全沟硬蜱在黑龙江小兴安岭莱姆病螺旋体传播中的作用

目的：探讨全沟硬蜱在莱姆病螺旋体传播中的作用。方法：用布旗法在林区草地采蜱，并分类鉴定；用直接荧光抗体法检查蜱类中肠带菌情况，并分离菌株。结果：全沟硬蜱为当地优势蜱种，人群发病与该蜱叮咬率密切相关；该蜱中肠带菌率为４０％，并从１４组（７０只）蜱中分离出２株莱姆病螺旋体；新分离株的单克隆抗体反应与国内分离株Ｍ７相同，而与美国菌株Ｂ３１有区别。结论：当地全沟硬蜱是莱姆病螺旋体的主要生物媒介。     

全沟硬蜱是我国北方地区莱姆病螺旋体的主要传播媒介

研究我国北方地区莱姆病螺旋体的生物媒介—蜱的种类、带菌状况及在传播莱姆病中的作用。用布旗法和动物诱捕法在山林地区采集蜱，分类鉴定，直接荧光抗体染色法查蜱中肠带菌率，ＢＳＫ培养基分离病原体，单克隆抗体鉴定菌株。调查蜱叮咬率与人群莱姆病感染率、患病率以及蜱的季节消长与莱姆病慢性游走性红斑（ＥＣＭ）病例发生的季节性关系。在北方１０省（市、区）共采集到１００００多只蜱，分属为２科７属１１种，以全沟硬蜱为优势种，占８０％～９５％。４种蜱的中肠携带莱姆病螺旋体，全沟硬蜱的带菌率高达２０．００％～４５．００％。从４种蜱分离到９８株莱姆病螺旋体，其中９０％以上是从全沟硬蜱分离的。全沟硬蜱叮咬率高的人群，莱姆病的感染率和患病率也高。全沟硬蜱的季节消长与ＥＣＭ发生的季节性相一致。证实我国北方地区至少有４种蜱的中肠内携带莱姆病螺旋体，莱姆病螺旋体的主要生物媒介是全沟硬蜱。     

中国莱姆病螺旋体主要生物媒介的调查研究

为研究中国莱姆病螺旋体的生物媒介———蜱的种类、带菌状况及在传播莱姆病中的作用 ,采用布旗法和动物诱捕法在山林地区采集蜱 ,进行分类鉴定 ,应用直接荧光抗体染色法查蜱中肠带菌率 ,BSK培养基分离病原体 ,单克隆抗体鉴定菌株。调查蜱叮咬率与人群莱姆病感染率、患病率以及蜱的季节消长与莱姆病慢性游走性红斑 (ECM )病例发生的季节性关系。在全国 2 0个省 (市、区 )共采集到170 0 0多只蜱 ,分属为 2科 8属 2 3种 ,蜱类分布的地区差异较大 ,北方林区以全沟硬蜱为优势种 ,南方则以二棘血蜱和粒形硬蜱为优势种。 9种蜱的中肠携带莱姆病螺旋体 ,其带菌率以全沟硬蜱、二棘血蜱和粒形硬蜱为高 ,分别为 2 0 .0 0 %～ 4 5.0 0 %、16.0 0 %～ 4 0 .0 0 %和 2 4 .0 0 %。从 8种蜱分离出 10 8株莱姆病螺旋体 ,其单克隆抗体反应与美国B31菌株有明显的差异 ,绝大多数中国菌株对H6831呈阴性反应。蜱叮咬率高的人群 ,莱姆病的感染率和患病率也高。全沟硬蜱的季节消长与ECM发生的季节性相一致。证实多种蜱的中肠内携带莱姆病螺旋体 ;我国北方林区莱姆病螺旋体的主要生物媒介是全沟硬蜱 ,南方林区二棘血蜱和粒形硬蜱是重要的生物媒介。     

