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[莱姆病伯氏疏螺旋体组感染——俄罗斯硬蜱传播的伯氏疏螺旋体病]

[Infections of the Lyme borreliosis group--ixodid tick-borne borrelioses in Russia].

作者信息

Korenberg E I

出版信息

Med Parazitol (Mosk). 1996 Jul-Sep(3):14-8.

PMID:9036274
Abstract

The universally accepted terms Lyme disease of Lyme borreliosis actually apply to the whole group of etiologically independent diseases. This group of diseases is designated as ixodid tick-borne borrelioses (ITBB) in contrast to argasid tick-borne borrelioses (ATBB) associated with soft ticks. Analysis of individual, etiologically specific diseases should be the matter of strategy in researches and diagnostic studies of ITBB. The prevalence of B. garinii and B. afzelii in the greater part of Eurasia is now beyond doubt. To date, ITBB cases have been registered in 46 of 50 Russian regions inhabited by I. persulcatus and I. ricinus ticks. Therefore, a considerable or even a great part of the world range of infections currently collectively called Lyme disease (LD) is located on the territory of Russia. The mean ITBB incidence rates in 1993-1994 was 3.1 per 100,00 inhabitants. Data reflect a considerable progress in ITBB diagnosis, made in the past two or three years rather than an increase in morbidity rates. The greatest incidence of ITBB is registered in the Ural and west Siberian regions (27 and 17.2%, respectively). In the following years, provided IBBT diagnosis and surveillance are properly organized, the eastern regions of Russia would account for the highest ITBB morbidity. Prognosis is that at least 10,000 to 12,000 new ITBB cases may be annually detected in Russia. ITBB affects mainly adult able-bodied persons. However, in 1993-1994 children under 14 years of age accounted for 1.4% of the total number of cases in Russia. On the whole, the proportion of city dwellers among ITBB patients was 84%, amounting to as high as 90-94% in some regions. The mean ITBB morbidity rate for the rural population in 1993-1994 was 1.8 per 100,000 inhabitants. In 1993-1994 IFA was regularly performed only in 21 regions. Analysis of paired serum samples obtained from suspected ITBB patients in due time yielded positive results in 65-70% of cases. To identify fresh ITBB cases more thoroughly, at least 200,000 persons should undergo serological testing every year. This number is approximately 25 times greater than the actual number of these tests annually performed in Russia. In this connection, IFA will retain for several years its contribution to a conventional laboratory test routinely used in Russia.

摘要

莱姆病或莱姆疏螺旋体病这些被普遍接受的术语实际上适用于整个病因独立的疾病组。与软蜱相关的argasid蜱传疏螺旋体病(ATBB)相比,这组疾病被指定为硬蜱传疏螺旋体病(ITBB)。对个体病因特异性疾病的分析应该是ITBB研究和诊断研究中的策略问题。目前,在欧亚大陆大部分地区,加氏疏螺旋体和阿氏疏螺旋体的流行情况已毋庸置疑。迄今为止,在俄罗斯有全沟硬蜱和蓖麻硬蜱栖息的50个地区中的46个地区已记录到ITBB病例。因此,目前统称为莱姆病(LD)的全球感染范围中相当一部分甚至很大一部分位于俄罗斯境内。1993 - 1994年ITBB的平均发病率为每10万居民3.1例。这些数据反映的是过去两三年在ITBB诊断方面取得的显著进展,而非发病率的上升。ITBB发病率最高的是乌拉尔和西西伯利亚地区(分别为27%和17.2%)。在接下来的几年里,如果ITBB的诊断和监测组织得当,俄罗斯东部地区将成为ITBB发病率最高的地区。据预测,俄罗斯每年可能至少检测到10000至12000例新的ITBB病例。ITBB主要影响身体健康的成年人。然而,在1993 - 1994年,14岁以下儿童占俄罗斯病例总数的1.4%。总体而言,ITBB患者中城市居民的比例为84%,在某些地区高达90 - 94%。1993 - 1994年农村人口的ITBB平均发病率为每10万居民1.8例。1993 - 1994年,仅在21个地区定期进行间接免疫荧光法(IFA)检测。对及时从疑似ITBB患者获取的配对血清样本进行分析,65 - 70%的病例呈阳性结果。为了更全面地识别新的ITBB病例,每年至少应有20万人接受血清学检测。这个数字大约是俄罗斯每年实际进行此类检测数量的25倍。就此而言,在未来几年里,IFA仍将是俄罗斯常规使用的传统实验室检测方法。

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