Department of Infectious Diseases and Epidemiology, Dermatology and Venereology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine.
Department of Medical Biochemistry, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine.
Cent Eur J Public Health. 2024 Sep;32(3):173-177. doi: 10.21101/cejph.a8114.
The purpose of the current study was to analyse the risks of Lyme borreliosis (LB) among 1,070 forestry workers, the influence of responsible behaviour (use of repellents, skin self-inspection) on Borrelia screening result status, and the occurrence of immediate and mid-term symptoms after tick bites and LB positive serological screening test.
The questionnaire was conducted as well as blood tests for LB disease by one-stage serological screening procedure using ELISA for specific B. burgdorferi IgM and IgG antibodies (EuroImmun AG company, Germany).
While 39.6% of foresters were LB positive among bitten foresters, as many as 27.0% were LB positive among those, who did not recall any tick attacks at all. Individuals with known history of tick bites had significantly higher odds (1.770×) of being LB positive (p < 0.05), while the use of repellents or skin self-inspection after visiting woods had no influence on LB results. The odds of skin discolouration after tick bites was significantly lower (0.682×) in case of LB positive test compared to LB negative test (p < 0.05), which can be explained by the fact that foresters could be unaware about erythema migrans appearance and timing, considering tick bite and developed later rash as completely separate events. Moreover, 69.1% of the bitten foresters with LB positive result developed no secondary symptoms (excluding those related to the skin), and the most frequent clinical symptoms were arthralgia (24.9%), followed by myalgia (7.6%), headache (5.7%), and damage to facial nerve (2.7%), which are non-specific and can be present in other illnesses.
Therefore, the recommendations proposed would be the regular laboratory testing for LB of sensitive and at-risk population, who visits endemic woody areas, irrespective of all other factors involved.
本研究旨在分析 1070 名林业工人患莱姆病（LB）的风险，负责任行为（使用驱虫剂、皮肤自我检查）对伯氏疏螺旋体筛查结果的影响，以及蜱叮咬和 LB 阳性血清学筛查试验后立即和中期症状的发生情况。
问卷调查和血检莱姆病，采用 ELISA 一步法血清学筛查程序检测特定 B. burgdorferi IgM 和 IgG 抗体（德国 EuroImmun AG 公司）。
在被蜱叮咬的林务员中，有 39.6%为 LB 阳性，而在那些完全不记得被蜱叮咬的人中，也有 27.0%为 LB 阳性。有蜱叮咬史的个体 LB 阳性的几率明显更高（1.770×）（p < 0.05），而在访问林地后使用驱虫剂或皮肤自我检查对 LB 结果没有影响。与 LB 阴性试验相比，LB 阳性试验中蜱叮咬后皮肤变色的几率显著降低（0.682×）（p < 0.05），这可以解释为林务员可能不知道游走性红斑的出现和时间，将蜱叮咬和随后出现的皮疹视为完全独立的事件。此外，69.1%的 LB 阳性蜱叮咬林业工人未出现二次症状（不包括与皮肤相关的症状），最常见的临床症状是关节痛（24.9%），其次是肌痛（7.6%）、头痛（5.7%）和面神经损伤（2.7%），这些症状是非特异性的，也可能存在于其他疾病中。
因此，建议对接触地方性林区的敏感和高危人群进行常规 LB 实验室检测，无论涉及其他因素如何。