我国莱姆病螺旋体生物媒介的初步调查

自1987年以来,我们在全国开展了莱姆病调查,从黑龙江、吉林、辽宁、内蒙、河北、新疆、湖北、四川、福建和北京等省、市采集的全沟硬蜱、粒形硬蜱、壤塘硬蜱、嗜群血蜱、二棘血蜱和长角血蜱分离出71株莱姆病螺旋体,其中55株从全沟硬蜱分离。全沟硬蜱是东北和西北针阔叶林区的优势蜱种,其带菌率为20~45%,表明全沟硬蜱是我国北方莱姆病螺旋体的主要生物媒介。虽然从我国南方的某些硬蜱属和血蜱属种类分离到莱姆病螺旋体,但是南方的主要生物媒介还不清楚。从我国蜱体内分离的螺旋体在超微结构、单克隆抗体反应和外表蛋白等方面与美国菌株有某些区别。     

山东省莱姆病地理流行病学研究

目的调查山东省莱姆病地理分布、媒介生物、动物宿主及病原分离情况,为今后防治提供依据。方法采用间接免疫荧光抗体试验(IFA)对6个调查点的人群进行莱姆病抗体检测;用直接免疫荧光抗体试验(DFA)检查优势蜱种及其携带莱姆病螺旋体情况,并用BSKⅡ培养基分离培养莱姆病螺旋体。宿主调查采用DFA检查鼠肾。用单克隆抗体和IFA进行菌株的鉴定。结果共检测血清1934份,阳性121份,感染率6.26%;鲁东、鲁南、鲁中、鲁西北感染率分别为5.76%、7.03%、0、9.81%;各年龄组差异无统计学意义(P>0.05);男性感染率为5.56%,女性为6.98%,两者间差异无统计学意义(χ2=1.67,P>0.05);山东省蜱类的优势种为长角血蜱,该蜱中肠带螺旋体率为12.00%;宿主动物调查显示,鼠类带莱姆病螺旋体率为13.26%,黑线姬鼠为优势种(占45.65%),带菌率高为14.24%。从86组培养物中分离到2株莱姆病螺旋体(TSH1、TSH2)。结论不同地区生态环境和传播媒介分布不同,各地区间莱姆病感染程度差别很大。长角血蜱可能为山东省莱姆病的重要生物媒介。     

用聚合酶链方法对北京林区莱姆病疫源地及莱姆病病原体基因型的探索性研究

目的：进一步明确北京林区是否存在莱姆病的自然疫源地及其分布，方法基于莱姆病螺旋体外膜蛋白A基因建立半巢式聚合酶链式反应(polymerase chain reactio,PCR)方法，对从北京6个林区采集的蜱和鼠进行检测和基因分型，选择阳性标准本进行克隆和序列测定，与已知序进行同源性比较，间接免疫荧光法检测抗莱姆病螺旋体IgG抗体，从长角血蜱中分离莱姆病螺旋体。结果：从门头沟区东灵山采集的标本中检测到莱姆病螺旋体DNA片段，3只游离全沟硬蜱1只检测阳性，57只寄全沟硬蜱若蜱中1只检测阳性；119只野鼠中9只检测阳性，其中8只，B.garinii阳性，1只B.afzelii阳性。50份野鼠血清有5份莱姆病螺旋体IgG抗体阳性，采集采的160只长角血蜱（20只／组）。未分离到莱姆病螺旋体菌株。结论：北京门头沟区东灵山可能存在莱姆病的自然疫源地，包括两个基因型，全沟硬蜱可能是莱姆病的传播媒体，野鼠可能是贮存宿主。     

中国20个省、区、市动物莱姆病初步调查研究

目的：广泛调查我国动物莱姆病分布情况。方法：血清流行病学和病原学研究。结果：１９８７～１９９７年间，牛、羊、狗、野兔和８种野鼠有莱姆病的感染存在，其中牛、羊、狗和野鼠的感染率分别为１８．１８％～３２．６１％、１７．１２％～６１．２１％、３８．５％～６０．００％和４１．１８％～８６．０５％；从黑线姬鼠和白腹巨鼠的胎鼠分离到莱姆病螺旋体，证实莱姆病螺旋体可通过胎盘垂直传播。９种蜱的中肠携带莱姆病螺旋体，带菌率以全沟硬蜱、二棘血蜱和粒形硬蜱为高，分别为２０．００％～４５．００％、１６．００％～４０．００％和２４．００％。从华南兔、８种野鼠和８种蜱分离出１２８株莱姆病螺旋体。证实黑线姬鼠和棕背是中国莱姆病螺旋体的重要储存宿主；多种蜱的中肠内携带莱姆病螺旋体，我国北方林区莱姆病螺旋体的主要生物媒介是全沟硬蜱，南方林区二棘血蜱和粒形硬蜱是重要的生物媒介。结论：我国动物莱姆病广泛存在     

