广州市2017年首例输入性莱姆病病例调查分析  

Investigation and analysis of the first imported lyme disease case in Guangzhou City in 2017

作　　者：徐建敏[1] 张豪[1] 魏跃红[1] 陈守义[1] 许聪辉[1] 陈海燕[1] 樊莉蕊[1] 任文锋[1] 陈坤才[1] XU Jianmin;ZHANG Hao;WEI Yuehong;CHEN Shouyi;XU Conghui;CHEN Haiyan;FAN Lirui;REN Wenfeng;CHEN Kuncai(Guangzhou Center for Disease Control and Prevention,Guangzhou,Guangdong 510440,China)

机构地区：[1]广州市疾病预防控制中心,广东广州510440

出　　处：《医学动物防制》2023年第10期1008-1010,1017,F0003,共5页Journal of Medical Pest Control

基　　金：广东省财政厅关于提前下达2022年中央财政基本公共卫生服务补助资金的通知(粤财社[2021]314号);广州市重点实验室基础研究计划项目(202102100001)。

摘　　要：目的对广州市2017年一起疑似输入性莱姆病病例的发病情况进行调查与核实,为当地莱姆病的调查处置和临床诊疗提供科学依据。方法结合该疑似病例的流行病学调查资料、临床症状和实验室检测结果,进行综合分析。结果该疑似病例2017年5月12日至5月25日有疫源地暴露史和蜱叮咬史,其身体出现5.0cm×8.0cm的游走性红斑,持续低烧十余天,C反应蛋白升高(24.49mg/L),莱姆病双份血清免疫球蛋白G(immunoglobulin G,IgG)抗体阳性。结论调查核实该病例为广州市2017年首例输入性莱姆病病例。莱姆病尚未列入我国疾病监测,缺乏有效防控措施,建议提高医务工作者对其重视程度及对该病的认识和诊治水平。目前在无疫苗可用的情况下,广州市疾控部门应协同政府相关部门,加强莱姆病的宣传工作,做好蜱的监测与防治,对蜱叮咬做好预防措施,完善疑似患者的诊治流程,尽量避免漏诊和误诊。被蜱虫叮咬出现疑似病例时,广州市各级疾控部门应尽快对其开展病原学调查、流行病学调查和疫源地灭蜱等一系列工作,避免疫情扩散。Objective To investigate and verify the case of a suspected imported Lyme disease in Guangzhou City in 2017,so as to provide a scientific basis for the investigation and disposal,clinical diagnosis and treatment of local Lyme disease.Methods A comprehensive analysis was conducted based on the epidemiological investigation,clinical symptoms and laboratory test results of the suspected case.Results The suspected case had a history of exposure to the endemic foci and tick bites from May 12 to May 25,2017.The patient body presented with 5.Ocmx8.Ocm erythema migrans,continuous low-grade fever for more than 10 days,elevated C-reactive protein(24.49mg/L),and double serum immunoglobulin G(IgG)antibody positive for Lyme disease.Conclusion The case is investigate and verified as the first imported case of Lyme disease in Guangzhou City in 2017.Lyme disease has not yet been included in the category of disease surveillance in China.Lack of effective prevention and control measures have not been formulated yet.It is suggested that medical workers should pay more attention to the disease and improve their understanding,diagnosis and treatment level of it.In the absence of available vaccine at present,Guangzhou CDC should collaborate with relevant government departments to strengthen the publicity of Lyme disease,do a good job in the monitoring and prevention of ticks,take preventive measures against tick bites,improve the diagnosis and treatment process of suspected patients,so as to avoid missed diagnosis and misdiagnosis as much as possible.In the case of suspected cases causes by tick bites,CDC departments at all levels in Guangzhou City should carry out a series of work such as etiological investigation,epidemiologic study and tick eradication of epidemic focus as soon as possible to avoid the spread of the epidemic.

关 键 词：莱姆病 游走性红斑 血清学检测 间接免疫荧光试验 流行病学调查 

分 类 号：R181.3[医药卫生—流行病学] R514[医药卫生—公共卫生与预防医学]