Mavin S, Watson E J, Evans R
S Mavin, National Lyme Borreliosis Testing Laboratory, Raigmore Hospital, Inverness IV2 3UJ, UK. Email
J R Coll Physicians Edinb. 2015;45(3):196-200. doi: 10.4997/JRCPE.2015.304.
This study examines the distribution of laboratory-confirmed cases of Lyme borreliosis in Scotland and the clinical spectrum of presentations within NHS Highland. Methods General demographic data (age/sex/referring Health Board) from all cases of Lyme borreliosis serologically confirmed by the National Lyme Borreliosis Testing Laboratory from 1 January 2008 to 31 December 2013 were analysed. Clinical features of confirmed cases were ascertained from questionnaires sent to referring clinicians within NHS Highland during the study period. Results The number of laboratory-confirmed cases of Lyme borreliosis in Scotland peaked at 440 in 2010. From 2008 to 2013 the estimated average annual incidence was 6.8 per 100,000 (44.1 per 100,000 in NHS Highland). Of 594 questionnaires from NHS Highland patients: 76% had clinically confirmed Lyme borreliosis; 48% erythema migrans; 17% rash, 25% joint, 15% neurological and 1% cardiac symptoms. Only 61% could recall a tick bite. Conclusion The incidence of Lyme borreliosis may be stabilising in Scotland but NHS Highland remains an area of high incidence. Lyme borreliosis should be considered in symptomatic patients that have had exposure to ticks and not just those with a definite tick bite.
本研究调查了苏格兰实验室确诊的莱姆病病例分布情况以及高地国民保健服务体系（NHS Highland）内病例的临床表现谱。方法 分析了2008年1月1日至2013年12月31日期间由国家莱姆病检测实验室血清学确诊的所有莱姆病病例的一般人口统计学数据（年龄/性别/转诊卫生委员会）。在研究期间，通过向高地国民保健服务体系内的转诊临床医生发送问卷来确定确诊病例的临床特征。结果 苏格兰实验室确诊的莱姆病病例数在2010年达到峰值，为440例。2008年至2013年期间，估计年平均发病率为每10万人6.8例（高地国民保健服务体系为每10万人44.1例）。在来自高地国民保健服务体系患者的594份问卷中：76%有临床确诊的莱姆病；48%有游走性红斑；17%有皮疹，25%有关节症状，15%有神经症状，1%有心脏症状。只有61%的人能回忆起被蜱叮咬过。结论 苏格兰莱姆病的发病率可能趋于稳定，但高地国民保健服务体系仍是高发病区。对于有蜱虫接触史的有症状患者，应考虑莱姆病，而不仅仅是那些有明确蜱叮咬史的患者。