长春地区首次发现莱姆病疫源地

目的确认长春地区是否莱姆病疫源地。方法用酶联免疫吸附试验等方法检测莱姆病人群特异IgG、IgM抗体，全沟硬蜱中肠伯氏疏螺旋体培养。长春地区全沟硬蜱733只，用BSK33℃培养，获得伯氏疏螺旋体培养物278株，用兔抗美国B31特异性单克隆抗体和针对莱姆病螺旋体种属特异M7，间接免疫荧光抗体进行试验。其结果与美国菌株稍有差异，同国内分离株M7相同。血清学调查298人份，15人阳性，平均感染率为5．03％。结果长春地区莱姆病疫源人群、家畜、动物感染莱姆病。结论首次确认长春地区存在莱姆病自然疫源地。     

全沟硬蜱经期传播莱姆病螺旋体的研究

目的：研究全沟硬蜱经期传播莱姆病螺旋体的能力。方法：以莱姆病螺旋体感染的KM鼠作为宿主动物，利用培养和PCR方法检测全沟硬蜱对吸血感染的莱姆病螺旋体的保持能力以及蜕化后若蜱对敏感动物的感染能力。结果：全沟硬蜱幼蜱攻击感染KM鼠后获得97.5%的阳性感染，并能保持所感染的莱姆病螺旋体至若蜱。幼蜱蜕化后,45.0%的若蜱仍携带姆病螺旋体并可通过叮咬感染敏感KM鼠。结论：全沟硬蜱具备经期传播莱姆病螺旋体的能力。     

长白山区莱姆病调查与实验室分析

目的：了解长白山区莱姆病传播媒介－全沟硬埤的地理位置,分布及其病原携带情况。方法：用酶联免疫吸附试验,间接免疫荧光试验检测莱姆病特异IgG抗体,结果：长白山区抓捕的620只硬蜱,全沟硬蜱为593只,占总数的95．80％,用BSK培养基33度培养,分纯后共获得纯阳性和伯氏疏螺旋体培养物243株,用免疫抗美国B31特异性多克隆抗体和针对莱姆病螺旋体种属特异单克隆抗体,间接免疫荧光荧光抗体试验进行鉴定,证明其单克隆抗体反应与美国菌株稍有差异,与国内分离株M7相同,血检826人,IgG,IgM大于等于1：128（抗体滴度）有49例,阳性率为5．93％,IgG,IgM大于等于1：64（抗体滴度）有82例;二项合计为15．85％,结论：长白山区是莱姆病重要疫源地,人群中有莱姆病感染存在,并有莱姆病发生。     

Patterns of Lyme disease diagnosis and treatment by family physicians in a southeastern state

This study examined how often physicians in Georgia diagnose and treat Lyme disease as well as the criteria they use to reach a diagnosis of Lyme disease. A survey was sent to 1,331 family physicians in Georgia concerning how many cases of Lyme disease the physicians diagnosed, and the criteria used to make the diagnosis, during the preceding 12 months. Of 710 responses, 167 physicians treated 316 cases of Lyme disease without a firm diagnosis. In addition, 125 physicians diagnosed 262 cases of Lyme disease, 130 without serologic testing and 132 with serologic testing. Family Physicians in Georgia diagnose Lyme disease at a rate 40 times greater than the surveillance case rate reported in Georgia.     

