我国东北林区莱姆病的调查

1987~1988年我们在牡丹江和延边林区对莱姆病进行了流行病学调查和临床观察,发现一些林场莱姆病的患病率和自然感染率较高。大青林场共有人口1 030人,在检查的628人中,发现莱姆病患者37例。在小白林场人群中进行了血清流行病学调查,发现伯氏包柔氏体自然感染率为22.5%。从牡丹江林区收集的全沟硬蜱中,分离出了3株包柔氏体,其中M7菌株经单克隆抗体测定和电镜观察,确证为伯氏包柔氏体。在医院收集162份疑似森林脑炎病人血清,其中38份血清抗伯氏包柔氏体抗体阳性。对15例经临床和血清学确诊的莱姆病患者进行了临床观察和治疗,证明大剂量青霉素可以治愈全身性红斑。并从1例慢性游走性红斑患者血液中分离出1株包柔氏体。     

First isolation ofRickettsia helvetica fromIxodes ricinus ticks in France

Two rickettsial isolates recovered fromIxodes ricinus ticks in Puy-de-Dôme (Central France) were characterized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, Western blot immunoassay, restriction fragment length polymorphism analysis, and sequencing of a portion of the citrate-synthase gene. By these methods, the isolates appeared to be identical to a member of the spotted fever group rickettsiae,Rickettsia helvetica. This first isolation ofRickettsia helvetica in France has epidemiologic importance; a serosurvey on Mediterranean spotted fever conducted previously in Puy-de-Dôme, where the infection is not endemic, demonstrated a high seroprevalence of nonspecific antibodies directed against spotted fever group rickettsiae lipopolysaccharides, and thus the possibility of infection due to a rickettsia different fromRickettsia conorii was suggested. The isolation ofRickettsia helvetica in anthropophilic ticks in the same area further supports this hypothesis.     

Early detection of Borrelia burgdorferi sensu lato infection in Balb/c mice by co-feeding Ixodes ricinus ticks

In Europe, Borrelia burgdorferi is transmitted by Ixodes ricinus to animals and human. When infected and uninfected ticks co-feed on a host, spirochetes are transmitted from ticks to animal and also to uninfected ticks. Here, we used uninfected ticks to co-feed with infected ticks on mice to evaluate this method to detect early infection in mice. A total of 128 mice were challenged by infected nymphs placed in capsules glued on the back of the mice. Three days later uninfected larvae were added in the capsule to co-feed with infected nymphs and were examined for Borrelia infection after natural detachment. Infection in mice was also determined by xenodiagnosis and by spirochete isolation from ear skin biopsy and back skin biopsy taken at the tick attachment site one month after infection. A total of 111 mice were found to be infected by at least one of these four methods. Borrelia infection was observed in 95% of mice by the co-feeding method, in 92% of mice by xenodiagnosis, in 69% and in 68% of mice by cultivation of ear and back skin biopsies, respectively. Our results demonstrate that the co-feeding method is a very sensitive method which can be used to detect very early infection in mice infected by tick bites.     

Infestation of sand lizards (<Emphasis Type="Italic">Lacerta agilis</Emphasis>) resident in the Northeastern Poland by <Emphasis Type="Italic">Ixodes ricinus</Emphasis> (L.) ticks and their infection with <Emphasis Type="Italic">Borrelia burgdorferi</Emphasis> sensu lato

Sand lizards (Lacerta agilis) were trapped and examined for ticks from May to September in 2002 and 2003 in Northeastern Poland. A total of 233 Ixodes ricinus (L.) ticks (76 larvae and 157 nymphs) was found on 31 of 235 captured lizards (13.2%). The tick infestation is relatively low compared to that of mammals and passerine birds from the same area (Siński et al. 2006, Gryczyńska et al. 2002). Tick infestation depended on the month of capture, being the highest in spring. In autumn no ticks were recorded on any of the captured lizards. The oldest lizards carried the highest number of ticks but no differences related to sex of the host were found. All the collected ticks were analysed by PCR for the presence of Borrelia burgdorferi sensu lato, the etiological agents of Lyme disease. Spirochetes were detected in 11 out of 233 (4.7%) ticks tested. Genetic analysis confirmed that the spirochetes are members of the Borrelia afzelii, B. garinii and B. burgdorferi sensu stricto genospecies. Mixed infection were not detected. The prevalence of infection was analysed in relation to months of the capture, age and sex of the lizards, but differences were not statistically significant. The obtained results suggest that lizards are probably not B. burgdorferi reservoirs, but further studies are required to confirm this.     

