Dahlberg Audun Olav, Aase Audun, Reiso Harald, Thortveit Erik, Eikeland Randi, Engstrøm Morten, Midgard Rune
Norwegian University of Science and Technology, Trondheim, NO-7491, Norway.
Department of Neurology, Molde Hospital, Møre and Romsdal Hospital Trust, Parkvegen 84, Molde, NO-6412, Norway.
BMC Infect Dis. 2025 May 16;25(1):711. doi: 10.1186/s12879-025-11104-0.
The frequency and mechanisms of persistent health complaints attributed to tick bites or tick-borne diseases are unknown. We evaluate such complaints in Norwegian cases and controls.
People older than 18 years with persistent health complaints of six months or more attributed to tick bites or tick-borne diseases (cases) were recruited into a nationwide cross-sectional study between October 2016 and January 2021. Demographic data, tick bites, antibiotic use, and tick-borne pathogen serology were recorded. We evaluated somatic symptoms (PHQ-15), fatigue (Fatigue Severity Scale), mental and physical health (RAND-36), affective symptoms (HAD Scale) and modern health worries (MHW Scale) as outcome measures. Serological tests included IgG antibodies against B. burgdorferi (Bb) and other tick-borne pathogens. The control population (n = 2803) was recruited from a tick-endemic region in Søgne, southern Norway. Differences between cases and controls were evaluated.
A total of 500 responses were collected through general practitioners (n = 14), by invitation (n = 94), and by Short Message Service (SMS) (n = 392). The estimate of prevalence is based on 392 of 270.000 included by SMS (0.15%). The SMS cohort reported better physical health than those recruited by invitation. Cases had significantly more somatic and affective symptoms, fatigue, comorbidities, and reduced quality of life related to health than controls. The differences in fatigue and physical health between cases and controls were not related to previous tick exposures. Bb IgG and other antibodies against tick-borne pathogens were more prevalent in cases than controls. In multivariable analyses, cases that were never treated did not exhibit higher somatic symptom scores compared to those treated multiple times. Seropositive Bb cases had worse mental health (p < 0.001) and more depressive symptoms (p = 0.017) than seronegative cases.
The crude prevalence of persistent health complaints in Norway attributed to tick bites or tick-borne diseases is 0.15%. The cases reported significantly poorer physical health, including increased fatigue, when compared to the controls. These relationships were not affected by tick exposures. However, poorer mental health in cases may be associated with Bb seropositivity, especially for the ones with comorbidities. In conclusion, no clear associations were found between tick bites, tick-borne diseases and persistent health complaints.
归因于蜱虫叮咬或蜱传疾病的持续性健康问题的发生率和机制尚不清楚。我们对挪威的病例和对照进行了此类问题的评估。
在2016年10月至2021年1月期间，将年龄超过18岁、有六个月或更长时间归因于蜱虫叮咬或蜱传疾病的持续性健康问题的人（病例）纳入一项全国性横断面研究。记录人口统计学数据、蜱虫叮咬情况、抗生素使用情况和蜱传病原体血清学。我们评估了躯体症状（PHQ-15）、疲劳（疲劳严重程度量表）、心理和身体健康（RAND-36）、情感症状（HAD量表）和现代健康担忧（MHW量表）作为结局指标。血清学检测包括抗伯氏疏螺旋体（Bb）和其他蜱传病原体的IgG抗体。对照人群（n = 2803）从挪威南部索格内的一个蜱虫流行地区招募。评估了病例和对照之间的差异。
通过全科医生（n = 14）、邀请（n = 94）和短信服务（SMS）（n = 392）共收集到500份回复。患病率估计基于短信纳入的270,000人中的392人（0.15%）。短信队列报告的身体健康状况优于通过邀请招募的人群。与对照组相比，病例的躯体和情感症状、疲劳、合并症明显更多，与健康相关的生活质量更低。病例和对照在疲劳和身体健康方面的差异与既往蜱虫暴露无关。Bb IgG和其他抗蜱传病原体的抗体在病例中比对照组更普遍。在多变量分析中，从未接受治疗的病例与多次接受治疗的病例相比，躯体症状评分并未更高。血清学阳性的Bb病例比血清学阴性的病例心理健康状况更差（p < 0.001），抑郁症状更多（p = 0.017）。
挪威归因于蜱虫叮咬或蜱传疾病的持续性健康问题的粗略患病率为0.15%。与对照组相比，病例报告的身体健康状况明显更差，包括疲劳增加。这些关系不受蜱虫暴露的影响。然而，病例中较差的心理健康可能与Bb血清学阳性有关，尤其是对于有合并症的患者。总之，在蜱虫叮咬、蜱传疾病和持续性健康问题之间未发现明确的关联。
