RESUMO
We present a sero-epidemiological study of 190 Belgian cases of Lyme borreliosis, a multisystemic disease caused by the spirochaete Borrelia burgdorferi and transmitted by a tick bite. The whole spectrum of clinical pictures was observed in these patients, including "erythema chronicum migrans" (63%), neurological involvement (47%) and arthritis (22%), frequently in combination. Our results are compared to findings in other countries. Among the 437 Ixodes ricinus ticks collected in the Sambre and Meuse valleys around Namur, we discovered 43 ticks (9.8%) with spirochaetes in the midgut. The ecology of these arthropods explains why this infection is more prevalent in the spring and the summer. Perhaps for the same reason, the incidence ranges from low near the coast to medium in the central part and high in the wooded south-eastern part of Belgium. The main conclusions are that Lyme borreliosis is endemic in Belgium, that all the clinical pictures can be observed ant that a clear epidemiological case-definition is needed, combining clinical signs and serological results.
Assuntos
Doença de Lyme/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antibacterianos/análise , Bélgica/epidemiologia , Grupo Borrelia Burgdorferi/imunologia , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Feminino , Imunofluorescência , Humanos , Lactente , Doença de Lyme/imunologia , Masculino , Pessoa de Meia-IdadeRESUMO
The investigation and follow-up of three cases of EPP led us to reevaluate the signs and symptoms of the disease, the usefulness of early skin biopsies and protoporphyrin and ferrochelatase determinations. A review of the literature brought forth the salient features of this inborn error of porphyrin metabolism and stressed the value of treatment with beta-carotene and canthaxantine but also the risk of the so-called "gold dust" retinopathy.
