scholarly journals Scientific rationale for medical and preventive measures improvement in lyme disease endemic areas (based on the data of Udmurt Republic)

2013 ◽  
Vol 94 (4) ◽  
pp. 517-522
Author(s):  
N G Guznischeva ◽  
A A Gilmanov ◽  
I G Zakirov
Keyword(s):  
Lyme Disease ◽  
Lyme Borreliosis ◽  
Preventive Measures ◽  
Erythema Migrans ◽  
Tick Bite ◽  
Tick Bites ◽  
Medical Aid ◽  
Udmurt Republic ◽  
Endemic Areas ◽  
Scientific Rationale

Aim. To provide the scientific rationale for medical and preventive measures improvement in Lyme disease endemic areas. Methods. Epidemiologic and biostatistical analysis of preventive measures holding in Lyme disease endemic areas was performed. Results. A decrease in mean longstanding prevalence of Lyme borreliosis by 31.5% was observed in the Udmurt Republic since 1999 to 2010. The tick-invaded area has increased by 25%, there was an increase in a borrelia-harboring ticks rate by 34.6%. The number of patients seeking medical aid because of the tick bites has increased by 25.4%, which can be attributed to increased social awareness. 62.5% of patients diagnosed with Lyme borreliosis were over 41 years old, the rate of unemployed patients was 61.1%. High prevalence of Lyme borreliosis in peasants living in highly endemic areas (southern part of the Udmurt Republic) related to low medical aid appealability due to tick bites and therefore untimely medical preventive measures, was registered. The prevalence of erythema migrans-free disease has increased 4.3 times. Among the Lyme borreliosis forms associated with erythema migrans, the 1.6 times increase in multiple erythema prevalence was observed, with increase by 24 times in the areas of high disease prevalence. The most severe disease course was observed in patients over 61 years old with erythema migrans-free disease. A single oral dose of doxycycline should be used for disease prevention in all patients seeking medical aid because of the tick bite. Conclusion. The offered preventive algorithm for Lyme disease allowed to prevent the disease development in 99.7% of all cases, the economical efficacy of doxycycline prophylaxis counted on 1 borrelia-harboring tick bite was estimated as 20 400 rubles.

scholarly journals AWARENESS OF LYME BORRELIOSIS OF THE PATIENTS OF TERNOPIL REGIONAL TB DISPENSARY

2017 ◽  
Author(s):  
L. P. Melnyk ◽  
L. A. Hryshchuk ◽  
M. Koziol–Montewka ◽  
P. S. Tabas ◽  
R. O. Klos
Keyword(s):  
Nervous System ◽  
Lyme Disease ◽  
Borrelia Burgdorferi ◽  
Lyme Borreliosis ◽  
Preventive Measures ◽  
Epidemiological Data ◽  
Sufficient Information ◽  
Tick Bites ◽  
The World ◽  
History Of

Background. Lyme disease has many clinical features similar tothose in sarcoidosis and tuberculosis. Epidemiological data in the world, in particular in Ukraine, proves the increase in Lyme borreliosis incidence. Ternopil region is endemic with Lyme borreliosis.Objective. The research was aimed to investigate the prevalence of infection with Borrelia burgdorferi and epidemiology features of borreliosis among the patients of Ternopil Regional TB Dispensary.Methods. In total, 29 patients were admitted to Departments of Differential Diagnostic, TB Therapy and TB Surgery of Ternopil Regional TB Dispensary in October 2016-January 2017. All the surveyed answered the questions of an integrated international questionnaire, where they noted the area and a number of tick bites, described the removal method, noted the survey for borreliosis pathogen and complaints after tick bites.Results. It was established that 5 respondents had a history of tick bites episodes, but only in one case the patient was examined of borreliosis. Tick bites were noticed in 3 patients with sarcoidosis and 1 with tuberculosis (TB) and exudative pleurisy, respectively.Conclusions. The absence of appeals for medical care, lack of sufficient information on Lyme borreliosis and disuse of preventive measures for tick bites by the interviewed patients of Ternopil regional TB dispensary departments proves the need of improvement of health education on Lyme borreliosis (LB) among this category of population. 24 (82.7%) of 29 respondents did not remember the tick bite. The symptoms of (LB) are similar to those in sarcoidosis and tuberculosis (pleural lesions, heart, joints, nervous system, skin), and the presence of tick bites gives the reasons to examine these patients of Borrelia burgdorferi senso lato.

scholarly journals Epidemiology of Lyme Disease in a Highly Endemic European Zone

