Clinical and Epidemiological Features of Actual Tick-Borne Infections under Conditions of Mass Vaccination against Tick-Borne Viral Encephalitis (by the Example of a Megapolis)

V. Mishchenko, I. V. Vyalykh, A. G. Sergeev, I. P. Bykov, M. Toporkova, V. Chalapa
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Abstract

Relevance. The clinical aspects of tick­borne viral encephalitis (TBE) and Lyme borrelliosis (LB) as monoinfections are well known. At the same time, the issues of interaction of pathogens in tick­borne encephalitis – Lyme borrelliosis mixed infection (TBE – LB mixed infection), the effectiveness of specific prophylaxis, their effect on the incidence rate and clinical forms have not been sufficiently studied.Aims. The aim of this work was to study the clinical course of TBE and TBE ­ LB mixed infection in patients with specific prophylaxis of TBE, as well as in its absence.Materials & Methods. Medical history data from 454 patients patients with a confirmed diagnosis of TBE and TBE – LB mixed infection during 2010–2017 were analyzed.Results. The clinical course of the disease in TBE mono­- and mixed infection, as well as the connection of immunization with the clinical forms of the disease are reflected. The dynamics of the registration of clinical forms of TBE and TBE – LB mixed infection for 8 years was shown using regression models. Synchronization of the incidence of focal and meningeal forms in TBE and TBE – LB mixed infection with a statistically significant decrease in the frequency of their occurrence was noted. The incidence of febrile forms in TBE monoinfection, as well as in mixed infections, remained practically unchanged.Сonclusions. It was found that the incidence of severe focal and meningeal forms of the disease in patients with TBE – LB mixed infection was 1.5 times lower, and the proportion of patients with febrile form TBE was statistically significantly higher than in the group of patients with TBE monoinfection, which may indicate a more favorable during TBE ­ LB mixed infection, and overdiagnosis of febrile form TBE in TBE – LB mixed infection. The increase in the rate of vaccination against TBE of the population contributed to a decrease in the number of TBE и TBE – LB mixed infection cases due to severe clinical forms (focal and meningeal).
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大规模预防蜱传病毒性脑炎条件下实际蜱传感染的临床和流行病学特征(以大城市为例)
的相关性。蜱传病毒性脑炎(TBE)和莱姆病(LB)作为单一感染的临床方面是众所周知的。同时,对蜱传脑炎-莱姆博氏病混合感染(TBE - LB混合感染)病原菌的相互作用、特异性预防措施的有效性、对发病率的影响及临床表现的研究还不够充分。本研究的目的是研究TBE和TBE - LB混合感染在TBE特异性预防患者中的临床病程,以及在没有TBE的情况下。材料与方法。对2010-2017年确诊为TBE和TBE - LB混合感染的454例患者的病史资料进行分析。反映了单纯性感染和混合性感染的临床病程,以及免疫与该病临床表现的联系。使用回归模型显示了8年来TBE和TBE - LB混合感染临床形式登记的动态。注意到TBE和TBE - LB混合感染中局灶性和脑膜形式的发生率同步,其发生频率在统计上显着降低。发热形式的发生率在TBE单一感染,以及在混合感染,实际上仍然unchanged.Сonclusions。发现TBE - LB混合感染患者严重局灶型和脑膜型的发病率比TBE单感染组低1.5倍,发热型TBE患者比例显著高于TBE - LB混合感染组,这可能表明TBE - LB混合感染期间更有利,而TBE - LB混合感染中有发热型TBE的过度诊断。由于严重的临床形式(局灶性和脑膜性),人口中流行性乙型脑炎疫苗接种率的提高有助于减少流行性乙型脑炎/流行性乙型脑炎- LB混合感染病例的数量。
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