Topolovec Jasna, Puntarić Dinko, Antolović-Pozgain Arlen, Vuković Dubravka, Topolovec Zlatko, Milas Josip, Drusko-Barisić Vladimira, Venus Miroslav
Public Health Institute of Osijek-Baranja County, Croatia.
Croat Med J. 2003 Oct;44(5):626-9.
To establish serologically a contact with causative agents of human monocytic and granulocytic ehrlichiosis, human babesiosis, recently detected rickettsioses, and Lyme disease in individuals with a history of tick bite from three counties in eastern Croatia.
Seroepidemiologic testing was performed in 102 subjects with a history of tick bite, who either requested examination for a tick bite or were suspected of having tick-borne disease. The study was carried out during the 1998-1999 period in the area of the Vukovar-Srijem, Osijek-Baranya, and Brod-Posavina counties. Serum analysis was performed by indirect immunofluorescence assay for the detection of antibodies to causative agents of human monocytic and granulocytic ehrlichiosis (Ehrlichia chaffeensis and human granulocytic ehrlichiosis agent), human babesiosis (Babesia divergens), and rickettsiosis. Enzyme-linked immunosorbent assay was used for the detection of antibodies to the spirochete Borrelia burgdorferi, the cause of Lyme disease. The assays were performed at the Department of Microbiology, Osijek Public Health Institute in Osijek, and their results were confirmed at the Department of Microbiology and Immunology, School of Medicine in Ljubljana, Slovenia.
Ehrlichia chaffensis antibodies were detected in 5 sera, and antibodies to the causative agent of human granulocytic ehrlichiosis in 7 sera. A low titer of antibodies to the etiologic agent of babesiosis (Babesia microti) was detected only in a single serum. Eight sera that were positive for rickettsial antibodies contained rather high titers of antibodies against Rickettsia conorii, the agent of Mediterranean fever, and Rickettsia rickettsii, the agent of Rocky Mountain spotted fever. In six out of these 8 sera, antibodies to Rickettsia typhi, the cause of murine typhus, were detected possibly as a cross-reaction with some "newly detected" rickettsia circulating in this part of Europe, most likely Rickettsia slovaca. Positive titer of antibodies to Borrelia burgdorferi was detected in 15 sera.
The agents of human monocytic and granulocytic ehrlichiosis and of possibly newly detected rickettsiae were indirectly demonstrated to circulate in eastern parts of Croatia. The results obtained by IFA failed to provide definite evidence for the circulation of the human babesiosis agent, because the IFA used in our study detected Babesia microti, which prevails in the USA, but not Babesia divergens, which is the predominant cause of the disease in Europe. Serologic evidence for Borrelia burgdorferi infection was demonstrated in 80% of the subjects suspected of having the skin manifestation of Lyme disease.
通过血清学方法，在克罗地亚东部三个县有蜱叮咬史的个体中，建立与人类单核细胞埃立克体病、粒细胞埃立克体病、人类巴贝斯虫病、近期发现的立克次体病以及莱姆病病原体的联系。
对102例有蜱叮咬史的受试者进行血清流行病学检测，这些受试者要么因蜱叮咬而要求检查，要么怀疑患有蜱传疾病。该研究于1998 - 1999年期间在武科瓦尔 - 斯里耶姆、奥西耶克 - 巴拉尼亚和布罗德 - 波萨维纳县地区开展。通过间接免疫荧光法进行血清分析，以检测人类单核细胞埃立克体病（查菲埃立克体和人类粒细胞埃立克体病原体）、人类巴贝斯虫病（分歧巴贝斯虫）和立克次体病病原体的抗体。采用酶联免疫吸附测定法检测莱姆病病原体伯氏疏螺旋体的抗体。检测在奥西耶克公共卫生研究所微生物科进行，其结果在斯洛文尼亚卢布尔雅那医学院微生物与免疫学系得到确认。
在5份血清中检测到查菲埃立克体抗体，7份血清中检测到人类粒细胞埃立克体病原体的抗体。仅在1份血清中检测到低滴度的巴贝斯虫病（微小巴贝斯虫）病原体抗体。8份立克次体抗体阳性的血清中含有较高滴度的抗地中海热病原体康氏立克次体和落基山斑疹热病原体立氏立克次体的抗体。在这8份血清中的6份中，检测到鼠型斑疹伤寒病原体伤寒立克次体的抗体，可能是与欧洲这一地区传播的一些“新发现”立克次体发生交叉反应，最有可能是斯洛伐克立克次体。在15份血清中检测到伯氏疏螺旋体抗体阳性。
间接证明人类单核细胞和粒细胞埃立克体病病原体以及可能新发现的立克次体在克罗地亚东部地区传播。本研究中使用的间接免疫荧光法未能为人类巴贝斯虫病病原体的传播提供确凿证据，因为该方法检测的是在美国流行的微小巴贝斯虫，而非欧洲该病主要病原体分歧巴贝斯虫。在80%怀疑有莱姆病皮肤表现的受试者中发现了伯氏疏螺旋体感染的血清学证据。
