Eliassen Knut Eirik, Berild Dag, Reiso Harald, Grude Nils, Christophersen Karen Sofie, Finckenhagen Cecilie, Lindbæk Morten
Norwegian Antibiotic Centre for Primary Care, Department of General Practice, University of Oslo, PO box 1130 Blindern, N-0318 Oslo, Norway.
Department of Infectious Diseases, Oslo University Hospital, Faculty of Medicine, University of Oslo, Kirkeveien 166, N-0460 Oslo, Norway.
Ticks Tick Borne Dis. 2017 Jan;8(1):1-8. doi: 10.1016/j.ttbdis.2016.06.006. Epub 2016 Jun 30.
The first stage of Lyme borreliosis (LB) is mainly the typical skin lesion, erythema migrans (EM), which is estimated to comprise 80-90% of all LB cases. However, the reporting of, and the actual incidence of LB varies throughout Europe. Studies from Sweden and Holland have found EM incidences varying from 53 to 464 EM/100,000 inhabitants/year. Under-reporting of LB is common and a coefficient of three to reach a realistic estimate is suggested. In Norway, it is mandatory to report only the second and third LB stages to the National Institute of Public Health. To find the Norwegian incidence of EM, we extracted data from the electronic medical records of regular general practitioners and out-of-hours services in the four counties with the highest rates of registered LB in the 5 years from 2005 to 2009. We found an EM incidence of 448 EM/100,000 inhabitants/year in these counties, which yields a national incidence of 148 EM/100,000 inhabitants/year. Our findings show that solitary EMs comprised almost 96% of the total LB incidence in Norway. Older females have the highest rates of EM. Phenoxymethylpenicillin is the most commonly used drug to treat EM in Norway, which complies with the national guidelines for antibiotic use. Antibody tests are performed in 15% of cases. Less than 1% of patients are referred to secondary care. The study also shows a high number of patients seeking care for tick bites without signs of infection and there is an overuse of antibiotics in these patients.
莱姆病（LB）的第一阶段主要是典型的皮肤病变——游走性红斑（EM），据估计，所有莱姆病病例中80 - 90%为此症状。然而，莱姆病的报告情况以及实际发病率在欧洲各地有所不同。瑞典和荷兰的研究发现，游走性红斑的发病率在每10万居民/年53至464例之间。莱姆病报告不足的情况很常见，有人建议乘以三的系数来得出实际估计数。在挪威，仅向国家公共卫生研究所报告莱姆病的第二和第三阶段是强制性的。为了查明挪威游走性红斑的发病率，我们从2005年至2009年这五年中莱姆病登记率最高的四个县的普通全科医生和非工作时间服务的电子病历中提取了数据。我们发现这些县的游走性红斑发病率为每10万居民/年448例，由此得出全国发病率为每10万居民/年148例。我们的研究结果表明，在挪威，孤立性游走性红斑几乎占莱姆病总发病率的96%。老年女性的游走性红斑发病率最高。在挪威，苯氧甲基青霉素是治疗游走性红斑最常用的药物，这符合国家抗生素使用指南。15%的病例进行了抗体检测。不到1%的患者被转诊至二级医疗机构。该研究还表明，有大量因蜱叮咬而就医但无感染迹象的患者，并且这些患者存在抗生素过度使用的情况。