Medicina ◽  
2020 ◽  
Vol 56 (3) ◽  
pp. 115 ◽  
Author(s):  
Agnė Petrulionienė ◽  
Daiva Radzišauskienė ◽  
Arvydas Ambrozaitis ◽  
Saulius Čaplinskas ◽  
Algimantas Paulauskas ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Lyme Borreliosis ◽  
Erythema Migrans ◽  
Geographical Area ◽  
Clinical Manifestations ◽  
Communicable Diseases ◽  
Urban Residents ◽  
Tick Bites ◽  
Wide Range ◽  
Baseline Characteristics

Background and objective: Lyme disease, also known as Lyme borreliosis (LB), is a tick-borne infectious disease caused by the spirochete bacteria Borrelia. The risk of infection depends on the geographical area, ecological factors, and human behavior. Clinical manifestations of Lyme borreliosis have a wide range, but the most frequent clinical symptom, which is also a diagnostic symptom, is a skin rash called erythema migrans (EM). The disease is very common worldwide. In Lithuania, the disease frequency is 99.9 cases per 100,000 population (Centre for Communicable Diseases and AIDS, Lithuania, 2017). The main aim of this study was to obtain the baseline characteristics of the disease regarding the infected Lithuanian population. Materials and Methods: We analyzed data from the Centre for Communicable Diseases and AIDS about all Lyme disease (A69.2) diagnosed patients over a three-year period (from 2014 to 2016) in Lithuania. Results: In 2014–2016, 7424 (crude incidence rate 85.4) cases with LB were diagnosed in Lithuania. Most of them (4633 (62.4%)) were identified in women. Older people were more likely to suffer from LB. Urban residents were 2.6 times more often affected that those living in villages. Tick bites were primarily observed in high season months, from May to September (90%), with the highest peak in July. There was a higher number of observed tick bites (p = 0.003) in the urban residents. Erythema migrans occurred in 75.6% LB cases, while other symptoms did not exceed a quarter of all LB cases. There were 7353 (99.6%) cases where LB was confirmed via clinical symptoms and/or laboratory tests. Also, 1720 (23.2%) patients were tested for LB immunoglobulins. Conclusions: This study found a high incidence of Lyme disease in Lithuania. We elucidated the baseline characteristics regarding the infected Lithuanian population which may ease medical clinicians’ work on new Lyme diagnoses.

scholarly journals Powassan Virus Encephalitis Following Brief Attachment of Connecticut Deer Ticks

2020 ◽  
Author(s):  
Henry M Feder ◽  
Sam Telford ◽  
Heidi K Goethert ◽  
Gary P Wormser
Keyword(s):  
United States ◽  
Lyme Disease ◽  
The United States ◽  
Tick Bite ◽  
Molecular Testing ◽  
Tick Bites ◽  
Epidemiologic Evidence ◽  
Powassan Virus ◽  
Tick Attachment ◽  
Virus Subtype

Abstract Background Powassan virus (POWV) is a tick-transmitted pathogen that may cause severe encephalitis; experimentally, it can be transmitted within just 15 minutes following a tick bite. The deer tick virus subtype of POWV (DTV) is transmitted by the deer tick and is the likely cause of the increase in the number of POWV cases reported in the United States. However, DTV has only been definitively documented in 6 patients by molecular analysis of the virus. Methods Two patients from Connecticut with encephalitis, who had a recent deer tick bite, were evaluated by the relevant serologic tests to determine if they had been infected with POWV. Evaluation also included molecular testing of an adult deer tick that had been removed from one of the patients. Results We documented neuroinvasive POWV infection in 2 children from Connecticut. Based on the results of testing the tick removed from case 2, this patient was infected by DTV, representing the 7th reported case and the first documented case of DTV infection in a child. Of note, the duration of the tick bites in both cases was very short. Conclusions We provide the first clinical and epidemiologic evidence that POWV/DTV can be rapidly transmitted to a human host, that is, within hours of tick attachment, which is distinctive when compared to other deer tick-transmitted infections such as Lyme disease.

scholarly journals Diagnostic parameters of modified two-tier testing in European patients with early Lyme disease

2020 ◽  
Vol 39 (11) ◽  
pp. 2143-2152
Author(s):  
ME Baarsma ◽  
JFP Schellekens ◽  
BC Meijer ◽  
AH Brandenburg ◽  
T. Souilljee ◽  
...  
Keyword(s):  
General Practice ◽  
Lyme Disease ◽  
General Population ◽  
Lyme Borreliosis ◽  
Erythema Migrans ◽  
Diagnostic Parameters ◽  
Second Tier ◽  
Population Controls ◽  
Higher Sensitivity ◽  
Better Than

