蜱传脑炎与莱姆病流行过程特征的异同

L. Rubis, O. Ekimova, О. S. Safonova, V. Е. Chevskaya
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引用次数: 0

摘要

目的:以卡累利阿共和国为例,探讨蜱传脑炎和莱姆病流行过程的共性和特点。材料和方法。根据官方统计数据、疫源地流行病学检查和实验室研究,分析2000-2021年感染蜱叮咬的频率、动态、强度、地域、性别、年龄和蜱传脑炎和莱姆病发病率的社会特征。对2379份成人血液样本的研究结果进行了分析,这些样本均为未患病且未接种过蜱传脑炎疫苗的成年人,以检测其病毒抗体的存在。2000-2021年蜱毒力由23.6%下降到1.3%,疏螺旋体感染率为13.4% ~ 38.4%。蜱传脑炎和莱姆病的平均长期发病率分别为6.2 / 10万和6.6 / 10万,发病率动态呈明显下降趋势,与蜱传人群医疗需求动态相关。蜱传脑炎的主要临床形式是脑膜(48%)。近年来,非红斑型螺旋体病占39.1%。蜱传脑炎病毒G类抗体检出率为11.8±0.7%。有感染蜱传脑炎和莱姆博氏螺旋体病风险的地区是共和国南部的中部和东部,在那里,过裂腹绦虫占主导地位。城镇居民在两种感染患者中所占比例较高,但城乡人群发病率无显著差异。40 ~ 49岁、50 ~ 59岁和60岁及以上人群蜱传螺旋体病的发病率是蜱传脑炎的1.6 ~ 2.2倍,但差异不显著。在工作年龄,男性的比例高于女性,在老年人中没有差异。结论:确定了蜱传脑炎和蜱传螺旋体病流行过程的异同特点,应采取相应措施,提高疾病的检出率,预测疫情,制定预防措施。
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Similarities and differences in the characteristics of the epidemical process tick-borne encephalitis and Lyme borreliosis
Objective: To identify common and distinctive characteristics of the epidemical process of tick-borne encephalitis and Lyme borreliosis on the example of the Republic of Karelia.Materials and methods. The frequency of infected tick bites, dynamics, intensity, territorial, gender, age and social features of the incidence of tick-borne encephalitis and Lyme borreliosis in 2000–2021 were analyzed according to official statistics, epidemiological examination of foci and laboratory studies. The results of studies of 2379 blood samples of adults who were not ill and not vaccinated against tick-borne encephalitis for the presence of antibodies to the virus were analyzed.Results. The virulence of ticks in 2000–2021 decreased from 23.6 to 1.3%, infection with borrelia at the level of 13.4– 38.4%. The average long-term incidence rates of tick-borne encephalitis and Lyme borreliosis were 6.2 and 6.6 per 100 thousand, the dynamics of incidence had an average pronounced downward trend, correlated with the dynamics of requests for medical care of the population affected by ticks. The main clinical form of tick–borne encephalitis is meningeal (48%). Non-erythemic forms of borreliosis in recent years amounted to 39.1%. Antibodies of class G to tick-borne encephalitis virus were detected in 11.8±0.7% of the examined individuals. The territory of risk of infection with tick-borne encephalitis and Lyme borreliosis is the central and eastern part of the south of the Republic, where I.persulcatus dominates. The proportion of urban residents among patients with both infections is higher, but the incidence of urban and rural populations did not have significant differences. The incidence rates of tick-borne borreliosis in persons aged 40-49, 50-59 and 60 years and older are 1.6-2.2 times higher than those of tick-borne encephalitis, but the difference is not significant. At working age, the percent of men is higher than women, there are no differences among the elderly.Conclusions: Similar and different features of the epidemic process of tick-borne encephalitis and tick-borne borreliosis have been identified, which should be taken to improving the detection of diseases, predicting the situation and planning preventive measures.
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