大兴安岭南段莱姆病的调查

1991年4～6月,我们在大兴安岭南段林区,对莱姆病进行了调查,应用间接免疫荧光抗体法检测496人居民血清,38人血清中抗莱姆病螺旋体IgG抗体效价≥1:128。根据临床表现和血清学调查,确诊莱姆病病例22例;从26只全沟硬蜱分离出4株莱姆病螺旋体。     

湖北省莱姆病血清流行病学调查研究

目的：查明湖北省人群莱姆病感染情况。方法：间接酶联免疫吸附试验、莱姆病血清流行病学调查。结果：从１１９２人中检出阳性１５２份,排除钩体ＭＡＴ阳性３０份,实际莱姆病ＩｇＧ抗体阳性１２２份,阳性率１０．４９％（１２２／１１６２）。其中五峰县１４．３９％,南漳县９．９２％,保康县７．１２％。男性阳性率１０．７１％,女性阳性率９．９４％,性别间差异无显著性。人群年龄为９～６８岁,２０～４０岁青壮年感染阳性率最高。不同职业人群感染率,农民８．９３％,林业工人１３．６５％,学生３．５７％。人群蜱叮咬率为５．９２％。有蜱叮咬史者莱姆病阳性率高达５６．７１％;而无明确蜱叮咬史者阳性率仅为７．６７％。确诊莱姆病关节炎４例。结论：湖北省人群中有莱姆病的感染存在,并有莱姆病发生。     

新疆石油探区职工莱姆病血清流行病学调查

目的 :查明本局所属新疆石油探区职工的莱姆病感染与发病情况。方法 :IFA和ELISA ,并结合个案流行病学调查结果及临床表现确诊。结果 :12 0 1名职工 ,感染 12 1人 ,感染率10 .0 7% ;确诊病人 81例 ,患病率 6.74%。结论 :首次证实天山南部石油探区为莱姆病重要流行区。     

牡丹江林区莱姆病分布的地理特点

1989年在牡丹江林区对4个不同地理地貌的林场进行了莱姆病的调查。在访问和检查的2 718人中,发现74例患者,其中54例是慢性游走性红斑,12例是神经系统损伤,8例是关节炎。从深山区到丘陵地均有莱姆病患者存在和发生。4个林场的患病率分布在11.6~45‰,深山区莱姆病的患病率明显高于丘陵地带。
从1例精神紊乱病人血液中分离到1株莱姆病螺旋体。
全沟硬蜱季节消长曲线和慢性游走性红斑病例曲线相一致,确证全沟硬蜱的媒介作用。     

Analysis of the antigenic determinants of the OspC protein of the Lyme disease spirochetes: Evidence that the C10 motif is not immunodominant or required to elicit bactericidal antibody responses

As Ixodes ticks spread to new regions, the incidence of Lyme disease (LD) in companion animals and humans will increase. Preventive strategies for LD in canines center on vaccination and tick control (acaricides). Both subunit and bacterin based LD veterinary vaccines are available. Outer surface protein C (OspC), a potent immunogen and dominant early antigen, has been demonstrated to elicit protective antibody (Ab) responses. However, a single OspC protein elicits a relatively narrow range of protection. There are conflicting reports as to whether the immunodominant epitopes of OspC reside within variable or conserved domains. A detailed understanding of the antigenic determinants of OspC is essential for understanding immune responses to this essential virulence factor and vaccinogen. Here, we investigate the contribution of the conserved C-terminal C10 motif in OspC triggered Ab responses. Using a panel of diverse recombinant full length OspC proteins and their corresponding C10 deletion variants (OspCΔC10), we demonstrate that the C10 motif does not significantly contribute to immunization or infection induced Ab responses in rabbits, rats, canines, horses and non-human primates. Furthermore, the C10 motif is not required to trigger potent bactericidal Ab responses. This study provides insight into the antigenic structure of OspC. The results enhance our understanding of immune responses that develop during infection or upon vaccination and have implications for interpretation of LD diagnostic assays that employ OspC.     