Abstract Modified two-tier testing (MTTT) for Lyme borreliosis (i.e. confirmation with an EIA instead of an immunoblot) has been shown to have improved sensitivity compared with standard two-tier testing (STTT) in samples from American patients, without losing specificity. The current study assesses the sensitivity and specificity of various algorithms of MTTT in European patients with erythema migrans (EM) as a model disease for early Lyme borreliosis, and in appropriate controls. Four different immunoassays were used in the first tier, followed by either an immunoblot or the C6-EIA, or were used as standalone single-tier test. These tests were performed on consecutively collected sera of 228 Dutch patients with physician-diagnosed EM in the setting of general practice, 231 controls from the general population, and 50 controls with potentially cross-reactive antibodies. All the variants of MTTT that were studied had significantly higher sensitivity compared with their equivalent STTT, while retaining comparable specificity. Within the MTTT algorithms, classifying equivocal results as positive yielded better diagnostic parameters than classifying equivocal results as negative. The best diagnostic parameters were found using the Enzygnost-2 assay in the first tier, followed by a C6-ELISA in the second tier (sensitivity 77.6%, 95% CI 71.7–82.9; specificity 96.1%, 95% CI 92.7–98.2). This algorithm performed significantly better than the equivalent STTT algorithm in terms of sensitivity (p < 0.001), while maintaining comparable specificity (population controls p = 0.617). Our results show that MTTT can be a useful tool for the serodiagnosis of European patients with early Lyme borreliosis.

scholarly journals Study of a Cohort of 1,886 Persons To Determine Changes in Antibody Reactivity to Borrelia burgdorferi 3 Months after a Tick Bite

2015 ◽  
Vol 22 (7) ◽  
pp. 823-827 ◽  
Author(s):  
Ram B. Dessau ◽  
Linda Fryland ◽  
Peter Wilhelmsson ◽  
Christina Ekerfelt ◽  
Dag Nyman ◽  
...  
Keyword(s):  
Borrelia Burgdorferi ◽  
Lyme Borreliosis ◽  
Erythema Migrans ◽  
Significant Rise ◽  
Tick Bite ◽  
Content Type ◽  
Paired Samples ◽  
Antibody Reactivity ◽  
Flagellar Antigen ◽  
Relative Change

ABSTRACTLyme borreliosis is a tick-borne disease caused by the bacteriumBorrelia burgdorferi. The most frequent clinical manifestation is a rash called erythema migrans. Changes in antibody reactivity toB. burgdorferi3 months after a tick bite are measured using enzyme-linked immunosorbent assays (ELISAs). One assay is based on native purified flagellum antigen (IgG), and the other assay is based on a recombinant antigen called C6 (IgG or IgM). Paired samples were taken at the time of a tick bite and 3 months later from 1,886 persons in Sweden and the Åland Islands, Finland. The seroconversion or relative change is defined by dividing the measurement units from the second sample by those from the first sample. The threshold for the minimum level of significant change was defined at the 2.5% level to represent the random error level. The thresholds were a 2.7-fold rise for the flagellar IgG assay and a 1.8-fold rise for the C6 assay. Of 1,886 persons, 102/101 (5.4%) had a significant rise in antibody reactivity in the flagellar assay or the C6 assay. Among 40 cases with a diagnosis of Lyme borreliosis, the sensitivities corresponding to a rise in antibodies were 33% and 50% for the flagellar antigen and the C6 antigen, respectively. Graphical methods to display the antibody response and to choose thresholds for a rise in relative antibody reactivity are shown and discussed. In conclusion, 5.4% of people with tick bites showed a rise inBorrelia-specific antibodies above the 2.5% threshold in either ELISA but only 40 (2.1%) developed clinical Lyme borreliosis.

scholarly journals Increased awareness and knowledge of Lyme Borreliosis and tick bite prevention among the general population in France: 2016 and 2019 health barometer survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alexandra Septfons ◽  
Julie Figoni ◽  
Arnaud Gautier ◽  
Noémie Soullier ◽  
Henriette de Valk ◽  
...  
Keyword(s):  
General Population ◽  
Lyme Borreliosis ◽  
Age Groups ◽  
Tick Bite ◽  
Tick Bites ◽  
Protective Measures ◽  
Information Campaigns ◽  
Phone Survey ◽  
Risk Areas ◽  
The Impact

