其中寄生于羊186只、牛29只、狗8只、游离蜱4只)。其次为微小牛蜱(Boophilus microplus)占21.99%(64/291),全部寄生于牛。共捕获老鼠27只,其中黄胸鼠(Rattus flauipectus)13只、褐家鼠(Rattusnorvegicus)7只、卡氏小鼠(Mus caroli)4只、小家鼠(Mus musculus)3只;鼠体尚未检到蜱类。结论本调查初步了解莱姆病生物媒介蜱和主要宿主鼠类在云南勐腊县磨憨口岸的分布状况,为在中老边境进一步开展莱姆病(Lyme disease)等虫媒传染病的调查打下基础。     

陕西省莱姆病媒介蜱的调查小记

目的调查了解陕西省莱姆病的媒介蜱类。方法采用拖旗法调查采集。结果获得蜱类标本1116只,经整理鉴定,计硬蜱科Ixodidae 5属15种,即硬蜱属Ixodes1种,血蜱属Haemaphysalis4种,璃眼蜱属Hyalomma3种,革蜱属Dermacentor5种,扇头蜱属Rhipicephalus2种。结论初步掌握了陕西省的常见蜱种。     

长白山林区莱姆病的血清学调查

[目的]了解长白山林区莱姆病的流行及发病情况.[方法]采用酶联免疫吸附试验(ELISA)法检测218名长白山林区人群的莱姆病抗体水平,对血清莱姆病抗体阳性者进行流行病学及临床表现相关调查.[结果]218名受检者中血清莱姆病抗体阳性者为18人(8.25%),其中青壮年人群感染率显著高于老年人群;阳性者中近2年内有蜱叮咬史者为10名.所有阳性者均有慢性游走性红斑皮疹症状,部分病例出现肌痛、关节炎、心功能异常及神经精神症状.[结论]长白山林区存在莱姆病流行,其状况与中国东北地区其他林区流行状况相类似.蜱叮咬是本病的重要传播途径,但亦不能排除其他途径.     

一种新疾病的生态学

莱姆病是由单敏硬蜱传播的由莱姆病螺旋体引起的蜱媒病。莱姆病患者的组织中和80％的单敏硬蜱可检出这种螺旋体。     

The pathologist's view of Lyme disease

Lyme disease is a multisystem disease caused by the spirochete Borrelia burgdorferi and is transmitted to humans primarily through Ixodid ticks. The clinical spectrum of the disease is continuing to expand while in its wake the pathology and histopathologic manifestations are being uncovered. We review the pathology of Lyme disease in man beginning with the tick bite. We present the pathologic changes of the rash, erythema migrans, as well as the neurologic, cardiac, and arthritic changes of the disease. We can expand our understanding of the immunobiology of Lyme disease by studying the interactions of B. burgdorferi in an experimental animal model.     

Investigation of Lyme disease in Xinjiang.

From April through July 1988, an epidemiological investigation on Lyme disease was carried out in Nalati Xanyuan, Xinjiang Uygur Autonomous Region, China. Of 150 Ixodes persulcatus ticks examined by darkfield microscopy, 42 (28%) were found to have spirochetes. Two strains of spirochetes were isolated from I. persulcatus with BSK medium. Rabbits inoculated with the spirochetes showed erythema chronicum migrans at the sites of inoculation and the spirochetes were found in the cerebrospinal fluid by darkfield microscopy. Serum samples from 63 patients were examined for antibodies to B. burgdorferi by IFA test and 11 of them were positive with a titer of 1:64. Upon these results, it may be concluded that natural focus of Lyme disease exists in Xinjiang, China.

     

Toll样受体和趋化因子与莱姆关节炎发病的相关性

莱姆病是一种由伯氏疏螺旋体引起,经蜱传播的自然疫源性疾病,也是一种人兽共患病,莱姆关节炎是莱姆病的晚期临床表现,严重者可终生致残,严重影响了人们的健康和生活质量,目前,对莱姆关节炎的致病机制尚不清楚,国内外已经取得了一系列进展,但有待进一步研究.现就Toll样受体和趋化因子与莱姆关节炎发病关系的研究做一综述.     

