Fahrer H, Sauvain M J, vd Linden S, Zhioua E, Gern L, Aeschlimann A
Rheumatologische Universitätsklinik, Bern.
Schweiz Med Wochenschr. 1988 Jan 16;118(2):65-9.
The epidemiology of "Lyme borreliosis" in Europe and the significance of positive antibody titers against Borrelia burgdorferi is not well known. Since "orienteering", a competitive cross country sport with a map and a compass, usually in forests, elevates the risk of being bitten by ticks and infected by B. burgdorferi, nearly 1000 orienteerers were included in a prospective study. - In this population the prevalence of positive IgG-antibodies (immunofluorescence technique) was almost 20% and of IgM-antibodies 4%. However, the frequency of associated symptoms in the clinical history of the probands was very low, even in individuals with highly positive titers. - We conclude that the rate of asymptomatic Borrelia infections is high in this special group, and probably also in the general population, and that one has therefore to be cautious in interpreting an isolated positive "Lyme titer". Further investigations are needed, and, in particular, follow-up of the many "positive" subjects without clinical symptoms may be helpful in understanding this fascinating disease better.
欧洲“莱姆病螺旋体病”的流行病学以及抗伯氏疏螺旋体抗体滴度呈阳性的意义尚不明确。由于“定向越野”这项通常在森林中借助地图和指南针进行的竞技性越野运动,会增加被蜱虫叮咬并感染伯氏疏螺旋体的风险,因此一项前瞻性研究纳入了近1000名定向越野运动员。在这个群体中,IgG抗体(免疫荧光技术)呈阳性的患病率近20%,IgM抗体呈阳性的患病率为4%。然而,即便在抗体滴度呈强阳性的个体中,先证者临床病史中相关症状的出现频率也很低。我们得出结论,在这个特殊群体中,无症状伯氏疏螺旋体感染率很高,在普通人群中可能也是如此,因此在解读单独的“莱姆滴度”呈阳性结果时必须谨慎。还需要进一步研究,尤其是对众多无临床症状的“阳性”受试者进行随访,可能有助于更好地了解这种引人入胜的疾病。