Lyme Borreliosis Infection Research Articles

The Lyme Borreliosis Spatial Footprint in the 21st Century: A Key Study of Slovenia.

After mosquitoes, ticks are the most important vectors of infectious diseases. They play an important role in public health. In recent decades, we discovered new tick-borne diseases; additionally, those that are already known are spreading to new areas because of climate change. Slovenia is an endemic region for Lyme borreliosis and one of the countries with the highest incidence of this disease on a global scale. Thus, the spatial pattern of Slovenian Lyme borreliosis prevalence was modelled with 246 indicators and transformed into 24 uncorrelated predictor variables that were applied in geographically weighted regression and regression tree algorithms. The projected potential shifts in Lyme borreliosis foci by 2050 and 2070 were calculated according to the RCP8.5 climate scenario. These results were further applied to developing a Slovenian Lyme borreliosis infection risk map, which could be used as a preventive decision support system.

The problem of Lyme borreliosis infections in urban and rural residents in Poland, based on National Health Fund data.

Some fragmentary studies show that the incidence of Lyme borreliosis in Poland is increasing. It has been generally accepted that the most affected are forestry workers and farmers. The aim of the study is to compare the incidence of borreliosis in urban and rural residents in 2008-2016. Databases on Lyme borreliosis from the National Health Fund and Central Statistical Office in Poland were analyzed. For each patient, ambulatory or discharged from every hospital, the diagnosis was compulsorily reported as encoded following the International Classification of Diseases. A steadily increasing number of patients with borreliosis in Poland was found, which doubled in 2008 - 2016. The incidence was similar in urban and rural residents. In all the provinces in Poland, an increase in incidence of borreliosis was observed, although there were big differences between them. The highest frequency of borreliosis was in Podlasie and Warmia-Masuria provinces. The lowest incidence of borreliosis was noticed in Wielkopolska province. In the most provinces the increase in the incidence of borreliosis was steady, except Warmia-Masuria, where it was very low in 2008, and soaring since 2011. The number of cases per year between 2008 - 2016 increased in both in males and females. The results suggest the need for higher awareness of the risk of Lyme borreliosis in urban residents, because the incidence of Lyme borreliosis is growing independently of the place of residence. Prompt measures to prevent tick bites and appropriate education are urgently needed.

Estimates for Lyme borreliosis infections based on models using sentinel canine and human seroprevalence data.

Two models were developed to estimate Lyme borreliosis (LB) cases. One was based on the seroprevalence of Borrelia infections in human samples. This model used corrections for false negative and false positive results from published test sensitivity and specificity measures. A second model based on Borrelia infections in sentinel dogs was used to quantify the prevalence of Lyme disease Borrelia infections in humans; the reference baseline for this model was human and canine infections in Germany. A comparison of the two models is shown and differences discussed. The relationships between incidence, prevalence and total infection burden for LB were derived from published data and these were used in both models to calculate annual incidence, prevalence and total LB infections. The modelling was conservative and based on medical insurance records coded for erythema migrans. Linear model growth rates were used in place of the commonly adopted exponential growth. The mean of the two models was used to create estimates for various countries and continents. Examples from the analyses for LB estimated for 2018 include: incidence – USA 473,000/year, Germany 471,000/year, France 434,000/year and UK 132,000/year; prevalence – USA 2.4 million, Germany 2.4 million, France 2.2 million and UK 667,000; total infections – USA 10.1 million, Germany 10.0 million, France 9.3 million and UK 2.8 million. Estimates for the world for 2018 are: incidence 12.3 million/year; prevalence 62.1 million; and total infection burden 262.0 million. These figures are far higher than officially published data and reflect not only the underestimation of diagnosed cases, which is acknowledged by health agencies, but also undiagnosed and misdiagnosed cases.

