Korenberg Edward, Likhacheva Tatyana
Gamaleya Research Institute of Epidemiology and Microbiology, Russian Academy of Medical Sciences, Gamaleya Str. 18, Moscow, 123098 Russia.
Int J Med Microbiol. 2006 May;296 Suppl 40:54-8. doi: 10.1016/j.ijmm.2006.02.001. Epub 2006 Mar 20.
As early as in the 1960s, Professor M.P. Chumakov suggested that primary tick-borne encephalitis (TBE) diagnoses made by practicing physicians should be verified by serological or virological methods. Verification showed that a large proportion of TBE cases (included in the official statistics of TBE morbidity) was accounted for by the so-called seronegative forms of the disease. Ixodid tick-borne borrelioses (ITBBs), or infections of the Lyme borreliosis group, which proved to be sympatric to TBE in Russia accounted for an even higher morbidity in past years. Some other tick-borne diseases were still unknown at that time. We analyzed 1062 case histories of patients with febrile diseases acquired through tick bites in the Udmurt Republic, Russia (one of the most hazardous regions with respect to TBE morbidity), recorded from 1965 to 1968, and 1509 similar cases recorded from 1983 to 1988. In the first period, 97 out of 684 cases (14.2%) included in the official statistics of TBE morbidity could be classified as ITBB according to modern case criteria. In the second period, 464 out of 1509 cases recorded as TBE (30.7%) were retrospectively diagnosed as ITBB. No specific diagnosis could be made in 7-17% of the total number of cases interpreted as 'tick-borne' diseases. A similar situation existed in other regions of Russia before 1996 and, as a consequence, the official parameters of annual TBE morbidity in different periods were overestimated by a factor of 1.2-1.6. Here, the long-term dynamics of TBE morbidity in Russia are presented as they appear according to official data and after correction with regard to estimations.
早在20世纪60年代，M.P. 丘马科夫教授就建议，执业医师做出的原发性蜱传脑炎（TBE）诊断应通过血清学或病毒学方法进行验证。验证结果表明，很大一部分TBE病例（包含在TBE发病率的官方统计数据中）是由该疾病的所谓血清阴性形式构成的。在俄罗斯，硬蜱传播的疏螺旋体病（ITBBs），即莱姆病疏螺旋体感染组的感染，被证明与TBE同域分布，在过去几年中其发病率甚至更高。当时其他一些蜱传疾病仍不为人知。我们分析了1965年至1968年记录在俄罗斯乌德穆尔特共和国（TBE发病率最高的危险地区之一）的1062例因蜱叮咬而患发热性疾病患者的病历，以及1983年至1988年记录的1509例类似病例。在第一个时期，根据现代病例标准，TBE发病率官方统计数据中的684例病例中有97例（14.2%）可归类为ITBB。在第二个时期，记录为TBE的1509例病例中有464例（30.7%）经回顾性诊断为ITBB。在被解释为“蜱传”疾病的病例总数中，有7% - 17%无法做出具体诊断。1996年之前俄罗斯其他地区也存在类似情况，因此，不同时期TBE年发病率的官方参数被高估了1.2 - 1.6倍。在此，呈现俄罗斯TBE发病率的长期动态，这是根据官方数据以及在考虑估计值进行校正后呈现的情况。
