莱姆病知识 (ZT)

starlight

这个Lyme Disease是户外活动中被Ticks叮咬引起的，很可怕的！上周末加拿大有多处城市举行游行，呼吁引起人们重视。

Lyme disease patients rally for better diagnostic tests
Updated Sun. Sep. 20 2009 10:00 PM ET

CTV.ca News Staff

Canadian Lyme disease patients are calling for better doctor training and more accurate tests so sufferers can be diagnosed and treated quickly before their side effects become crippling and chronic.

At rallies across Canada this week, patients called for greater awareness of the disease within the medical community, and asked provincial governments to train doctors to recognize the disease.

"We have people on crutches, we have people that couldn't come today because they are bedridden," Lyme disease patient Gwen Barlee told CTV News at a rally in Vancouver. "Most people I know who have Lyme disease don't have jobs anymore."

More than 20,000 cases of Lyme disease are diagnosed across North America every year.

The disease is contracted through the bite of an infected tick. Bacteria from the bite enter the bloodstream and can infect joints, the heart and even the brain.

Some experts believe that thousands more suffer for years without an accurate diagnosis. They say blood tests used in Canada are not as sophisticated as those used in the United States, and that few doctors are trained to recognize the symptoms.

Lyme disease can be cured early with antibiotics. However, it can lead to a lifetime of pain, disability and neurological problems if left untreated.

"Our treatment is very expensive, very prolonged and our prognosis is now uncertain," said patient Rob Manten at a rally in Ontario. "I want to see things changed and I call on our government to assist us in making that happen."

Their message echoed that of experts published in the Canadian Medical Association Journal earlier this year.

In their report, researchers said Lyme disease, which was largely unheard of in the 1980s, is now found across the country.

The tick that carries the Lyme-causing bacteria Ixodes scapularis is found in Nova Scotia, New Brunswick, southern Quebec, southern Ontario and southeastern Manitoba.

The tick that spreads the bacterium in the West, Ixodes pacificus, is now widespread in southern British Columbia.

The researchers called for better surveillance measures for ticks as they spread throughout Canada. They also called on public health officials to better inform the public and doctors about local risk levels, prevention and the need for early diagnosis.

"Current passive surveillance for tick vectors has identified new endemic areas, but additional methods are needed to precisely identify where Lyme disease is emerging in Canada," they wrote.

With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip

starlight

The best and easiest defence against tick-borne infection is to avoid being bitten. Simple precautions to help you stay safe include:

1) Out walking, wear suitable clothing: use gaiters, or tuck long trousers into socks, and choose clothes with elastic or drawstrings at the waist, wrist, and ankle, to help deter ticks from crawling under clothes and attaching. Clothing made from smooth or waxed material is hard for ticks to climb, and light-coloured fabrics make them easier to see. Wearing shorts in tick habitat is an invitation to be bitten!

2) Use a repellent: insect repellents that contain "permethrin" can be sprayed on to clothing. DO NOT APPLY THIS CHEMICAL DIRECTLY TO SKIN. Allow clothing to dry thoroughly before wearing (N.B. Permethrin is highly toxic to cats. Make sure they do not come into contact with treated clothing).

Repellents that contain 25% "DEET" can be applied to skin but they evaporate quickly and need repeated application. N.B. Confine application to small areas of the arms, legs, and neck, as treatment over large areas can cause toxicity, especially in children. "DEET"-free and herbal products for topical application are available from various outlets. See the BADA-UK Products page.

3) Carry a tick remover: when visiting tick habitat, carry a tick-removal tool and antiseptic wipes. Tick removers are available from the BADA-UK Products page, and from some veterinary surgeries and chain pet stores.

4) Walk in the centre of paths: avoid over hanging vegetation at the edge of paths where ticks may be waiting.

5) Have a "tick buddy": when planning an excursion into tick habitat, have a designated "tick buddy" to help you check your body. Pay particular attention to the scalp as ticks can easily hide under hair.

6) Deter ticks from gardens: careful landscaping of park areas and gardens can help to deter ticks, as they thrive in humid environments and avoid sunny, dry areas. The following tips can help you create a "safe zone":

a) Keep leaf litter to a minimum.

b) Keep grass short and cut back overhanging vegetation from the edge of paths.

c) Divide lawns from shrub areas with wood chips or gravel.

d) Keep seating and play equipment away from borders, trees, and bird feeders.

e) Use fencing to divide gardens from deer habitat.

