[蜱传脑炎及莱姆病。蜱传脑炎地区病原体的传播和疾病风险[j]。

M Holbach, R Oehme
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摘要

了解蜱传病原体的分布和感染疾病的相关风险,对于确保在歇斯底里和无视之间作出适当反应,以及决定接种疫苗的适当性至关重要。以德国巴伐利亚州Lohr a. M.镇为例,调查和比较了蜱虫中tbe病毒和伯氏疏螺旋体的流行情况,并评估了各自因叮咬而感染疾病的风险。采用聚合酶链反应(PCR)方法,从洛尔附近5个不同生物群落中采集1657只蜱,检测tbe病毒,408只蜱检测伯氏疏螺旋体。研究结果与德国其他地区的早期发现进行了比较。感染疾病的风险是根据传播率和表现率以及该区域的流行病学数据估计的。调查蜱中tbe病毒感染率为0.12% (95% CI: 0.05 ~ 0.44%)。这与其他4个tbe风险区相当,但明显低于tbe高风险区。成蜱检出率为14.9%(11.8 ~ 19.0%),约为若虫检出率(7.2%,范围4.6 ~ 11.7%)的2倍。根据这些流行率,被蜱虫叮咬感染脑膜炎/脑炎的风险约为1:10 000,感染莱姆病的风险约为1:100,后者要求蜱虫至少附着2-3天。
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[Tick-borne encephalitis and Lyme borreliosis. Spread of pathogens and risk of illness in a tick-borne encephalitis region].

A knowledge of the distribution of tick-borne agents and the related risks of contracting diseases are essential to ensure an appropriate response between hysteria and disregard, and to decide the appropriateness of vaccination. Illustrated by the German town of Lohr a. M. (Bavaria), the prevalence of TBE-virus and Borrelia burgdorferi in ticks was investigated and compared, and the respective risk of contracting disease from a bite assessed. Using the polymerase chain reaction (PCR), a total of 1657 ticks obtained from five different biotopes around Lohr were examined for the TBE-virus, and 408 ticks for Borrelia burgdorferi. The results were compared with earlier findings in other regions of Germany. The risk of contracting illness was estimated on the basis of transmission and manifestation rates, together with epidemiological data from the region. The prevalence of TBE-virus was 0.12% (95% CI: 0.05-0.44%) in the ticks investigated. This is comparable with that in 4 other regions rated as TBE-risk regions, but significantly lower than that in rated high-risk regions. Borrelia burgdorferi was detected in 14.9% (11.8-19.0%) of adult ticks, roughly twice the prevalence found in nymphs (7.2%, range 4.6-11.7%). On the basis of these prevalences, the risk of contracting meningitis/encephalitis from a tick bite is about 1:10,000, and the risk for Lyme Borreliosis is about 1:100, the latter requiring that the tick remains attached for at least 2-3 days.

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