Vaccination of horses with Lyme vaccines for dogs induces short-lasting antibody responses

Borrelia burgdorferi can induce Lyme disease. Approved Lyme vaccines for horses are currently not available. In an effort to protect horses, veterinarians are using Lyme vaccines licensed for dogs. However, data to assess the response of horses to, or determine the efficacy of this off-label vaccine use are missing. Here, antibodies against outer surface protein A (OspA), OspC, and OspF were quantified in diagnostic serum submissions from horses with a history of vaccination with canine Lyme vaccines. The results suggested that many horses respond with low and often short-lasting antibody responses. Subsequently, four experimental vaccination trials were performed. First, we investigated antibody responses to three canine vaccines in B. burgdorferi-naïve horses. One killed bacterin vaccine induced antibodies against OspC. OspA antibodies were low for all three vaccines and lasted less than 16 weeks. The second trial tested the impact of the vaccine dose using the OspA/OspC inducing bacterin vaccine in horses. A 2 mL dose produced higher OspA and OspC antibody values than a 1 mL dose. However, the antibody response again quickly declined, independent of dose. Third, the horses were vaccinated with 2 doses of a recombinant OspA vaccine. Previous vaccination and/or environmental exposure enhanced the magnitude and longevity of the OspA antibody response to about 20 weeks. Last, the influence of intramuscular versus subcutaneous vaccine administration was investigated for the recombinant OspA vaccine. OspA antibody responses were not influenced by injection route. The current work highlights that commercial Lyme vaccines for dogs induce only transient antibody responses in horses which can also be of low magnitude. Protection from infection with B. burgdorferi should not be automatically assumed after vaccinating horses with Lyme vaccines for dogs.     

Functional signs in patients consulting for presumed Lyme borreliosis

IntroductionLittle is known about the functional symptoms associated with Lyme borreliosis (LB) in Europe. We aimed to assess functional symptoms associated with presumed LB and to compare patients with and without confirmed LB.Materials and methodsWe performed a retrospective monocenter study. Patients consulting for presumed LB were included.ResultsBetween November 2015 and June 2018, 355 patients were included (mean age: 51 years, 52% of women) of which 48 had LB: erythema migrans (42%), early disseminated LB (50%; 35% of neuroborreliosis cases), and late disseminated LB (8%). The most frequently reported functional symptoms were neuropathic pain (23%), arthralgia (23%), and asthenia (17%). Other functional symptoms were rare (≤ 10%). Three hundred and seven (86%) patients did not have LB. Patients with confirmed LB reported fewer functional symptoms than patients without LB (1.8 (± 1.7) vs. 3.6 (± 2.5), P < 0.001) with a shorter duration of symptoms (< 3 months in 48% vs. 16% of cases, P < 0.001). They less often reported asthenia (17% vs. 59%, P < 0.001), widespread pain (10% vs. 31%, P = 0.003), myalgia (10% vs. 32%, P = 0.002), memory disorders (4% vs. 16%, P = 0.03), irritability (2% vs. 23%, P ± 0.001), and sadness (0% vs. 16%, P = 0.003).ConclusionIn patients consulting for presumed LB, patients diagnosed with LB had fewer and shorter functional symptoms than patients without LB.     

新疆阿勒泰地区人(畜)莱姆病血清流行病学调查

目的：调查新疆阿勒泰地区人（畜）莱姆病感染情况。方法：间接免疫荧光试验（ＩＦＡ）、酶联免疫吸附试验（ＥＬＩＳＡ）。结果：羊、牛、马和人血清莱姆病抗体阳性率分别为２２５％（１９９／８８３）、１７３％（６９／３９９）、２５０％（５／２０）和９０５％（１８／１９９）。血清学阳性的人和动物中，有的表现出莱姆病的临床症状与体征。动物血清阳性率明显高于人。结论：首次证实该地区存在莱姆病自然疫源地，并初步揭示人（畜）莱姆病的流行特点及相互关系     

湖南省郴州地区莱姆病调查

调查郴州地区莱姆病分布情况。方法：采用间接免疫荧光抗体法，于1991年在地处湘粤交界的南岭山区宜章县莽山林场设点凋查。结果：共查林区人群257人，血清抗莱姆病螺旋体抗体（IgG）阳性者16人，阳性率为6．23％。对16例个案调查，有明确蜱叮咬史者6例，占37．5％；并发现典型游走性红斑病例3例。结论：南岭山区可能是莱姆病疫区，人群中有莱姆病的发生和流行。