Cerebral Aneurysm in Lyme Neuroborreliosis with Regression After Medical Treatment

Lyme disease in the United States is caused predominantly by the spirochete Borrelia burgdorferi and affects multiple organ systems. Lyme Borreliosis infrequently involves the peripheral and central nervous system, and the term Neuroborreliosis is used for the latter case. The most common manifestations of Neuroborreliosis include cranial neuropathy and lymphocytic meningitis. It can also cause cerebral vasculitis leading to both wall thickening and endothelial obliteration. Other manifestations include stroke, with over 50 documented cases, and rarely nonaneurysmal subarachnoid hemorrhage and intraparenchymal hemorrhage. Intracranial aneurysm detected in the setting of Lyme Borreliosis infection has been previously documented in four cases [3,4]. However, the existence of a causal relationship between Lyme infection and intracranial aneurysm has been debated. We discuss these cases, and present our own case of a man with Lyme Neuroborreliosis with an intracranial aneurysm which regressed upon completion of treatment with ceftriaxone.

Evidence for Ixodes holocyclus (Acarina: Ixodidae) as a vector for human lyme Borreliosis infection in Australia.

Ixodes holocyclus (Acarina: Ixodidae) and Ixodes cornuatus (Acarina: Ixodidae) are two tick species found in the more densely populated areas of Australia and are known to be the cause of the neurotoxic disease tick paralysis in humans and mammals. Borreliosis otherwise known as Lyme disease is an emerging infectious disease in humans in Australia. Borrelia burgdorferi sensu stricto (Spirochaetales: Spirochaetaceae) and sensu lato are closely related spirochetal species that are the causative agents of Lyme disease in humans. Clinical transmission of this tick-borne disease can be identified in several but not all cases by a characteristic rash known as erythema migrans. However, there has been no study of the tick vectors of this infection in Australia. We used morphological and molecular techniques to identify unequivocally the ticks on the patients of this study to be I. holocyclus and then show the presence of B. burgdorferi sensu stricto infection in erythema migrans biopsies. I. holocyclus has not previously been associated with erythema migrans or Lyme disease. Two patients presented to the lead author’s medical practice with erythema migrans in mid and late 2012. The morphology and cytochrome oxidase 1 and ITS2 genes of the two ticks were studied. The skin at the attachment site was sampled by central biopsy for both real time and endpoint Borrelia polymerase chain reaction (PCR) analysis and subsequent sequencing. Morphologically, the two ticks were either I. holocyclus or I. cornuatus . Molecular studies and nucleotide sequencing revealed that both ticks were I. holocyclus . Real time and endpoint PCR on the central tissue biopsy samples returned positive results for B. burgdorferi DNA. Our results are evidence for transmission of B. burgdorferi sensu stricto species to humans by the tick I. holocyclus in Australia. I. holocyclus is commonly associated with human tick bites on virtually the entire eastern coastline of Australia.

Newly considering on cases of annular erythema associated with Ixodes persulcatus tick bites showing negative results for Lyme borreliosis infection

Newly considering on cases of annular erythema associated with Ixodes persulcatus tick bites showing negative results for Lyme borreliosis infection

Lyme Borreliosis: An Update for Canadian Dermatologists

Lyme borreliosis is a multisystemic tick-borne spirochetosis, which may result in dermatologic, musculoskeletal, cardiovascular, and neurologic manifestations. Patients with suspected acute Lyme borreliosis infection may be referred for urgent dermatologic review. Canadian dermatologists should be aware of the latest information regarding the diagnosis and management of Lyme borreliosis. This review is based on a PubMed database search combining the word "Lyme" with variations of the word "Canada." Data sources included articles from the fields of ecology, epidemiology, laboratory diagnostics, and clinical management. In this review, the ecological basis of spirochete transmission by tick vectors is described. The latest available Canadian epidemiologic data are summarized. North American clinical manifestations of Lyme borreliosis are contrasted with European presentations. The Canadian Public Health Laboratory Network's diagnostic guidelines are summarized. Finally, treatment recommendations are outlined.

