LYME DISEASE - A TOPICAL HEALTH ISSUE IN ROMANIA
Abstract:
In the past three years, climatic changes have entailed important changes in the vector circulation, and, implicitly, in the incidence of anthropozoons. This is particularly valid in the case of Lyme disease, which is mainly transmitted in our geographical area via Ixodes ricinus, whose incidence has increased, in Romania, from 0.5%000 inhabitants in 2009 to 1.5%000 inhabitants in 2010, and to 2.2%000 inhabitants in 2011, respectively. The highest incidence, two deviations above the national mean incidence, has been found in Sibiu county. Methods: We undertook an observational study, from 2009 to 2011, of the confirmed cases of infection with Borrelia spp. We analyzed the batch from a demographic point of view and we investigated the clinical and stage aspects, diagnosis issues, the therapy and the evolution of every case. Results: If, in 2009, 15 cases of Lyme disease were clinically and serologically confirmed by ELISA and Western Blot tests, in 2010 their number increased to 71, and in 2011 to 128. More cases were confirmed in female patients (sex ratio 1:1,47), in the urban area (143 cases), in the summer months (June and July), in patients who were aware of the disease transmission moment (77,10% cases). The migratory erithema was present in 128 cases, associated or not with general manifestations. Stage II was diagnosed in 51 patients, who had articular, cerebral meningitis and cardiovascular manifestations. Stage III of neuroborreliosis was diagnosed in 37 patients. Conclusions: In the absence of constant investigations in the cardiology, neurology and ophthalmology units, Lyme disease remains under-assessed. The measures that address the vector must be complemented by specific prophylactic measures and serological investigations, at least in the case of persons exposed to occupational hazards– foresters, farmers and of those who recognize the tick bite.
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