Arthropod-Borne Diseases: The Camper's Uninvited Guests
Arthropod-Borne Diseases: The Camper's Uninvited Guests
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DOI：
10.1128/microbiolspec.iol5-0001-2014
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发表时间：
2015-08-01
影响因子：
3.7
通讯作者：
Juckett, Gregory
中科院分区：
文献类型：
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作者：
Juckett, Gregory
节肢动物传播的疾病是户外活动中节肢动物与人接触的主要问题。这里讨论的节肢动物包括蛛形纲动物（蜱）和昆虫。大多数节肢动物咬伤和蜇伤都是轻微的，值得注意的例外是蜜蜂蜇伤过敏。蜱虫传播疾病最多。主要的硬蜱媒介包括黑腿蜱、狗蜱和孤星蜱，它们传播莱姆病和各种立克次体病。驱虫剂、氯菊酯喷雾剂和适当的蜱虫检查可以显著降低这种风险。莱姆病和较轻的南方蜱相关皮疹病（STARI）的特点是，在莱姆病的情况下，伴有早期、播散性和晚期的全身性症状。治疗用强力霉素或头孢曲松。根据主观症状无限期治疗“慢性莱姆病”是无益的。立克次体疾病包括埃立克体病、无形体病和落基山斑疹热，其特征是发烧、头痛和可能的皮疹，应在等待实验室确认的同时用多西环素进行经验治疗。兔热病是一种细菌性疾病（弗朗西斯菌），由蜱虫和兔子传播，以发热和腺病为特征。治疗是用庆大霉素或链霉素。巴贝斯虫病是一种类似疟疾的原生动物疾病，在健康宿主中引起一种自限性流感样疾病，但可能因免疫系统受损而危及生命。治疗是阿托伐醌和阿奇霉素。其他与蜱虫有关的疾病包括病毒性疾病（波瓦桑病、科罗拉多蜱虫热、心脏地带病毒）、蜱虫传播的回归热（疏螺旋体）和蜱虫麻痹（毒素）。蚊子、虱子、跳蚤和螨虫以其令人讨厌的叮咬而闻名，但即使在美国，它们也是越来越重要的疾病媒介。
Arthropod-borne diseases are a major problem whenever outdoor activities bring arthropods and people into contact. The arthropods discussed here include arachnids (ticks) and insects. Most arthropod bites and stings are minor, with the notable exception being bee-sting anaphylaxis. Ticks cause the most disease transmission. Key hard tick vectors include black-legged (Ixodes), dog (Dermacentor), and lone star (Amblyomma) ticks, which transmit Lyme and various rickettsial diseases. Insect repellents, permethrin sprays, and proper tick inspection reduce this risk significantly. Lyme disease and the milder southern-tick-associated rash illness (STARI) are characterized by the erythema migrans rash followed, in the case of Lyme disease, by early, disseminated, and late systemic symptoms. Treatment is with doxycycline or ceftriaxone. Indefinite treatment of "chronic Lyme disease" based on subjective symptoms is not beneficial. Rickettsial diseases include ehrlichiosis, anaplasmosis, and Rocky Mountain spotted fever, which are characterized by fever, headache, and possible rash and should be empirically treated with doxycycline while awaiting laboratory confirmation. Tularemia is a bacterial disease (Francisella) spread by ticks and rabbits and characterized by fever and adenopathy. Treatment is with gentamicin or streptomycin. Babesiosis is a protozoal disease, mimicking malaria, that causes a self-limited flu-like disease in healthy hosts but can be life threatening with immune compromise. Treatment is with atovaquone and azithromycin. Other tick-related conditions include viral diseases (Powassan, Colorado tick fever, heartland virus), tick-borne relapsing fever (Borrelia), and tick paralysis (toxin). Mosquitoes, lice, fleas, and mites are notable for their annoying bites but are increasingly significant disease vectors even in the United States.