Beekeepers in central Europe are at high risk for contracting Lyme borreliosis

SummaryLyme borreliosis is known to be associated with several outdoor professions and activities, but the incidence of Lyme borreliosis in beekeepers has not previously been investigated. We distributed questionnaires based on various earlier investigations and 732 beekeepers responded. We found that in 31.1% of the responders, Lyme borreliosis had been diagnosed. Factors found to be associated with the likelihood of Lyme borreliosis infection were: the estimated percentage of tick bites received during beekeeping (number of tick bites during beekeeping compared to total number of tick bites); the total number of bites; the duration of beekeeping; migratory beekeeping and locating hives in forests. Stepwise discriminant analysis identified the estimated percentage of tick bites received during beekeeping as the most relevant factor. Protection against tick bites was used by only a minority of responders (11.4%). From our results, we must conclude that beekeepers should be considered as a high risk group for Lyme borreliosis when compared to the general population and even forest workers. Education to increase the use of protection must be encouraged in order to decrease the incidence of Lyme borreliosis.

Évaluation des performances de quatre immunoblots commercialisés pour la confirmation de la borréliose de Lyme dans une population de patients suivis en Rhône-Alpes

Summary Objective Likewise biological diagnosis resting on the serology is fussy. Immunoblot is employed to confirm antibody specificity after positive Lyme screening. Our objective: to compare analytical performances of four immunoblots commercialized for Lyme disease in our population positive for screening of Lyme disease. Material and methods We tested 42 well-defined sera of patients at different stages of Lyme borreliosis and 33 non-confirmed diagnoses. Results by four serological confirmation tests were analysed: Europe Line ® (Virotech, InGen), Ecoblot ® (Virotech, Meridian), EU Lyme WB ® (MarDx, Trinity Biotech) and Recomblot ® (Mikrogen, DiaSorin). Reactivity of two major proteins, VlsE (IgG) and OspC (IgM) were especially studied. Technical criteria were also evaluated: automated use, simplicity of reading and cost of use. Results For the patients with Lyme disease, the IgG are founded in 85,7%, 83,3%, 76,2% and 78,6% respectively by the immunoblots (Europe Line ® , Ecoblot ® , EU Lyme WB ® and Recomblot ® ) and the IgM are founded in 69%, 54.8%, 85.7% et 73.8% des IB. For the patients with suspicion of Lyme not confirmed, the IgG immunoblots are positives in 15.2%, 21.2%, 24.2% and 18.2%, respectively. For the same patients, the IgM immunoblots are positives in 27.3%, 30.3%, 45.5% and 30.3%. Immunoblot results should be interpreted carefully, and in relation to the clinical-epidemiological and biological findings. Discrepancies in findings on identical sera indicate the need to standardise serological confirmation of Lyme borreliosis infection. A good confirmatory test would need to have proven specificity in the particular population being tested, as advised by the ISO 15189 accreditation norm.

Serodiagnosis of Lyme borreliosis infection using surface plasmon resonance

Background Label-free biosensors are ideally suited for the direct monitoring of binding events without the need for additional labeling substances; however, their application in the field of serodiagnosis is not trivial. The major problem is the unspecific adsorption of blood serum components to the sensor surface. Methods A surface plasmon resonance (SPR) sensor has been used for the direct detection of Lyme borreliosis specific antibodies in blood serum. The combination of an optimal dilution factor with the addition of suitable detergents minimizes the unspecific adsorption. Serum samples from healthy donors and infected patients have been analyzed and the results were compared with a certified immunoassay and a western blot. Results A serum dilution of 1:20 in HBS-buffer with 0.05% Tween20 and 1 mg/mL carboxymethyl dextran reduces unspecific adsorption significantly and enables the identification of antibodies against the OspC/pepC10 antigen pair with a sensitivity of 92% and that against the VlsE/C6 pair with 81% sensitivity; the specificities are 82% and 86% respectively. Positive hits in the western blot could also be determined in the SPR-assay with a correlation of 96.5%. Conclusion The presented optical label-free technique has the potential for a precise and fast identification of pathogen-specific antibodies without the need for a secondary labeling antibody.

