Heininger U, Zimmermann T, Schoerner C, Brade V, Stehr K
Klinik mit Poliklinik für Kinder und Jugendliche, Friedrich-Alexander-Universität, Erlangen-Nürnberg.
Monatsschr Kinderheilkd. 1993 Nov;141(11):874-7.
Lyme borreliosis is transmitted by tick bites. Approximately every fifth local tick (Ixodes ricinus) is infected. Transmission, therefore does not occur with every bite, and disease doesn't always follow infection. The goal of the study was to investigate the risks of infection and disease after tick bites in the area of Erlangen/Germany.
Between April 1989 and October 1991 seventy-one of our out-patients (30 females, 41 males) aged 6 months to 29 years had a tick bite and were enrolled into the study. After the ticks had been removed, a blood specimen for a specific Borrelia burgdorferi antibody assay (IFT) was collected. An interview by phone was performed 4 weeks later and an appointment for a second blood collection was arranged.
In 69 patients the initial titer was negative, in two patients it was 1:32. Sixty patients could be reached by phone, and in 43 a second blood sample was available. There was seroconversion detectable in 4 instances, two of whom were asymptomatic, one had unspecific symptoms and one developed lymphocytoma. There were no manifestations of late stage disease in the study population.
These results confirm the current recommendation of the Bundesgesundheitsamt (German Federal Health Institute) that generally antibiotic treatment after a tick bite is not necessary.
莱姆病由蜱虫叮咬传播。大约每五只当地蜱虫(蓖麻硬蜱)中就有一只被感染。因此,并非每次叮咬都会导致传播,而且疾病也并非总是在感染后出现。本研究的目的是调查德国埃尔朗根地区蜱虫叮咬后感染和发病的风险。
1989年4月至1991年10月期间,我们的71名门诊患者(30名女性,41名男性),年龄在6个月至29岁之间,被蜱虫叮咬后纳入研究。蜱虫被移除后,采集血液样本进行特定的伯氏疏螺旋体抗体检测(免疫荧光试验)。4周后进行电话访谈,并安排第二次采血预约。
69名患者的初始滴度为阴性,两名患者的滴度为1:32。通过电话联系到了60名患者,其中43名有第二次血液样本。有4例检测到血清转化,其中两例无症状,一例有非特异性症状,一例发展为淋巴细胞瘤。研究人群中未出现晚期疾病表现。
这些结果证实了德国联邦卫生局目前的建议,即蜱虫叮咬后一般无需进行抗生素治疗。