McCall C L, Curns A T, Rotz L D, Singleton J A, Treadwell T A, Comer J A, Nicholson W L, Olson J G, Childs J E
Viral and Rickettsial Zoonoses Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Vector Borne Zoonotic Dis. 2001 Summer;1(2):119-27. doi: 10.1089/153036601316977723.
A retrospective cohort study was conducted among troops training at Fort Chaffee, Arkansas, from May through June 1997, to identify infections caused by tick-borne pathogens. Serum samples were tested by IFAs for antibodies to selected Rickettsia and Ehrlichia species and by an investigational EIA for spotted fever group Rickettsia lipopolysaccharide antigens. Of 1,067 guardsmen tested, 162 (15.2%) had antibodies to one or more pathogens. Of 93 guardsmen with paired serum samples, 33 seroconverted to Rickettsia rickettsii or spotted fever group rickettsiae (SFGR) and five to Ehrlichia species. Most (84.8%) of the personnel who seroconverted to SFGR were detected only by EIA, and seropositivity was significantly associated with an illness compatible with a tick-borne disease. In addition, 34 (27%) of 126 subjects with detectable antibody titers reported a compatible illness. The primary risk factor for confirmed or probable disease was finding > 10 ticks on the body. Doxycycline use and rolling up of long sleeves were protective against seropositivity. The risk of transmission of tick-borne pathogens at Fort Chaffee remains high, and use of the broadly reactive EIA suggests that previous investigations may have underestimated the risk for infection by SFGR. Measures to prevent tick bite and associated disease may require reevaluation.
1997年5月至6月，在阿肯色州查菲堡接受训练的部队中进行了一项回顾性队列研究，以确定蜱传病原体引起的感染。血清样本通过间接荧光抗体法检测针对特定立克次体和埃立克体物种的抗体，并通过一种研究性酶免疫分析法检测斑点热群立克次体脂多糖抗原。在接受检测的1067名国民警卫队队员中，162人（15.2%）对一种或多种病原体呈抗体阳性。在93名有配对血清样本的国民警卫队队员中，33人血清转化为立氏立克次体或斑点热群立克次体（SFGR），5人血清转化为埃立克体物种。血清转化为SFGR的人员中，大多数（84.8%）仅通过酶免疫分析法检测到，血清阳性与符合蜱传疾病的病症显著相关。此外，在126名可检测到抗体滴度的受试者中，34人（27%）报告有符合的病症。确诊或可能患病的主要危险因素是在身体上发现超过10只蜱。使用强力霉素和卷起长袖可预防血清阳性。查菲堡蜱传病原体的传播风险仍然很高，使用具有广泛反应性的酶免疫分析法表明，先前的调查可能低估了SFGR感染的风险。预防蜱叮咬及相关疾病的措施可能需要重新评估。
