Cisak Ewa, Chmielewska-Badora Jolanta, Zwoliński Jacek, Wójcik-Fatla Angelina, Polak Jolanta, Dutkiewicz Jacek
Department of Occupational Biohazards, Institute of Agricultural Medicine, Lublin, Poland.
Ann Agric Environ Med. 2005;12(1):127-32.
The objective of the present study was to assess the risk of borreliosis and anaplasmosis (ehrlichiosis) among the forestry workers of the Roztocze National Park (south-eastern Poland) by examination of Ixodes ricinus ticks living in park area with PCR method, and by the serological and clinical examination of the workers. In 406 examined ticks, the prevalence of infection with Borrelia burgdorferi sensu lato was 11.5 %. The nested PCR reaction for determining the genospecies showed that the most common was Borrelia burgdorferi sensu stricto (55.3 % of total positive) followed by Borrelia afzelii (38.3 %). As many as 6.1 % out of 115 examined ticks showed the presence of Anaplasma phagocytophilum DNA. The infection rate was high in males and females (14.3 % and 11.1 % respectively) and low in nymphs (1.5 %). In 46 out 113 examined forestry workers (40.7 %) the presence of specific IgG and/or IgM antibodies against Borrelia burgdorferi sensu lato was found in ELISA test, while only 4 out of 56 urban blood donors showed a positive response (p<0.0001). The prevalence of IgG antibodies against Anaplasma phagocytophilum determined with the use of indirect immunofluorescence test (IFA) was 17.7 % in forestry workers compared to 5.4 % in reference group of blood donors (p<0.05). No correlation was found between the presence of antibodies to A. phagocytophilum and to B. burgdorferi s. l. Clinical investigations of 113 forestry workers showed 3 cases of borreliosis (2.7 %) and no cases of anaplasmosis (ehrlichiosis). In conclusion, forestry workers of the Roztocze National Park in south-eastern Poland are often exposed to Ixodes ricinus ticks infected with Borrelia burgdorferi and Anaplasma phagocytophilum, and show a high proportion of asymptomatic borreliosis and anaplasmosis (ehrlichiosis) manifested by a positive serologic response, while the number of clinical cases is relatively low.
本研究的目的是通过采用聚合酶链反应（PCR）方法检测罗兹托切国家公园（波兰东南部）林区工人所在公园区域内的蓖麻硬蜱，并对工人进行血清学和临床检查，来评估林区工人感染莱姆病和无形体病（埃立克体病）的风险。在406只被检测的蜱中，广义伯氏疏螺旋体的感染率为11.5%。用于确定基因种的巢式PCR反应表明，最常见的是狭义伯氏疏螺旋体（占总阳性数的55.3%），其次是阿氏疏螺旋体（38.3%）。在115只被检测的蜱中，多达6.1%检测到嗜吞噬细胞无形体DNA。成年蜱的感染率较高，雄性和雌性分别为14.3%和11.1%，若虫的感染率较低（1.5%）。在113名接受检测的林区工人中，有46名（40.7%）在酶联免疫吸附测定（ELISA）试验中检测到针对广义伯氏疏螺旋体的特异性IgG和/或IgM抗体，而在56名城市献血者中只有4名呈阳性反应（p<0.0001）。采用间接免疫荧光试验（IFA）测定，林区工人中抗嗜吞噬细胞无形体IgG抗体的阳性率为17.7%，而献血者对照组为5.4%（p<0.05）。未发现抗嗜吞噬细胞无形体抗体和抗广义伯氏疏螺旋体抗体之间存在相关性。对113名林区工人的临床调查显示，有3例莱姆病（2.7%），无无形体病（埃立克体病）病例。总之，波兰东南部罗兹托切国家公园的林区工人经常接触感染伯氏疏螺旋体和嗜吞噬细胞无形体的蓖麻硬蜱，血清学反应呈阳性表明无症状莱姆病和无形体病（埃立克体病）的比例较高，而临床病例数相对较少。