中华硬蜱叮咬免疫兔后中肠消化细胞形态测量分析

本文采用军事医学科学院生产的多功能系统，对叮咬经不同抗原免疫接种兔后的中华硬蜱中肠消化细胞进行形态学测量分析，以了解蜱中肠受损程度和各种抗原诱导免疫力产生的强弱。结果表明：蜱血餐后其中肠增粗，肠壁增厚：消化细胞数量增加，体积增大；而细胞核相对较小，核体密度、表面积密度变小。中华硬蜱叮咬免疫兔后上述各种吸血后的正常反应不如佐剂对照组，尤以纯化抗原接种组明显，其中肠也增粗，由于大量消化细胞受损伤而脱落，使得消化细胞数减少，由于大量消化细胞受损脱落使消化细胞数减小和消化细胞平均截面面积减小。由于核固缩、核碎裂、核溶解早于细胞碎裂脱落，使细胞核的体密度和表面积密度明显减小。与对照组相比，肠直径、肠壁面积、消化细胞截面数、数面密度、截面面积和消化细胞核的体密度及表面积密度均有显著性或非常显著性差异。受损程度依次为纯化抗原（ＰＡ）组、中肠抗原（ＭＡ）组、唾液腺抗原（ＳＧＡ）组和全虫抗原（ＷＴＡ）组。卵抗原（ＯＡ）组损伤最轻。本实验的五个免疫接种组中有四个组能有效诱导宿主产生免疫力，以１０５ＫＤ纯化抗原接种作用最强，在选择制备抗蜱疫苗时可供参考     

The paradox of the binomial Ixodes ricinus activity and the observed unimodal Lyme borreliosis season in Hungary

The change of ambient temperature plays a key role in determining the run of the annual Lyme season. Our aim was to explain the apparent contradiction between the annual unimodal Lyme borreliosis incidence and the bimodal Ixodes ricinus tick activity run – both observed in Hungary – by distinguishing the temperature-dependent seasonal human and tick activity, the temperature-independent factors, and the multiplicative effect of human outdoor activity in summer holiday, using data from Hungary in the period of 1998–2012. This separation was verified by modeling the Lyme incidence based on the separated factors, and comparing the run of the observed and modeled incidence. We demonstrated the bimodality of tick season by using the originally unimodal Lyme incidence data. To model the outdoor human activity, the amount of camping guest nights was used, which showed an irregular run from mid-June to September. The human outdoor activity showed a similar exponential correlation with ambient temperature to that what the relative incidence did. It was proved that summer holiday has great influence on Lyme incidence.     

中华硬蜱叮刺宿主后免疫相互作用的研究

在实验室条件控制下,中华硬蜱重复叮咬家兔后吸血量明显减少,初次叮咬后吸血增重233.78±44.71mg,第二和第三次叮咬分别下降至67.03±25.18mg和80.23±29.96mg(P<0.001)。被咬后的家兔血清经ELISA测定其体内蜱抗体(OD值0.48)较对照组家兔(OD值0.08)显著高(P<0.01)。免疫后家兔其~3H-TdR淋巴细胞转化试验和皮肤试验与对照组家兔有显著差异,表明家兔对中华硬蜱叮咬所产生的获得住免疫力,包括宿主的体液免疫和细胞免疫。     

Transverse Myelitis Secondary To Coexistent Lyme Disease And Babesiosis

Abstract

Objective: To describe transverse myelitis secondary to coexistent Lyme disease and babesiosis.

Method: Case report.

Background: A 7 4-year-old man presented with rapid onset of weakness, numbness, and tingling in his legs, with symptoms ascending to his hands and forearms within days. He recalled an insect bite to his scapular area 2 weeks earlier.

Findings: T2-weighted magnetic resonance imaging demonstrated diffuse hyperintensity from T1 through T1 2. Western blot and enzyme-linked immunosorbent assay identified infection with Borrelia burgdorferi, the spirochete responsible for Lyme disease. Giemsa-stained blood smears identified ring forms later recognized by polymerase chain reaction as Babesia microti, the piroplasm responsible for babesiosis. Initial examination revealed C7 motor and T3 sensory complete tetraplegia, with recovery to T 4 paraplegia by 2 months.

Conclusion: The history, physical examination, imaging, and serologic studies were consistent with transverse myelitis related to Lyme disease and babesiosis. The severity and permanence of this patient’s deficits were greater than those reported in the majority of previous cases of transverse myelitis due to Lyme disease alone, suggesting a possible role for coinfection with babesiosis.     

从新疆采集的全沟硬蜱中分离出莱姆病病原体

1987年5月,在新疆玛纳斯县芦草沟采集19只全沟硬蜱(Ixodes persulcatus),用金黄地鼠接种和纯培养的方法分离出1株形态、免疫学特征与伯氏疏螺旋体(Borrelis burg-dorferi)相同的疏螺旋体,表明当地存在着莱姆病疫源地。