Abstract Background Lyme borreliosis (LB) is the most frequent tick-borne disease in France. In the absence of a vaccine, LB prevention mainly relies on reducing tick bites. In 2016, the French Ministry of Health launched a national plan against tick-borne infections, including a prevention component. To evaluate the impact of this prevention strategy, we assessed knowledge and practices of tick bite prevention using the 2016 and 2019 national surveys on health attitudes and beliefs known as the French Health Barometer. Methods The Health Barometer is a repeated nationwide phone survey conducted annually on a random sample aged 18 to 75 years living in mainland France. In 2016 and 2019, participants were asked, among others, about their exposure to ticks, their behavior and practices regarding tick bites, and their knowledge about LB and its prevention. Results In 2019, 30% of the population reported a lifetime tick bite and 6% in the last year, an increase from 25% and 4%, respectively, in 2016 (p < 0.001). In 2019, 25% of the population felt exposed to tick bites compared to 23% in 2016 (p < 0.001). The proportion of participants who had heard about LB and who considered themselves well informed respectively increased from 66% and 29% in 2016 to 79% and 41% in 2019, (p < 0.001). In 2019 compared to 2016, a greater part of the French population applied protective measures against tick bites, particularly wearing protective clothing (74% vs 66%, p < 0.001) and regular tick checks and prompt tick removal after exposure (54% vs 47%, p < 0.001). Conclusions A substantial proportion of French residents are exposed to tick bites and apply protective measures. Our findings indicate a trend toward an increased knowledge and awareness of tick bites and LB between 2016 and 2019 in France. Our results can be used to target future information campaigns to specific age groups or at-risk areas in addition to the general population. However, we need to further study the barriers to the use of preventive measures.

scholarly journals Disseminated and chronic Lyme borreliosis in Norway, 1995 – 2004

2005 ◽  
Vol 10 (10) ◽  
pp. 1-2 ◽  
Author(s):  
K Nygård ◽  
A B Brantsaeter ◽  
R Mehl
Keyword(s):  
Lyme Borreliosis ◽  
Erythema Migrans ◽  
Clinical Manifestations ◽  
Laboratory Diagnosis ◽  
Incidence Rates ◽  
Tick Bites ◽  
Serological Tests ◽  
Clear Trend ◽  
Acrodermatitis Chronica Atrophicans ◽  
Insect Repellents

Lyme borreliosis is the most common tickborne infection in Norway. All clinical manifestations of Lyme borreliosis other than erythema migrans are notifiable to Folkehelseinstituttet, the Norwegian Institute of Public Health. During the period 1995-2004 a total of 1506 cases of disseminated and chronic Lyme borreliosis were reported. Serological tests were the basis for laboratory diagnosis in almost all cases. The annual numbers of cases showed no clear trend over the period, but varied each year between 120 and 253 cases, with the highest number of cases reported in 2004. Seventy five per cent of cases with information on time of onset were in patients who fell ill during the months of June to October. There was marked geographical variation in reported incidence rates, with the highest rates reported from coastal counties in southern and central Norway. Fifty six per cent of the cases were in males and 44% in females. The highest incidence rate was found in children aged between 5 and 9 years. Neuroborreliosis was the most common clinical manifestation (71%), followed by arthritis/arthralgia (22%) and acrodermatitis chronica atrophicans (5%). Forty six per cent of patients were admitted to hospital. Prevention of borreliosis in Norway relies on measures to prevent tick bites, such as use of protective clothing and insect repellents, and early detection and removal of ticks. Antibiotics are generally not recommended for prophylaxis after tick bites in Norway.

scholarly journals Geographical and genospecies distribution of Borrelia burgdorferi sensu lato DNA detected in humans in the USA

2014 ◽  
Vol 63 (5) ◽  
pp. 674-684 ◽  
Author(s):  
Kerry L. Clark ◽  
Brian F. Leydet ◽  
Clifford Threlkeld
Keyword(s):  
Lyme Disease ◽  
Borrelia Burgdorferi ◽  
Skin Biopsy ◽  
Lyme Borreliosis ◽  
Erythema Migrans ◽  
Skin Lesions ◽  
Sensu Stricto ◽  
Borrelia Burgdorferi Sensu Lato ◽  
Southern States ◽  
The Usa

