Lyme borreliosis (Lyme disease): molecular and cellular pathobiology and prospects for prevention, diagnosis and treatment

2004 ◽  
Vol 6 (2) ◽  
pp. 1-22 ◽  
Author(s):  
Paul G. Auwaerter ◽  
John Aucott ◽  
J. Stephen Dumler
Keyword(s):  
Lyme Borreliosis ◽  
Clinical Presentation ◽  
Tissue Injury ◽  
Erythema Migrans ◽  
Clinical Manifestations ◽  
Systemic Infection ◽  
Ecological Risks ◽  
Tick Bites ◽  
Active Infection ◽  
Immunological Reactions

Lyme borreliosis is a systemic infection caused by the spirochaete Borrelia burgdorferi, which is transmitted by tick bites and maintained in a delicately balanced ecological cycle. Recent increases in the population densities of tick hosts, the abundance of ticks and the proximity of man to natural tick habitats have led to an escalating worldwide incidence of Lyme borreliosis, and nonspecific clinical manifestations have yielded significant misunderstanding of the disease. After entry, B. burgdorferi activates local inflammation, yet evades host defences and facilitates dissemination by potentially masquerading with host components such as plasmin and complement. The extent of tissue injury is determined by the aggressiveness of host inflammation and immunological reactions, as well as by genetic attributes of the spirochaete. The clinical presentation can be highly varied, including early manifestations that are limited to erythema migrans and ranging to disseminated infection with arthritis, carditis, cranial nerve palsy, peripheral neuropathy, meningitis, or other manifestations. Diagnostic tests have improved, but are unhelpful during certain stages of infection. Therapy varies depending on the degree of involvement, and recovery is usually rapid and complete. Post-treatment clinical manifestations in the absence of evidence for active infection are still poorly understood. The understanding of how B. burgdorferi survives in the environment and interacts with human and mammalian hosts has improved. However, further advances in prevention and therapy depend on continued investigation of the ecological risks and improved understanding of the pathobiology of this obligate bacterial parasite.

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 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.

Lyme borreliosis

2013 ◽  
pp. 772-777
Author(s):  
Andreas Krause ◽  
Volker Fingerle
Keyword(s):  
Lyme Borreliosis ◽  
Erythema Migrans ◽  
Clinical Manifestations ◽  
Lyme Arthritis ◽  
Symptomatic Therapy ◽  
Positive Serology ◽  
Antibiotic Resistant ◽  
Acrodermatitis Chronica Atrophicans ◽  
Rapid Healing ◽  
The Central Nervous System

Lyme borreliosis (LB) is a multisystem infectious disease caused by the tick-borne spirochete Borrelia burgdorferi. The most frequent clinical manifestations include erythema migrans, meningoplyneuritis, and arthritis. Diagnosis of LB is made on clinical grounds and usually supported by a positive serology. Early diagnosis and treatment almost always leads to a rapid healing of the disease. However, in late manifestations gradual remission of symptoms may take several weeks to months. In rare cases, the pathogen can persist for many years or induce a persisting immunopathological response that may cause acrodermatitis chronica atrophicans, chronic neuroborreliosis of the central nervous system, or antibiotic resistant Lyme arthritis. However, even these chronic manifestations usually slowly regress after thorough antibiotic and symptomatic therapy, although in part with irreversible organ defects.

Lyme borreliosis

2013 ◽  
Author(s):  
Andreas Krause ◽  
Volker Fingerle
Keyword(s):  
Lyme Borreliosis ◽  
Erythema Migrans ◽  
Clinical Manifestations ◽  
Lyme Arthritis ◽  
Symptomatic Therapy ◽  
Positive Serology ◽  
Antibiotic Resistant ◽  
Acrodermatitis Chronica Atrophicans ◽  
Rapid Healing ◽  
The Central Nervous System

Lyme borreliosis (LB) is a multisystem infectious disease caused by the tick-borne spirochete Borrelia burgdorferi. The most frequent clinical manifestations include erythema migrans, meningoplyneuritis, and arthritis. Diagnosis of LB is made on clinical grounds and usually supported by a positive serology. Early diagnosis and treatment almost always leads to a rapid healing of the disease. However, in late manifestations gradual remission of symptoms may take several weeks to months. In rare cases, the pathogen can persist for many years or induce a persisting immunopathological response that may cause acrodermatitis chronica atrophicans, chronic neuroborreliosis of the central nervous system, or antibiotic resistant Lyme arthritis. However, even these chronic manifestations usually slowly regress after thorough antibiotic and symptomatic therapy, although in part with irreversible organ defects.

scholarly journals Surveillance of Lyme borreliosis in Germany, 2002 and 2003

2005 ◽  
Vol 10 (4) ◽  
pp. 5-6 ◽  
Author(s):  
W H Mehnert ◽  
G Krause
Keyword(s):  
Lyme Borreliosis ◽  
Erythema Migrans ◽  
Clinical Manifestations ◽  
Risk Of Infection ◽  
Notifiable Disease ◽  
German States ◽  
Serious Infection ◽  
East German ◽  
Vector Borne ◽  
Made In

