An epidemic of oligoarticular arthritis in children and adults in three connecticut communities

摘要: An epidemic form of arthritis has been occurring in eastern Connecticut at least since 1972, with the peak incidence new cases summer and early fall. Its identification possible because tight geographic clustering some areas, a characteristic preceding skin lesion patients. The authors studied 51 residents three contiguous communities—39 children 12 adults—who developed an illness characterized by recurrent attacks asymmetric swelling pain few large joints, especially knee. Attacks were usually short (median: 1 week) much longer intervening periods complete remission 2.5 months), but lasted for months. To date typical patient had recurrences, 16 patients have none. A median 4 weeks (range: 1–24) before onset arthritis, 13 (25%) noted erythematous papule that into expanding, red, annular lesion, as 50 cm diameter. Only 2 159 family members such did not develop (P < 0.000001). overall prevalence was 4.3 per 1,000 residents, among living on four roads 10. Six families more than affected member. Nine 20 symptomatic low serum C3 levels, compared to none 31 asymptomatic 0.005); no iridocyclitis or positive test antinuclear antibodies. Neither cultures synovium synovial fluid nor serologic tests agents known cause arthritis. “Lyme arthritis” is thought be previously unrecognized clinical entity, epidemiology which suggests transmission arthropod vector.