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德国南部的莱姆病。关于病例发生率及携带伯氏疏螺旋体的蜱(蓖麻硬蜱)流行病学的流行病学数据

[Lyme borreliosis in South Germany. Epidemiologic data on the incidence of cases and on the epidemiology of ticks (Ixodes ricinus) carrying Borrelia burgdorferi].

作者信息

Wilske B, Steinhuber R, Bergmeister H, Fingerle V, Schierz G, Preac-Mursic V, Vanek E, Lorbeer B

机构信息

Max-von-Pettenkofer-Institut für Medizinische Mikrobiologie und Hygiene der Universität München.

出版信息

Dtsch Med Wochenschr. 1987 Nov 6;112(45):1730-6. doi: 10.1055/s-2008-1068320.

Abstract

Among 2403 ticks (Ixodes ricinus) tested in 1985 for Borrelia 328 (13.6%) were carriers (adults about 20%, nymphs about 10%, larvae about 1%). The highest prevalence of infected ticks was among adult ticks in the Isar region north of Munich (33.8%). Among 9383 persons whose serum had been examined by fluorescence serology in 1985 and 1986, 1035 (11%) had raised Borrelia-specific IgG and/or IgM antibodies greater than or equal to 1:64. In 18.7% only IgM antibodies were demonstrated. Among 375 proven cases there were 78 with erythema migrans, 211 with neurological signs, 48 with Lyme arthritis and 36 with acrodermatitis. Seasonal incidence peaks were in June-August for erythema migrans, July-September for neurological signs, with no clear-cut seasonal peaks with Lyme arthritis and acrodermatitis. The incubation time for 80% of cases of each abnormality was 5-29 days for erythema migrans, 20-59 for neurological signs and 2-8 months for Lyme arthritis. Erythema migrans was most frequent among those aged 30-60 years, neurological signs among children and juveniles up to 20 years and those aged 40 to 70 years, Lyme arthritis among those aged 30-60 years, and acrodermatitis among those aged 40-80 years. Significantly more women than men developed acrodermatitis.

摘要

1985年,在对2403只蓖麻硬蜱进行伯氏疏螺旋体检测时,发现328只(13.6%)为携带者(成虫约20%,若虫约10%,幼虫约1%)。感染蜱的最高患病率出现在慕尼黑以北伊萨尔地区的成年蜱中(33.8%)。在1985年和1986年通过荧光血清学检查血清的9383人中,1035人(11%)的伯氏疏螺旋体特异性IgG和/或IgM抗体升高至大于或等于1:64。仅18.7%的人检测出IgM抗体。在375例确诊病例中,有78例出现游走性红斑,211例有神经系统症状,48例有莱姆关节炎,36例有肢端皮炎。游走性红斑的季节性发病高峰在6 - 8月,神经系统症状在7 - 9月,莱姆关节炎和肢端皮炎没有明显的季节性高峰。每种异常情况80%的病例潜伏期为:游走性红斑5 - 29天,神经系统症状20 - 59天,莱姆关节炎2 - 8个月。游走性红斑在30 - 60岁人群中最常见,神经系统症状在20岁及以下儿童和青少年以及40至70岁人群中出现,莱姆关节炎在30 - 60岁人群中出现,肢端皮炎在40 - 80岁人群中出现。患肢端皮炎的女性明显多于男性。

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