Features of the epidemiological history of patients with Lyme borreliosis

R. F. Sayfullin, N. Zvereva, M. A. Sayfullin, S. Smetanina, E. V. Kardonova, O. Shamsheva
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Abstract

In the treatment of Lyme borreliosis (LB), early diagnosis is a key component. The epidemiological history of the patient plays one of the leading roles in suspected borreliosis and at the same time is an important criterion for clinical diagnosis.Purpose. Analysis of epidemiological history data in outpatient cases of LB in Moscow.Material and methods. We conducted a retrospective, non-randomized, single-center cohort study, based on the analysis of data from 660 outpatient records of patients, referred by local physician with tick bite or suspicion of LB, and consulted by an infectious disease specialist on the basis of the Infectious clinical hospital No.1 in Moscow. For further analysis, patients were divided by age and the presence or absence of LB. Confirmation of LB was based on clinical and/or laboratory criteria using methods of enzyme immunoassay and immune blot.Results. We have updated the epidemiological features of the LB for Moscow, such as: the relative number of cases in the administrative districts of Moscow, places and seasonality of tick bites. Among children, compared with adults, cases of a tick bite without the development of LB was predominant, which must be taken into account in order to avoid overdiagnosis of LB. In patients with LB, an indication of the fact of tick bite in the anamnesis was much less common than going to its habitats.Conclusion. Our data clarify the epidemiological features of LB for residents of Moscow. In the absence of a history of indications of tick bite, an informative sign for clinical diagnosis is a visit to its habitats, including not only trips to wooded areas, but also to suburban areas and parks.
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莱姆病borreliosis患者流行病学史的特点
在莱姆病的治疗中,早期诊断是一个关键的组成部分。患者的流行病学史是诊断疑似螺旋体病的重要依据之一,同时也是临床诊断的重要依据。莫斯科门诊LB病例流行病学史资料分析。材料和方法。我们进行了一项回顾性、非随机、单中心队列研究,基于对660例门诊记录的数据分析,这些患者由莫斯科第一感染临床医院的当地医生转诊,被蜱叮咬或怀疑为LB,并由传染病专家咨询。为了进一步分析,患者按年龄和是否存在LB进行分组。LB的确认基于临床和/或实验室标准,使用酶免疫测定和免疫印迹方法。我们更新了莫斯科蜱虫病的流行病学特征,例如:莫斯科行政区的相对病例数、蜱虫叮咬的地点和季节性。在儿童中,与成人相比,蜱叮咬未发展为LB的病例占主导地位,必须考虑到这一点,以避免LB的过度诊断。在LB患者中,在记忆中表明蜱叮咬事实的情况远少于前往其栖息地的情况。我们的数据阐明了莫斯科居民LB的流行病学特征。在没有蜱虫叮咬迹象的情况下,临床诊断的一个信息标志是访问其栖息地,不仅包括前往树木繁茂的地区,还包括郊区和公园。
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