Magri Julie M, Johnson Melissa T, Herring Timothy A, Greenblatt Jesse F
Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA.
J Am Board Fam Pract. 2002 Jul-Aug;15(4):277-84.
Lyme disease is the most commonly reported vectorborne illness in the United States and is endemic in many counties in the Northeast, including counties in New Hampshire. Previous studies conducted elsewhere on Lyme disease have indicated substantial differences between physician practices and published consensus guidelines for diagnosis and treatment.
During 1999, we mailed a 21-item questionnaire to 600 randomly selected family practice physicians, internists, and pediatricians in New Hampshire.
Respondents answered a median of 10 (76.9%) of 13 knowledge items correctly. Most physicians (73.6%) underestimated the incidence of erythema migrans among Lyme disease patients, and 41.2% would either test or offer treatment to an asymptomatic patient with deer-tick bite. When surveyed, most respondents (72.4%) planned to recommend Lyme disease vaccine to high-risk persons. Approximately one half (44.8%) reported giving empiric antibiotic treatment of Lyme disease solely because of patient concern.
New Hampshire primary care physicians indicated good knowledge about Lyme disease. Lack of awareness about Lyme disease diagnostic criteria, however, could contribute to misdiagnosis through overreliance on laboratory testing. Lyme disease vaccine appeared to be well accepted by physicians, although the vaccine has since been withdrawn from the US market. Both inappropriate management of tick bite and empiric treatment of unsubstantiated Lyme disease diagnoses were common.
莱姆病是美国报告最多的媒介传播疾病，在东北部的许多县呈地方性流行，包括新罕布什尔州的一些县。此前在其他地方进行的关于莱姆病的研究表明，医生的做法与已发表的诊断和治疗共识指南之间存在很大差异。
1999年期间，我们向新罕布什尔州随机抽取的600名家庭医生、内科医生和儿科医生邮寄了一份包含21个项目的问卷。
受访者正确回答了13个知识项目中的中位数10个（76.9%）。大多数医生（73.6%）低估了莱姆病患者中游走性红斑的发病率，41.2%的医生会对无症状的鹿蜱叮咬患者进行检测或提供治疗。在接受调查时，大多数受访者（72.4%）计划向高危人群推荐莱姆病疫苗。约一半（44.8%）的受访者报告称，仅因患者担忧就给予莱姆病经验性抗生素治疗。
新罕布什尔州的初级保健医生对莱姆病有较好的了解。然而，对莱姆病诊断标准缺乏认识可能会因过度依赖实验室检测而导致误诊。尽管莱姆病疫苗后来已从美国市场撤出，但医生们似乎对其接受度较高。蜱叮咬的不当处理和未经证实的莱姆病诊断的经验性治疗都很常见。
