Dworkin Mark S, Shoemaker Phyllis C, Fritz Curtis L, Dowell Mark E, Anderson Donald E
Epidemic Intelligence Service, Washington State Department of Health, Seattle 98155, USA.
Am J Trop Med Hyg. 2002 Jun;66(6):753-8. doi: 10.4269/ajtmh.2002.66.753.
Each year, many residents of and visitors to endemic regions of the western United States are exposed to the vector of tick-borne relapsing fever (TBRF), an underrecognized and underreported disease. Through review of report forms and literature review, we identified 450 cases of TBRF acquired in the United States in 11 western states (and in British Columbia by a U.S. resident) from January 1977 to January 2000. Exposure sites were in forested areas, at varying elevations, in mountainous regions (Cascade, Rocky Mountain, San Bernardino, and Sierra Nevada ranges) of the United States and Canada and in limestone caves in central Texas. Only 13 counties accounted for approximately 50% of all cases. Forty percent of the cases were not residents of the state where TBRF exposure occurred, including 7% from 11 states where TBRF is not endemic. TBRF is endemic in the United States and is a disease affecting travelers, who may return home with the disease to areas where physicians are not familiar with it.
美国西部流行地区的许多居民及游客每年都会接触到蜱传回归热（TBRF）的传播媒介，这是一种未得到充分认识和报告的疾病。通过审查报告表格及文献综述，我们确定了1977年1月至2000年1月期间在美国11个西部州（以及一名美国居民在不列颠哥伦比亚省）感染TBRF的450个病例。暴露地点位于森林地区，海拔各异，分布在美国和加拿大的山区（喀斯喀特山脉、落基山脉、圣贝纳迪诺山脉和内华达山脉）以及得克萨斯州中部的石灰岩洞穴中。仅13个县就占了所有病例的约50%。40%的病例并非TBRF暴露发生州的居民，其中7%来自11个非TBRF流行州。TBRF在美国呈地方性流行，且是一种会影响旅行者的疾病，这些旅行者可能携带该病回国至医生并不熟悉该病的地区。