Lyme borreliosis is a potentially serious infection common in Germany, but little data about its incidence, distribution, and clinical manifestations are available. Lyme borreliosis is not a notifiable disease in Germany, but six of Germany’s 16 states – Berlin, Brandenburg, Mecklenburg-Vorpommern, Sachsen, Sachsen-Anhalt and Thüringen, have enhanced notification systems, which do include Lyme borreliosis. The efforts made in these states to monitor confirmed cases through notification are therefore an important contribution to understanding the epidemiology of Lyme borreliosis in Germany. This report summarises the analysis of Lyme borreliosis cases submitted to the Robert Koch-Institut during 2002-2003. The average incidence of Lyme borreliosis of the six East German states was 17.8 cases per 100 000 population in 2002 and increased by 31% to 23.3 cases in 2003, respectively. Patient ages were bimodally distributed, with incidence peaks among children aged 5- 9 and elderly patients, aged 60- 64 in 2002, and 65- 69 in 2003. For both years, 55% of patients were female. Around 86% of notified cases occurred from May to October. Erythema migrans affected 2697 patients (89.3%) in 2002 and 3442 (86.7%) in 2003. For a vector-borne disease, like Lyme borreliosis, the risk of infection depends on the degree and duration of contact between humans and ticks harbouring Borrelia burgdorferi. As infectious ticks probably occur throughout Germany, it is likely that the situation in the remaining 10 German states is similar to that of the states in this study.

scholarly journals An unusual case of Lyme borreliosis: can we miss it?

2019 ◽  
Vol 11 (2) ◽  
Author(s):  
Antigona Begolli Gerqari ◽  
Mybera Ferizi ◽  
Sadije Halimi ◽  
Albina Ponosheci ◽  
Arjeta Zogaj Berisha ◽  
...  
Keyword(s):  
Lyme Borreliosis ◽  
Unusual Case ◽  
Skin Diseases ◽  
Erythema Migrans ◽  
Skin Symptoms ◽  
Skin Erythema ◽  
Infective Disease ◽  
Balkan Region ◽  
Infected Insect ◽  
Immunological Reactions

Lyme borreliosis is an infective disease that is usually transmitted to humans via biting by bacteria-infected Ixodes tick. The disease is multisystemic and the affected organs are the skin (Erythema migrans), nervous system, eyes, heart and joints. Borrelia burgdorferi is the bacterium that causes borreliosis and the hosts are rodents of the genus Apodemus. In the Balkan region, Ixodes ricinus is the most representative vector. A bite from an infected insect is the most common mode of transmitting Borrelia; however, transplacental transmission has also been documented. Pathogenesis of the disease consists of both direct and indirect mechanisms of immunological reactions which result in the production of IgM antibodies to Borrelia in the first 3-6 weeks, and production of IgG class after 6 weeks. Many skin diseases and skin symptoms mimicking Lyme borreliosis, such as dermatomycosis, erysipelas, and undefined hyperpigmentation must be elaborated and considered for borreliosis, as skin symptoms of borreliosis can imitate many of them.

scholarly journals Clinical and epidemiologic characteristics of lyme borreliosis and tick-borne encephalitis mixed infections in Krasnoyarsk kray

2013 ◽  
Vol 94 (2) ◽  
pp. 211-215
Author(s):  
N S Minoranskaya ◽  
E I Minoranskaya
Keyword(s):  
Clinical Features ◽  
Lyme Borreliosis ◽  
Mixed Infection ◽  
Large Population ◽  
Erythema Migrans ◽  
Clinical Manifestations ◽  
Control Group ◽  
Mixed Infections ◽  
Tick Borne Encephalitis

Aim. To reveal clinical features of Lyme borreliosis and tick-borne encephalitis mixed infections in Krasnoyarsk Kray. Methods. The main group consisted of 226 patients with mixed infection of Lyme borreliosis and tick-borne encephalitis (males - 57.1%, females- 42.9%, mean age 43.7±1.0 years), who were examined and compared to the control group of 88 patients with tick-borne encephalitis alone (males - 56.8%, females - 43.2%, mean age 43.9±1.8 years). Results. About 40% of acute Lyme borreliosis cases in Krasnoyarsk Kray are a mixed infection of Lyme borreliosis and tick-borne encephalitis, that is closely related to a large population of Ixodidae infected by both agents. There is no characteristic epidemiologic background in more than a half of all cases. Typical clinical features for mixed infection of Lyme borreliosis and tick-borne encephalitis are severe onset with toxic constant hyperthermia or hyperpyrexia, and joint pain (18.6% of cases). Erythema migrans was present in 22.6% of cases, involvement of central nervous system (35.4%) was mostly often associated with meningitis and meningoencephalitis (29.2%). Bannwarth syndrome (3.1%) is a clinical type of Lyme borreliosis not associated with erythema in mixed infection. Cardiovascular system damage is transient and associated with intoxication. In 57.1% of cases the diagnosis of mixed infection was confirmed at dispensary follow-up 1.5, 3, 6 months after the clinical manifestations of the disease. Conclusion. The most common clinical form of mixed infection is the non-erithemic form of Lyme borreliosis and febrile form of tick-borne encephalitis, late Lyme borreliosis after the suffered mixed infection was registered in 30.1% of cases.

