Forrester Joseph D, Meiman Jonathan, Mullins Jocelyn, Nelson Randall, Ertel Starr-Hope, Cartter Matt, Brown Catherine M, Lijewski Virginia, Schiffman Elizabeth, Neitzel David, Daly Elizabeth R, Mathewson Abigail A, Howe Whitney, Lowe Lindsay A, Kratz Natalie R, Semple Shereen, Backenson P Bryon, White Jennifer L, Kurpiel Phillip M, Rockwell Russell, Waller Kirsten, Johnson Diep Hoang, Steward Christopher, Batten Brigid, Blau Dianna, DeLeon-Carnes Marlene, Drew Clifton, Muehlenbachs Atis, Ritter Jana, Sanders Jeanine, Zaki Sherif R, Molins Claudia, Schriefer Martin, Perea Anna, Kugeler Kiersten, Nelson Christina, Hinckley Alison, Mead Paul
MMWR Morb Mortal Wkly Rep. 2014 Oct 31;63(43):982-3.
On December 13, 2013, MMWR published a report describing three cases of sudden cardiac death associated with Lyme carditis. State public health departments and CDC conducted a follow-up investigation to determine 1) whether carditis was disproportionately common among certain demographic groups of patients diagnosed with Lyme disease, 2) the frequency of death among patients diagnosed with Lyme disease and Lyme carditis, and 3) whether any additional deaths potentially attributable to Lyme carditis could be identified. Lyme disease cases are reported to CDC through the Nationally Notifiable Disease Surveillance System; reporting of clinical features, including Lyme carditis, is optional. For surveillance purposes, Lyme carditis is defined as acute second-degree or third-degree atrioventricular conduction block accompanying a diagnosis of Lyme disease. During 2001-2010, a total of 256,373 Lyme disease case reports were submitted to CDC, of which 174,385 (68%) included clinical information. Among these, 1,876 (1.1%) were identified as cases of Lyme carditis. Median age of patients with Lyme carditis was 43 years (range = 1-99 years); 1,209 (65%) of the patients were male, which is disproportionately larger than the male proportion among patients with other clinical manifestations (p<0.001). Of cases with this information available, 69% were diagnosed during the months of June-August, and 42% patients had an accompanying erythema migrans, a characteristic rash. Relative to patients aged 55-59 years, carditis was more common among men aged 20-39 years, women aged 25-29 years, and persons aged ≥75 years.
2013年12月13日，《发病率与死亡率周报》发表了一篇报告，描述了3例与莱姆心肌炎相关的心脏性猝死病例。州公共卫生部门和美国疾病控制与预防中心（CDC）开展了一项后续调查，以确定：1）在确诊为莱姆病的特定人群中，心肌炎是否格外常见；2）确诊为莱姆病和莱姆心肌炎的患者的死亡频率；3）是否能识别出其他可能归因于莱姆心肌炎的死亡病例。莱姆病病例通过国家法定传染病监测系统上报给CDC；临床特征（包括莱姆心肌炎）的报告为自愿性质。为监测目的，莱姆心肌炎定义为在诊断莱姆病的同时出现急性二度或三度房室传导阻滞。在2001 - 2010年期间，共有256,373份莱姆病病例报告提交给了CDC，其中174,385份（68%）包含临床信息。在这些病例中，1,876例（1.1%）被确定为莱姆心肌炎病例。莱姆心肌炎患者的中位年龄为43岁（范围 = 1 - 99岁）；1,209例（65%）患者为男性，这一比例显著高于有其他临床表现患者中的男性比例（p<0.001）。在有此信息的病例中，69%在6 - 8月确诊，42%的患者伴有游走性红斑，这是一种特征性皮疹。与55 - 59岁的患者相比，心肌炎在20 - 39岁的男性、25 - 29岁的女性以及≥75岁的人群中更为常见。