The present study investigated the cause of illness in human patients primarily in the southern USA with suspected Lyme disease based on erythema migrans-like skin lesions and/or symptoms consistent with early localized or late disseminated Lyme borreliosis. The study also included some patients from other states throughout the USA. Several PCR assays specific for either members of the genus Borrelia or only for Lyme group Borrelia spp. (Borrelia burgdorferi sensu lato), and DNA sequence analysis, were used to identify Borrelia spp. DNA in blood and skin biopsy samples from human patients. B. burgdorferi sensu lato DNA was found in both blood and skin biopsy samples from patients residing in the southern states and elsewhere in the USA, but no evidence of DNA from other Borrelia spp. was detected. Based on phylogenetic analysis of partial flagellin (flaB) gene sequences, strains that clustered separately with B. burgdorferi sensu stricto, Borrelia americana or Borrelia andersonii were associated with Lyme disease-like signs and symptoms in patients from the southern states, as well as from some other areas of the country. Strains most similar to B. burgdorferi sensu stricto and B. americana were found most commonly and appeared to be widely distributed among patients residing throughout the USA. The study findings suggest that human cases of Lyme disease in the southern USA may be more common than previously recognized and may also be caused by more than one species of B. burgdorferi sensu lato. This study provides further evidence that B. burgdorferi sensu stricto is not the only species associated with signs and/or symptoms consistent with Lyme borreliosis in the USA.

Diagnosis, Treatment, and Prevention Practices for Lyme Disease by Clinicians, United States, 2013-2015

2021 ◽  
pp. 003335492097323
Author(s):  
Alyssa R. Beck ◽  
Grace E. Marx ◽  
Alison F. Hinckley
Keyword(s):  
United States ◽  
Health Care ◽  
Lyme Disease ◽  
Disease Diagnosis ◽  
Tick Bite ◽  
Clinical Practices ◽  
Tick Bites ◽  
Treatment And Prevention ◽  
High Incidence ◽  
Disease Testing

Objectives Although tick-borne diseases account for a large number of health care visits in the United States, clinical practices for tick bite and Lyme disease treatment and prevention are not well understood. The objective of this study was to better understand factors associated with clinical practices related to tick bites and Lyme disease. Methods In 2013-2015, questions about tick-bite evaluation, Lyme disease diagnosis and treatment, appropriate use of Lyme disease testing, and tick-bite prevention were included in Porter Novelli’s DocStyles survey, a nationally representative annual web-based survey of health care providers. We performed analyses of responses by provider license type and state-level incidence (high or low) of Lyme disease in 2019. Results A total of 4517 providers were surveyed across the 3 study years. Overall, 80.9% of providers reported that they had evaluated at least 1 patient for a tick bite, 47.6% had diagnosed at least 1 patient with Lyme disease, and 61.9% had treated at least 1 patient for Lyme disease in the previous year. Providers from states with a high incidence of Lyme disease saw more patients for tick bites and Lyme disease than providers from states with a low incidence of Lyme disease. Few providers correctly chose Lyme disease testing as clinically useful in the hypothetical case of a patient from a state with a high incidence of Lyme disease with an arthritic knee (36.0%) or with new-onset atrioventricular block (39.5%), and respondents across all provider types incorrectly chose testing when not clinically indicated. Most providers (69.7%) reported routinely recommending tick-bite prevention methods to patients. Conclusions Many providers evaluate patients for tick bites and treat patients for Lyme disease, but knowledge about appropriate testing is low. Providers may benefit from tailored education about appropriate Lyme disease diagnosis, testing, and effective tick-bite prevention.

scholarly journals Serological Follow-up of Patients with Erythema Migrans: Persistence of Antibody Response to Borrelia Burgdorferi in Lyme Disease Patients

2003 ◽  
Vol 1 (2) ◽  
pp. 73-77
Author(s):  
I. Christova ◽  
R. Komitova
Keyword(s):  
Lyme Disease ◽  
Antibody Response ◽  
Treatment Failure ◽  
Lyme Borreliosis ◽  
Erythema Migrans ◽  
Serum Samples ◽  
Laboratory Examinations ◽  
One Year ◽  
Antibody Kinetics

The rate of seroconversion before treatment and antibody kinetics after treatment were analyzed and possible interpretations of serologic findings was proposed. Serum samples from 219 patients with Erythema migrans were tested by ELISA for antibodies against B. burgdorferi. Twenty-eight (28 %) to 55 % of the patients showed isolated IgM antibody response, 3–5 % showed isolated IgG response, 6–16 % showed concomitant IgM and IgG responses, and 24–63 % tested seronegative depending on number of days passed after the onset of Lyme borreliosis. One year after treatment, 38 % of the patients still had IgG response and 10% had IgM antibodies against B. burgdorferi. Furthermore, 4 of 106 seronegative patients revealed IgM response three months after treatment despite lack of signs or symptoms of active Lyme borreliosis. We concluded that persistence of antibody response is not indicative of treatment failure, although regular clinical and laboratory examinations, including PCR, should follow successful treatment.

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