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.

Lyme Disease

1994 ◽  
Vol 15 (5) ◽  
pp. 167-173
Author(s):  
Robert S. Baltimore ◽  
Eugene D. Shapiro
Keyword(s):  
Lyme Disease ◽  
Lyme Borreliosis ◽  
Clinical Manifestations ◽  
Systemic Infection ◽  
The United States ◽  
Lyme Arthritis ◽  
Medical Attention ◽  
The Us ◽  
Ixodes Ticks ◽  
The Common

Introduction and Definitions Lyme borreliosis (Lyme disease) is a systemic infection caused by a spirochete, Borrelia burgdoferi. It is the most common vector-borne disease in the United States. Lyme disease was first described in Lyme, Connecticut (hence its name), where a cluster of children who had unexplained arthritis first were brought to medical attention by one of their parents. Investigation of this "epidemic" of arthritis led to the description of Lyme arthritis and ultimately to the discovery of its bacterial etiology. The clinical manifestations of Lyme borreliosis are protean; this, coupled with the practical difficulties of confirming the diagnosis in many patients, has led to many misconceptions about Lyme disease. Indeed, there is much we do not know about the disease, which was only recognized in the US as a distinct entity slightly more than 15 years ago, and the cause of which was first identified only about 10 years ago. Epidemiology ECOLOGY AND TRANSMISSION Borrelia burgdorferi is transmitted by ticks of the Ixodid species. In the US, the common vectors are Ixodes dammini (the deer tick), reported to be the same species as I scapularis, in the Northeast and the Midwest and I pacificus (the western black-legged tick) on the Pacific Coast. Ixodes ticks are much smaller than the common wood tick; the nymphal Ixodes tick is about the size of a pencil point (1 to 2 mm).

scholarly journals Clinical and epidemiological features of lyme borreliosis

2021 ◽  
Vol 9 (1) ◽  
pp. 80-86
Author(s):  
I.V. Lutai ◽  
A.S. Ivanova ◽  
T.A. Husieva
Keyword(s):  
Lyme Disease ◽  
Lyme Borreliosis ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Multiple Choice Questions ◽  
Tick Bites ◽  
Working Population ◽  
Anonymous Questionnaire ◽  
Epidemiological Features ◽  
Number Of Patients

Lyme borreliosis (LB) is the most common transmissible disease of tick-borne origin. This disease is a significant medical challenge due to the damage to many organs and systems and the tendency to chronicity and long-term disability in the future. Currently, there is an upward trend in the incidence of Lyme disease in Sumy Oblast. Thus, in Ukraine in 2015 the incidence was 7.96 per 100,000 population, and in 2019 it increased to 10.62. The average level of indicators was exceeded in Kyiv Oblast (29.0), Cherkasy Oblast (25.4), Vinnytsia Oblast (23.09), Sumy (25.89) Oblast, and Kyiv (2.54). The peak of tick activity in Ukraine is registered in May and has increased by 4.23 times. The maximum number of patients falls within the working population and causes significant state financial damage. The increase in the number of cases indicates a spread of Lyme disease in Sumy Oblast. In order to prevent the spread, it is necessary to study all possible causes of this disease and find ways to eliminate them. This was the ground for the creation of a unified anonymous questionnaire, which covers the main issues regarding this disease from the standpoint of different population groups. A unified anonymous "Questionnaire for Lyme disease patients" contains 16 multiple choice questions and an option for comments. The first group of questions concerned gender, age, and social data of respondents (the largest part of patients fell within the working population – 42.86%). The next group of questions clarified the epidemiological features of this pathology (circumstances, date, time, location, body part bitten). Most often tick bites occurred during walks in the urban forests (42.86% of cases). Most respondents reported that tick bites had happened in June and July (39.29%). Other questions were designed to determine patients' awareness about Lyme borreliosis prevention. The next group of questions was aimed at clarifying the clinical features of the disease (lower extremities were the most frequent site of a tick bite) (46.43%), with erythema dominating among the clinical manifestations of Lyme borreliosis (91.07%). According to the anonymous questionnaire, we analyzed and evaluated awareness of diagnosis, clinical signs, and measures of Lyme disease prevention in the patients who were receiving treatment at Municipal Non-Commercial Enterprise of Sumy Regional Council "Medical Clinical Center of Infectious Diseases and Dermatology Named After Z. Krasovytskyi" and SSU University Clinic.

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