Transcriptional response of human dendritic cells toBorrelia garinii—defective CD38 and CCR7 expression detected

Lyme borreliosis is a disease, which can affect several organs and cause a variety of symptoms. In some patients, the infection may become chronic, even after antibiotic therapy, and cause persisting damage. Dendritic cells (DC) are involved in the initiation of innate and adaptive immune responses. To study interactions between Borrelia garinii (Bg), one of the causative agents of Lyme borreliosis, and human DC, we used a cDNA microarray to compare the Bg-induced DC transcriptional response with the response induced by LPS. The Bg-induced response consisted of a smaller number of genes than the LPS-induced response. The microarray showed that the ectoenzyme CD38, which has an important role in DC chemotaxis and migration to lymph nodes, was strongly up-regulated by LPS but practically not at all by Bg. This finding was confirmed with quantitative RT-PCR and with flow cytometry at the protein level. In addition, RT-PCR showed that CCR7 expression was 11-fold greater in LPS-stimulated than in Bg-stimulated cells. These findings suggest that Bg may affect crucial DC functions by blocking the up-regulation of important molecules in DC migration to lymph nodes, thus affecting further immune responses in Lyme borreliosis infection.

Transcriptional response of human dendritic cells to Borrelia garinii –defective CD38 and CCR7 expression detected (43.18)

Abstract Lyme borreliosis is a tick-borne disease that can affect several organs and cause a variety of symptoms. In some patients, the infection may become chronic even after antibiotic therapy and cause persisting damage. Dendritic cells (DC) are involved in the initiation of both innate and adaptive immune responses. To study interactions between Borrelia garinii (Bg), one of the causative agents of Lyme borreliosis, and human dendritic cells, we used a cDNA microarray to compare the Bg induced DC transcriptional response to responses induced by lipopolysaccharide (LPS). The Bg induced response consisted of a smaller number of genes than the LPS induced response. The microarray showed that the ectoenzyme CD38, which has an important role in DC chemotaxis and migration to lymph nodes, was strongly up-regulated by LPS but practically not at all by Bg. This finding was confirmed with quantitative RT-PCR and with flow cytometry at protein level. In addition, RT-PCR showed that the expression of the dominant mediator of DC migration, CCR7, was 11-fold greater in LPS stimulated than in Bg stimulated cells. These findings suggest that Bg may affect crucial DC functions by blocking the up-regulation of important molecules in DC migration, thus affecting further immune responses in Lyme borreliosis infection. This study was supported by the Academy of Finland (Microbes and Man project)

Determinants of the geographic distribution of Puumala virus and Lyme borreliosis infections in Belgium.

BackgroundVector-borne and zoonotic diseases generally display clear spatial patterns due to different space-dependent factors. Land cover and land use influence disease transmission by controlling both the spatial distribution of vectors or hosts, and the probability of contact with susceptible human populations. The objective of this study was to combine environmental and socio-economic factors to explain the spatial distribution of two emerging human diseases in Belgium, Puumala virus (PUUV) and Lyme borreliosis. Municipalities were taken as units of analysis.ResultsNegative binomial regressions including a correction for spatial endogeneity show that the spatial distribution of PUUV and Lyme borreliosis infections are associated with a combination of factors linked to the vector and host populations, to human behaviours, and to landscape attributes. Both diseases are associated with the presence of forests, which are the preferred habitat for vector or host populations. The PUUV infection risk is higher in remote forest areas, where the level of urbanisation is low, and among low-income populations. The Lyme borreliosis transmission risk is higher in mixed landscapes with forests and spatially dispersed houses, mostly in wealthy peri-urban areas. The spatial dependence resulting from a combination of endogenous and exogenous processes could be accounted for in the model on PUUV but not for Lyme borreliosis.ConclusionA large part of the spatial variation in disease risk can be explained by environmental and socio-economic factors. The two diseases not only are most prevalent in different regions but also affect different groups of people. Combining these two criteria may increase the efficiency of information campaigns through appropriate targeting.

