Evans J
Section of Rheumatology, Yale University School of Medicine, New Haven, CT 06510.
Curr Opin Rheumatol. 1994 Jul;6(4):415-22. doi: 10.1097/00002281-199407000-00011.
In the United States, Lyme disease is the most common arthropod-borne infection. The majority of cases occur in the Northeast, the Midwest, and California, which are areas with established foci of Borrelia burgdorferi. Phenotypic and genotypic diversity of B. burgdorferi has resulted in its classification into three separate genospecies and may account for differences in disease expression. Clinical features of Lyme disease have expanded to include a flulike illness without erythema migrans and the persistence of intrathecal antibody responses after successful antibiotic therapy in neuroborreliosis. Better understanding of the pathogenic mechanisms of Lyme arthritis will help guide future treatment decisions, and recent progress made in assessing the risk of infection from tick bites and vaccine development may help calm public anxiety about Lyme disease.
在美国，莱姆病是最常见的节肢动物传播感染。大多数病例发生在东北部、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。伯氏疏螺旋体的表型和基因型多样性导致其被分为三个不同的基因种，这可能解释了疾病表现的差异。莱姆病的临床特征已扩展至包括无游走性红斑的流感样疾病，以及神经莱姆病在成功进行抗生素治疗后鞘内抗体反应的持续存在。对莱姆关节炎致病机制的更好理解将有助于指导未来的治疗决策，并且在评估蜱叮咬感染风险和疫苗开发方面取得的最新进展可能有助于平息公众对莱姆病的焦虑。
