Aslan Başbulut Eşe, Gözalan Ayşegül, Sönmez Cemile, Cöplü Nilay, Körhasan Berrin, Esen Berrin, Akın Levent, Ertek Mustafa
Refik Saydam National Public Health Agency, Department of Communicable Diseases Research, Ankara, Turkey.
Mikrobiyol Bul. 2012 Apr;46(2):247-56.
Lyme disease or lyme borreliosis is a zoonosis caused by Borrelia burgdorferi transmitted by ticks, especially Ixodes species. Lyme borreliosis is a multi-systemic disease that invades the skin, musculoskeletal, cardiovascular and central nervous systems. Tick-borne encephalitis (TBE) is an important arboviral infection caused by tick-borne encephalitis virus (TBEV). The central nervous system is affected and the disease most often manifests as meningitis, encephalitis or meningoencephalitis. Previous studies have shown that B.burgdorferi and TBEV can be transmitted by the same tick species (Ixodes ricinus). Although the geographic location and climate is similar to some south-eastern European countries where lyme borreliosis and TBE have been reported, the incidence and prevalence of these diseases in Turkey still remain unclear. The aim of this study was to determine the seroprevelance of B.burgdorferi and TBEV in healthy population in Tekkeköy (41° 8-13' North; 36° 24-31' East), a district of Samsun province, Turkey with evidence of tick-borne disease and to explore the possible correlations of life styles of healthy individuals and prevelance. The cross-sectional study population included 419 people selected using a random proportional sampling method. All participants were asked at interview to complete a questionnaire and peripheral blood samples were collected. From the blood samples, B.burgdorferi IgG and IgM antibodies were evaluated using commercial ELISA (Euroimmun, Germany) and confirmed with Western blot (WB, Euroimmun, Germany). ELISA method was also used to asses IgM and IgG antibodies against TBEV, and neutralization test was used for confirmation. Of the 419 samples, 17 (4%) were positive for B.burgdorferi IgG by ELISA, however 14 (14/419; 3.3%) of them were confirmed by WB. B.burgdorferi seropositivity was higher among people living in rural areas, at an altitude of ≥ 400 meters and in locations ecologically suitable for wild boar and rabbits; seropositivity was also seen to be higher among dog owners (p= 0.001, p= 0.001, p= 0.001, p= 0.001, p= 0.018, respectively). For TBEV, two samples yielded IgG positive, and one IgM positive results by ELISA, however none of them were confirmed by neutralization assay. Nevertheless, one of those three TBEV ELISA positive samples, was found positive for West Nile virus specific antibodies with neutralization test. The results of this study emphasized the presence of tick-borne diseases in that specific region, and in this regard the need for public health interventions has been demonstrated.
莱姆病或莱姆疏螺旋体病是一种由蜱虫传播的人畜共患病，病原体为伯氏疏螺旋体，尤其是某些硬蜱属物种。莱姆疏螺旋体病是一种多系统疾病，会侵袭皮肤、肌肉骨骼、心血管和中枢神经系统。蜱传脑炎（TBE）是由蜱传脑炎病毒（TBEV）引起的一种重要的虫媒病毒感染。中枢神经系统会受到影响，该病最常表现为脑膜炎、脑炎或脑膜脑炎。先前的研究表明，伯氏疏螺旋体和TBEV可由同一种蜱虫（蓖麻硬蜱）传播。尽管土耳其的地理位置和气候与一些报告过莱姆病和蜱传脑炎的东南欧国家相似，但这些疾病在土耳其的发病率和流行率仍不明确。本研究的目的是确定土耳其萨姆松省特克凯科伊区（北纬41°8 - 13′；东经36°24 - 31′）有蜱传疾病证据的健康人群中伯氏疏螺旋体和TBEV的血清阳性率，并探讨健康个体的生活方式与流行率之间的可能关联。横断面研究人群包括采用随机比例抽样方法选取的419人。所有参与者在访谈时被要求填写一份问卷，并采集外周血样本。从血样中，使用商用酶联免疫吸附测定法（德国欧蒙公司）评估伯氏疏螺旋体IgG和IgM抗体，并用免疫印迹法（德国欧蒙公司）进行确认。酶联免疫吸附测定法也用于检测抗TBEV的IgM和IgG抗体，并用中和试验进行确认。在419份样本中，酶联免疫吸附测定法检测出17份（4%）伯氏疏螺旋体IgG呈阳性，但其中14份（14/419；3.3%）经免疫印迹法确认。生活在农村地区、海拔≥400米且生态环境适合野猪和兔子生存的人群中，伯氏疏螺旋体血清阳性率较高；养狗者的血清阳性率也较高（分别为p = 0.001、p = 0.001、p = 0.001、p = 0.001、p = 0.018）。对于TBEV，酶联免疫吸附测定法有两份样本IgG呈阳性，一份样本IgM呈阳性，但中和试验均未确认。然而，在这三份TBEV酶联免疫吸附测定法阳性样本中，有一份经中和试验发现西尼罗河病毒特异性抗体呈阳性。本研究结果强调了该特定地区存在蜱传疾病，在这方面已证明有必要采取公共卫生干预措施。