Lyme Borreliosis Infection in Europe

Lyme borreliosis is the most common tick-borne disease in the United States and Europe. It is caused by spirochetes of the Borrelia burgdorferi species complex which are transmitted by ticks of the genus Ixodes. This paper presents a review of the studies published about Lyme borreliosis in Europe and in Italy. Seroepidemiologic studies have been conducted in various European countries concerning patients, groups at risk and general population. The distribution of LB in Europe is very variable and the risk is associated with occupational and recreational activities in forested areas and with residence in rural area. Taking the limitations of seroprevalence methods into account, it is evident that the prevalence of Lyme borreliosis varies considerably in different European countries, with an overall increasing prevalence from west to east in central-eastern Europe, a gradient of decreasing incidence in Spain and Greece and from north to south in Italy.

Evidence of a Lyme borreliosis infection from the viewpoint of laboratory medicine

More than 20 years after the first description of the pathogen Borrelia burgdorferi the diagnosis of Lyme borreliosis is based primarily on clinical criteria. Multiple differential diagnoses have to be considered and laboratory confirmation based on various test procedures is required until now. For screening assays the immunofluorescence assay (IFA), enzyme linked immunoassay (EIA), or indirect hemagglutination assay (IHA) are frequently in use. During the last ten years a stepwise diagnostic procedure in USA and Europe has been recommended. The use of a serological screening assay as the first diagnostic step, followed by a confirmatory assay only in the case of a positive or borderline result of the screening assay is now “state of the art”. The most frequently used method is a sensitive enzyme linked immunoassay followed by a sensitive and specific immunoblot technique. However, the quality of these indirect serological tests and, most importantly, the interpretation criteria of the commercial tests vary dramatically. The choice of Borrelia strains, antigen preparation, production conditions and test procedures vary widely. The immunoblot, used as a confirmatory assay, must meet the highest quality standards but in practice under routine laboratory conditions, these levels are often not reached. The major reason for this “shortcoming” is that Lyme borreliosis is not a sexually transmitted disease and no official approval has been required by the commercial suppliers so far. Another increasingly important aspect is the introduction of molecular biological assays into laboratory routines. Numerous authors published many articles about the usefulness of polymerase chain reaction as a diagnostic tool for the detection of borreliae in human specimens. However, a routine method has not yet been established. Furthermore, no standardized method for DNA isolation from different human specimens has been developed so far. For this reason PCR is not accepted as a routine method and the application should be restricted to a few laboratories with experience in the field of Lyme borreliosis. In summary, it is important to inform clinicians about the limitations of the tests used and it would be very helpful to stage a European or worldwide conference to establish accepted rules for the diagnosis of Lyme borreliosis.

Lyme Disease: antibodies against Borrelia burgdorferi in farm workers in Argentina

Lyme Disease is a tick-borne (specially by Ixodes ticks) immune-mediated inflammatory disorder caused by a newly recognize spirochete, Borrelia burgdorferi. Indirect fluorescent antibody (IF) staining methods and enzyme-linked immunosorbent assay are frequently relied upon to confirm Lyme borreliosis infections. Although serologic testing for antibodies has limitations, it is still the only practical means of confirming B. burgdorferi infections. Because we have no previous report of Lyme disease in human inhabitants in Argentina, a study was designed as a seroepidemiologic investigation of the immune response to B. burgdorferi in farm workers of Argentina with arthritis symptoms. Three out of 28 sera were positive (#1, 5 and 9). Serum #1 was positive for Immunoglobulin G at dilution 1:320, serum #5 and #9 both to dilution 1:160; while for Immunoglobulin M all (#1, 5 and 9) were positive at low dilution (1:40) using IF. The results showed that antibodies against B. burgdorferi are present in an Argentinian population. Thus caution should be exercised in the clinical interpretation of arthritis until the presence of B. burgdorferi be confirmed by culture in specific media.