Positive Lyme serology in subacute bacterial endocarditis. A study of four patients

Lyme borreliosis is a multisystem inflammatory disorder caused by the tick-borne spirochete Borrelia burgdorferi. Clinical manifestations are protean, involving the skin, joints, peripheral and central nervous systems, and the heart. However, the presentation of Lyme disease often overlaps with that of other conditions. We describe four patients from a region endemic for Lyme disease who had elevated levels of antibodies reactive to B burgdorferi and whose signs and symptoms were initially attributed to Lyme borreliosis but whose subsequent blood cultures established a diagnosis of nonspirochetal subacute bacterial endocarditis. Although immunoblots on serum samples from three of the four patients were consistent with prior infection from B burgdorferi, a positive immunoblot does not establish active infection. Similarly, seropositivity to B burgdorferi only indicates possible exposure to this organism. The occurrence of positive serologies to B burgdorferi in the presence of other diseases can lead to diagnostic confusion.     

Fatal adult respiratory distress syndrome in a patient with Lyme disease

A dry cough, fever, generalized maculopapular rash, and myositis developed in a 67-year-old woman; she also had markedly abnormal liver function test results. Serologic tests proved that she had an infection of recent onset with Borrelia burgdorferi, the agent that causes Lyme disease. During a two-month course of illness, her condition remained refractory to treatment with antibiotics, salicylates, and steroids. Ultimately, fatal adult respiratory distress syndrome developed; this was believed to be secondary to Lyme disease.     

西北部分地区莱姆病与人、家养动物、啮齿动物关系的研究

1991—1999年,先后对甘肃铧尖、迭部和新疆阿勒泰铁热克提三地区莱姆病与人、家养动物、啮齿动物的关系作了调查研究。研究发现三地区森林草原为莱姆病自然疫源地,有传播莱姆病的媒介和保菌宿主,并从森林革蜱(D.silvarum)、草原革蜱(D.nuttalli)、日本血蜱(H.japoni-ca)和黑线姬鼠(A.agrarius)、黄毛鼠(R.losea)、棕背(鼠平)(C.rufocanus)、鼹形田鼠(E.talplinus)体内分离到了伯氏疏螺旋体(Borrelia burgdorferi),查到了特异性抗体,家养动物阳性率22.12％,啮齿动物阳性率18.48％,不仅发现当地人群中有一定程度的感染(受检2869人份,阳性241人份,阳性率8.40％),而且还先后发现病人126例。阐述了当地莱姆病流行上与人、家养动物和啮齿动物之间的相互关系,证实了两种传播方式,即1.莱姆病在啮齿动物之间流行,人进入该流行区被带伯氏螺旋体的蜱叮咬而患病;2.莱姆病在啮齿动物之间流行,家畜动物进入该流行区觅食时,将带有伯氏疏螺旋体的蜱又带到了人们的生活区,再叮咬生活区的人而发病。     

The prevalence of Borrelia burgdorferi seropositivity in an area endemic for Lyme disease

We conducted a seroprevalence survey of antibodies to Borrelia burgdorferi in West Central Wisconsin, an area endemic for Lyme disease. One hundred and thirty-seven of 153 patients having blood drawn at the Eau Claire Family Medicine Clinic and the associated rural Augusta practice participated in the study and were tested for the presence of antibodies to B burgdorferi and questioned about Lyme disease risk factors. An enzyme-linked immunosorbent assay showed that 15 (10.9%) of the 137 persons had serological evidence of exposure to B burgdorferi. None of these 15 persons reported a past or current history of clinical Lyme disease, and they were not found to have more symptoms commonly associated with Lyme disease than seronegative patients. We conclude that the prevalence of positive Lyme serologies in this area is similar to that of other endemic areas and that subclinical or asymptomatic infection probably accounts for many of these positive results.     

Tick exposure and Lyme disease at a summer camp in Maryland

After investigating an outbreak of Lyme Disease among counselors at a summer camp in Kent County, Maryland in 1994, we wanted to determine the incidence of Lyme Disease (LD) at the camp the following summer and identify risk factors for tick exposure. Any ticks that were detected on campers' skin or clothing were collected by the camp nurse and we studied them for infection with Borrelia burgdorferi. In addition, we sent detailed questionnaires home with the 1,623 campers. A total of 537 campers returned the questionnaire and 200 had found ticks on their skin or clothing while at camp. Risks were analyzed using logistic regression models. Participation in the ropes-course, night-trip and camp-out events significantly increased the risk of tick exposure (OR 1.6 to 2.3). Six cases of LD were identified among campers, which was an estimated incidence of 3.3 per 1,000 campers/10-14 day camp session, and two counselors had LD. Of the 238 ticks collected mainly in June-July 1995, 19% were identified as Ixodes scapularis larvae and nymphs; 11% of the latter were infected with B. burgdorferi. The risk for LD in campers and staff was much higher than that of the general population despite the use of tick-exposure precautions. Focused interventions need to be put in place in summer camps to prevent transmission of LD.     

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.