[Epidemiologic-clinical aspects of tick borne borreliosis in the Szczecin Province].

The aim of the study was to assess if Szczecin voivodeship is an area of endemic borreliosis, assess the risk due to B. burgdorferi infection in habitants and evaluate clinical manifestations of borreliosis. The study was conducted in 1993-1995, material comprised 299 persons (211 men and 88 women) aged from 3 to 78 years, divided into two groups. Group I consisted of foresters working in four forestry districts, occupationally exposed to tick bite. Group II was completed of Szczecin voivodeship habitants, sporadically exposed to tick bite. Control group consisted of 30 healthy persons without exposure to tick bite. Research programme of study comprised epidemiologic data, clinical examination, evaluation of serum anti-B.b antibodies in all persons and assessment of some infectious parameters (red cells sedimentation--RCS, leukocytosis and C-Reactive Protein--CRP) during borreliosis. High prevalence of borreliosis was noted in both groups. Risk of borreliosis was similar in four forestry districts (Tab. 1). The hazard of infection was not restricted to forest areas only but was present in some parts of Szczecin and its suburbs (parks and gardens). Infection by B.b. was observed in both males and females in all age groups. Risk of B.b infection increased accordingly to duration of exposure but in some examined persons after single tick bite the disease developed (Tab. 2). Some of infected persons do not demonstrate clinical symptoms of borreliosis (Tab. 3). In most cases the disease was diagnosed in early stage of infection (Tab. 4). During infection different organs and systems were involved (Tab. 5). In clinical study skin was the most often affected organ followed by nervous system and joints (Tab. 5, 7). Clinical manifestations comprised erythema migrans chronicum, radiculitis, arthritis, meningitis, encephalitis and uveitis (Tab. 6). Serological study revealed the presence of serum anti-B.b antibodies in 47.6% of examined persons with occupational risk involving tick bite, and 32.7% persons of sporadic risk with negative serology of borreliosis in control group (Tab. 8). The parameters of acute inflammatory phase (RCS, CRP, leukocytosis) are of limited value in diagnosis of borreliosis.