Zusammenfassung
Ziel der Studie war es, das Risiko einer Anaplasmen-Infektion in bekannten Endemie-Gebieten der Lyme-Borreliose in der Zentral-Slowakei zu erfassen. Die Zirkulation von Anaplasma phagocytophilum in Zecken und Wildtieren wurde schon seit Jahren in Naturherden dieses Gebietes beobachtet. Aus dieser Region wurden Serumproben von Patienten gewonnen, die nach einem Zeckenstich klinische Symptome der Lyme-Borreliose entwickelt hatten. Insgesamt wurden Seren von 76 Patienten mittels eines kommerziellen Immunofluoreszenz Assays zum Nachweis von IgG Antikörpern gegen A. phagocytophilum getestet; 19 (25%) waren positiv. Eine Infektion mit A. phagocytophilum wurde bei einem Kind (4%), 12 Erwachsenen (39%) im Alter zwischen 22 und 56 Jahren und bei sechs Personen (32%) über 56 Jahre serologisch bestätigt. Ein statistisch signifikanter Unterschied in der Seroprävalenz (P < 0,01) wurde zwischen Kindern und Erwachsenen ermittelt. IgG-Antikörper gegen A. phagocytophilum wurden bei sieben Patienten mit klinischer Lyme-Borreliose, bei sieben Personen mit Antikörpern gegen Borrelia burgdorferi sensu lato und bei fünf Borrelien-seronegativen Personen ermittelt. Die häufigsten Symptome bei den A. phagocytophilum seropositiven Patienten waren Kopfschmerzen, Gelenks- und Muskelschmerzen, Fieber, Ausschlag, und Lymphknotenschwellung. Diese Patienten stammten aus den Gemeinden Vtáčnik (5/19), Štiavnické vrchy (1/19), Kremnické vrchy (10/19) und Žiarska kotlina (3/19). Die Ergebnisse zeigen, dass ein Risiko für Infektionen mit A. phagocytophilum in den Naturherden der Zentral-Slowakei besteht, sodass die humane Anaplasmose in die Differentialdiagnose mit einbezogen werden sollte, insbesondere dann, wenn eine akut fieberhafte Erkrankung nach Zeckenstich auftritt.
Summary
The aim of this study was to determine the risks of human anaplasmosis in an area of central Slovakia endemic for Lyme borreliosis. The circulation of Anaplasma phagocytophilum in ticks and wild animals has been observed in natural foci in this area for several years. Samples of human sera from patients with Lyme borreliosis and persons with a history of recent tick bite and clinical symptoms indicating Lyme borreliosis were collected in central Slovakia. A total of 76 human sera were analyzed using an indirect HGE IgG immunofluorescent assay kit. IgG antibodies against A. phagocytophilum were found in 19 (25%) sera (15 female, 4 male patients). A. phagocytophilum infection was serologically confirmed in one (3.8%) child, 12 (38.7%) persons aged 22–56 and six (31.6%) persons older than 56. A statistically significant difference in seroprevalence (P < 0.01) was observed between children (3.8%, 1/26) and adults (36%, 18/50). Antibodies against A. phagocytophilum were detected in seven patients with clinically diagnosed Lyme borreliosis and in another seven individuals with assessed antiborrelia antibodies. IgG antibodies against A. phagocytophilum were detected in five persons seronegative for borrelia. The most frequent clinical symptoms in patients with positive A. phagocytophilum serology were cephalalgia, arthralgia, myalgia, fever, exanthema, neurological symptoms and lymphadenopathy. Positive sera were obtained from patients living in villages and towns in the orographic entities Vtáčnik (5/19), Štiavnické vrchy (1/19), Kremnické vrchy (10/19) and Žiarska kotlina (3/19). Our results demonstrate the risk of acquiring A. phagocytophilum infection in natural foci in central Slovakia. Human anaplasmosis should be considered in the differential diagnosis, especially in cases of acute febrile illness with tick-bite history.
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Kocianová, E., Košt'anová, Z., Štefanidesová, K. et al. Serologic evidence of Anaplasma phagocytophilum infections in patients with a history of tick bite in central Slovakia. Wien Klin Wochenschr 120, 427–431 (2008). https://doi.org/10.1007/s00508-008-1000-y
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DOI: https://doi.org/10.1007/s00508-008-1000-y