山东省莱姆病地理流行病学研究

Seroepidemiological study of Lyme disease in Shandong province

目的调查山东省莱姆病地理分布、媒介生物、动物宿主及病原分离情况,为今后防治提供依据。方法采用间接免疫荧光抗体试验(IFA)对6个调查点的人群进行莱姆病抗体检测;用直接免疫荧光抗体试验(DFA)检查优势蜱种及其携带莱姆病螺旋体情况,并用BSKⅡ培养基分离培养莱姆病螺旋体。宿主调查采用DFA检查鼠肾。用单克隆抗体和IFA进行菌株的鉴定。结果共检测血清1934份,阳性121份,感染率6.26%;鲁东、鲁南、鲁中、鲁西北感染率分别为5.76%、7.03%、0、9.81%;各年龄组差异无统计学意义(P>0.05);男性感染率为5.56%,女性为6.98%,两者间差异无统计学意义(χ2=1.67,P>0.05);山东省蜱类的优势种为长角血蜱,该蜱中肠带螺旋体率为12.00%;宿主动物调查显示,鼠类带莱姆病螺旋体率为13.26%,黑线姬鼠为优势种(占45.65%),带菌率高为14.24%。从86组培养物中分离到2株莱姆病螺旋体(TSH1、TSH2)。结论不同地区生态环境和传播媒介分布不同,各地区间莱姆病感染程度差别很大。长角血蜱可能为山东省莱姆病的重要生物媒介。

Objective To provide useful information for prevention and control of Lyme disease by investigating geographic distribution, medical vector, animal host and pathological separation of Lyme disease in Shandong province. Methods IFA was used to test antibody of Borrelia burgdorferi. DFA was used to determine the dominant tick and the rate of its carrying B. burgdorferi. We isolate and culture pathogen with BSK medium. DFA was also used to investigate host animals. Results 1934 sera were examined, 121 of which were positive and the infection ratio was 6.26% ; The infection ratio of the east, the south, the middle, the west-north of Shandong province was 5.76%, 7.03%, 0 and 9.81%, respectively. There was no significant difference between the age groups （P 〉 0.05）. The infection ratio was 5.56 % for men, and 6.98 % for women, and there was no statistis significant difference between them. The investigation showed that the dominant tick specie was Haernaphysalis longicornis in Shandong province. 12.00 percent of H. long＇wornis contained spirachetes as determined by direct immunolfluorescence test. The investigation of animal host showed that 13.26 percent of rodents carried B. burgdorferi, of which Mus musculus was found as the dominant species, accounting for 45.65 % and the germ-carrying rate was 14.24 %. Two B. burgdorferi （TSH1, TSH2 ） was isolated from 86 H. longicornis cultivation. Conclusion The distribution of ecology environment and vectors in different regions was rather different in the infection of Lyme disease. H. longicornis may play the dominent role in transmission of B. burgdorferi to human in Shandong province.