Abstract
BackgroundA number of tick-borne pathogens circulate in the Belgian tick population in addition to the causative agent of Lyme borreliosis. However, so far, only a few patients with tick-borne diseases other than Lyme borreliosis have been reported in Belgium. The aim of this study was to investigate the occurrence of other human tick-borne infections in Belgium and their possible clinical manifestation.MethodsPatients with fever (> 37.5 °C) after a tick bite or those with erythema migrans (EM) were included in the study. EDTA-blood samples were screened for the presence of DNA from Borrelia burgdorferi sensu lato, Borrelia miyamotoi, Anaplasma phagocytophilum, Neoehrlichia mikurensis, spotted fever group rickettsiae (genus Rickettsia), Babesia spp., Bartonella spp., Spiroplasma ixodetis and tick-borne encephalitis virus, using multiplex PCR methods. A questionnaire on, among others, demographics and clinical symptoms, was also filled in.ResultsOver a period of 3 years, 119 patients with EM and 14 patients with fever after a recent tick bite were enrolled in the study. Three samples initially tested positive for N. mikurensis by quantitative PCR (qPCR), but the results could not be confirmed by other PCR methods, and repetition of the DNA extraction procedure and qPCR test was not successful. The qPCR test results for the other tick-borne pathogens were negative.ConclusionsIn general, only a few patients with fever after a tick bite could be identified. Although no tick-borne pathogens were detected, their occurrence cannot be excluded based on the limited number of patients and the limitations inherent to current methodologies. This study underscores the possibility of false-positive PCR results and the necessity for the development of multiple independent tools for the sensitive and specific detection of emerging tick-borne pathogens.Graphical
Highlights
A number of tick-borne pathogens circulate in the Belgian tick population in addition to the causative agent of Lyme borreliosis
The tick Ixodes ricinus is the main vector of Lyme borreliosis in Europe, and is known to transmit several other infectious diseases as well, including tick-borne encephalitis (TBE), anaplasmosis and babesiosis [2, 3]
The aim of this study was to evaluate the presence of tick-borne pathogens other than Borrelia spirochetes using PCR techniques in blood collected from patients with a recent tick bite and fever, a common symptom of these other infections, and in patients with an erythema migrans (EM), the most common clinical manifestation of Lyme borreliosis
Summary
A number of tick-borne pathogens circulate in the Belgian tick population in addition to the causative agent of Lyme borreliosis. The relapsing fever spirochete B. miyamotoi is present in ticks, no cases of B. miyamotoi disease, or of neoehrlichiosis, caused by infections with the intracellular bacterium N. mikurensis, have been reported in Belgium [14, 15]. The latter, previously called ‘Candidatus N. mikurensis’, was only recently cultured successfully which is why it lost its candidatus status [14]. A handful of human infections have been described, but so far never in Belgium [20, 21]
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