IMUNIZACE PROTI LYMESKÉ BORELIÓZE -PRVNÍ ZKUŠENOSTI

Lyme Disease Immunization - Initial Experience

The ever increasing rate of new cases of Lyme disease, the tendency for chronicity in certain forms of the diseaseand especially the disputable effect of causal therapy resulted in strenuous efforts to develop an effective vaccine.The authors sum up recent experience with vaccination in the U.S.A. and Europe. Two studies in the U.S. duringthe years 1994 through 1997 included more than 20 000 probands. In one of the studies, coordinated by Steer (10936 probands), during the first year twenty-two people of the vaccinated group contracted the disease compared toforty-three people of the non-vaccinated, i.e. placebo group. The vaccine efficacy was 49 percent. During the secondyear of the study, after the third dose of the vaccine, sixteen vaccinated people contracted the disease vs. sixty-sixplacebo probands. Vaccine efficacy was 76 percent. Its administration was accompanied by mild to moderate localor systemic reactionlasting up to three days.In the next study, coordinated by Sigal (10 305 probands) the vaccine efficacy was sixty-eight percent in the firstyear and ninety-two percent in the second, respectively. Both studies proved the vaccine to be safe and efficient inLyme disease prevention.In comparison with these large long-term double-blind, placebo-controlled studies European research resultspresented to the medical community for the first time in 1998 in Vienna appear to be of lesser value. Recombinantpolyvalent vaccine based on OspC lipoprotein isolated from Borrelia burgdorferi sensu lato was used but only eightyvolunteers from Aland Islands participated in the study.

Key words:
Lyme disease, immunisation, recombinant polyvalent vaccine, lipoprotein OspC.