For more comprehensive information, see the BADA-UK "Tick Control" section.

7) Keep pets tick free: tick-control products that are "spot on" or "spray on" are available from veterinary surgeries but are not suitable for all types of animal. Talk to your vet about which control method is suitable for your particular pet. For further information see the BADA-UK Pet Problems section.

8) Treat pet accessories with repellents: pyrethrum-based sprays are available from pet shops and veterinary surgeries, and there are herbal repellents available for treating accessories such as dog-jackets and bedding. You can also treat vehicle upholstery if your pet travels regularly. Warning: Pyrethrum-based products are highly toxic to cats and should not be used in households where cats are present. Always follow the manufacturers' instructions to avoid accidental poisoning by overdose.

9) Groom pets thoroughly: make sure you also brush against, as well as with, the hair-growth to see any embedded ticks. Check inside the ears, around the eyes, on the chin and around the muzzle, as well as between pads and toes. For further information see the BADA-UK  Pet Problems section.

10) Don't bring ticks home: take off outer clothes before going in doors. Ticks are very intolerant to being dried out so suitable clothing can be treated in a tumble dryer to kill any ticks that may remain hidden. Tests have demonstrated that ticks can survive a full cycle in the washing machine and short periods in a dryer so high heat and prolonged periods of drying would be necessary to kill any remaining ticks.

starlight

继续科普.  :lol:

莱姆病或莱姆疏螺旋体病是一种传染性的蜱媒病，由伯氏疏螺旋體 (一种革蘭氏陰性菌微生物)，导致的疾病。

因为这种病被公认是在1975年10月，在康乃狄克州的老莱姆镇,莱姆镇和东哈丹姆附近地区首次发现而得名。这种病是由于被感染的蜱叮咬而传染的。1982年，美国国家卫生总局的威利·伯格多费（Willy Burgdorfer）和同事从丹敏硬蜱（Ixodes dammini）分离到莱姆病病原体。 莱姆病是一种地区性、全身性、慢性为症性蜱媒螺旋体病。早期以皮肤慢性游走性红斑为特点，以后出现神经、心脏或关节病变，通常在夏季和早秋發病，可发生于任何年龄，男性略多于女性。

病因
由蜱传播的Burgdorferi疏螺旋体为病原体。

病理
1、红斑表玻全层血管周围和间质中有淋巴细胞、浆细胞或嗜酸性白细胞浸润，表皮及真皮乳头水肿。

2、关节受累时的滑膜改变与类风湿性关节炎相似。

病徵
1、皮肤病变：常为首发症状，特征性表现为慢性游走性红斑，初起为红色斑疹或丘疹，逐渐扩大成环殂损害。一般出现在蜱叮咬后3—32天，好发于躯干、大腿、腹股沟，、腋下等处。

2、神经系统病变：约见于15%的患者，与皮疹同时或消退后1—6周出现。表现为脑膜炎、脑神经炎、舞蹈症、小脑共济失调，出现脑膜刺激征、昏迷、面瘫或三叉神经痛等。

3、心脏病变：见于8%左右的患者，常于皮损出现3周后发生房室传导阻滞、心肌炎、心包炎或全心炎等。

4、关节病变：约见于60%的患者，多累及大关节，尤其是膝关节，反复发作肿胀、疼痛，10%的患者可转变为慢性关节炎。

5、其他表现：发热、乏力、肌痛、恶心、呕吐、结膜炎、虹膜炎、淋巴结及肝脾大等。

诊断
实验室检查
1、血常规：白细胞总数正常，中性粒细胞可稍增多。

2、血沉增快类风湿因子阴性。循环免疫复合阳性。

3、抗burgdorfer疏螺旋体抗体滴度≥1:256。

经线检查
可见受累关节周围软组织肿胀影，少数患者有软骨和骨侵蚀表现。

诊断标准
美国疾病控制中心提出，符合下列任何1条者均可诊断为莱姆病。

1、在流行区，慢性游走性红斑（单个红斑的直径必须至少为5cm，并应由医生检查确定）或抗burgdorfer疏螺旋体抗体滴度≥1:256，及1个或1个以上器官系统受累。

2、在非流行区，慢性游走性红斑及抗burgdorfer疏螺旋体抗体滴度≥1:256。，或慢性游走性红斑及1个或1个以上器官系统受累，或抗体滴度≥1:256。及1个或1个以上器官系统受累。