Stanek G
Hygieneinstitut, Universität Wien.
Wien Med Wochenschr. 1995;145(7-8):155-61.
In Europe and in other parts of the world, Lyme borreliosis is recognized increasingly by physicians and serodiagnostic laboratories. However, it is currently difficult to present conclusive epidemiologic data. There are no widely accepted case definitions for the numerous clinical features due to or supposed to be linked to infection with Borrelia burgdorferi. Clinical diagnosis of suspected cases of Lyme borreliosis requires confirmation by the demonstration of the aetiologic agent and the recognition of its causative role in the respective disorder. The specificity of serological tests for Lyme borreliosis is impaired by several phenomena including cross-reacting antibodies. Interpretation of serological test results may lead to the clinical diagnosis of Lyme borreliosis and in consequence to antibiotic treatment. Complications in order to treat suspected disseminated Lyme disease may be severe, as recently reported (45). No reliable data of Lyme borreliosis prevalence can be offered so far. This is partly due to incomplete reporting of Lyme borreliosis cases to specialized institutions, and partly due to the insufficiency of the diagnostic process. The true incidence and prevalence of this disease cannot be determined and one must wait for the results of the development of specific and dependable methods to identify actual infection.
在欧洲和世界其他地区,莱姆病越来越受到医生和血清诊断实验室的关注。然而,目前很难提供确凿的流行病学数据。对于众多由伯氏疏螺旋体感染引起或被认为与之相关的临床特征,尚无广泛认可的病例定义。疑似莱姆病病例的临床诊断需要通过病原体的鉴定及其在相应疾病中致病作用的确认来证实。莱姆病血清学检测的特异性受到包括交叉反应抗体在内的多种现象的影响。血清学检测结果的解读可能导致莱姆病的临床诊断,进而引发抗生素治疗。正如最近报道的那样,治疗疑似播散性莱姆病的并发症可能很严重(45)。目前尚无可靠的莱姆病患病率数据。部分原因是莱姆病病例向专业机构的报告不完整,部分原因是诊断过程存在不足。这种疾病的真实发病率和患病率无法确定,必须等待开发出特定且可靠的方法来识别实际感染的结果。