Evans J
Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520-8031, USA.
Curr Opin Rheumatol. 1995 Jul;7(4):322-8. doi: 10.1097/00002281-199507000-00010.
In the United States, Lyme disease is the most common arthropod-borne infection. The majority of cases are reported from the Northeast, the Midwest, and California, which are areas with established foci of Borrelia burgdorferi. Advances in the understanding of the epidemiology of Ixodes ticks, the established vector for transmission of Lyme disease, provided strategies to reduce tick populations and the risk of acquiring disease. Genotypic diversity of subspecies of B. burgdorferi has been associated with differences in disease expression. New methods for detection of B. burgdorferi have expanded understanding of the pathogenesis of Lyme disease and provided clues into the mechanisms responsible for persistent symptoms. A safe vaccine for the prevention of Lyme disease in humans has been developed, and clinical vaccine efficacy trials are currently under way.
在美国，莱姆病是最常见的节肢动物传播感染。大多数病例报告来自东北部、中西部和加利福尼亚州，这些地区是伯氏疏螺旋体的既定疫源地。对莱姆病传播媒介——硬蜱流行病学认识的进展，为减少蜱虫数量和降低感染疾病风险提供了策略。伯氏疏螺旋体亚种的基因多样性与疾病表现差异有关。伯氏疏螺旋体的新检测方法拓宽了对莱姆病发病机制的认识，并为导致持续症状的机制提供了线索。一种用于预防人类莱姆病的安全疫苗已研制出来，目前正在进行临床疫苗疗效试验。
