Surveillance of Lyme borreliosis in Germany, 2002 and 2003

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.

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Lyme borreliosis

Oxford Textbook of Rheumatology ◽

10.1093/med/9780199642489.003.0101_update_002 ◽

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.

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Lyme borreliosis

10.1093/med/9780199642489.003.0101 ◽

2013 ◽

Cited By ~ 1

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

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Disseminated and chronic Lyme borreliosis in Norway, 1995 – 2004

Eurosurveillance ◽

10.2807/esm.10.10.00568-en ◽

2005 ◽

Vol 10 (10) ◽

pp. 1-2 ◽

Cited By ~ 19

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.

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

Kazan medical journal ◽

10.17816/kmj1591 ◽

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.

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LYME BORRELIOSIS: CLINICAL MANIFESTATIONS AND ADVANCES IN DIAGNOSIS AND CONTROL

Journal of Experimental Biology and Agricultural Sciences ◽

10.18006/2020.8(6).721.729 ◽

2020 ◽

Vol 8 (6) ◽

pp. 721-729

Author(s):

Sandip Kumar Khurana ◽

◽

Anju Sehrawat ◽

Ruchi Tiwari ◽

Khan Sharun ◽

...

Keyword(s):

Lyme Disease ◽

Early Stage ◽

Erythema Migrans ◽

Clinical Manifestations ◽

Neurological Involvement ◽

Vector Borne Diseases ◽

Clinical Syndromes ◽

Clinical Presentations ◽

Vector Borne ◽

And Control

Lyme disease or borreliosis is presumed one of the most significant vector-borne diseases globally. The disease is re-emerging in numerous parts of world. It has expanded dramatically in newer areas in recent decades. Lyme disease is caused by Borrelia burgdorferi yet additionally by other borrelial species, B. afzelii and B. garini which cause diverse clinical syndromes. Spatial distribution and clinical presentations differ depending on the causative species. Clinical manifestations of Lyme disease can be delineated in three stages. The first stage is presented in the form of erythema migrans at the site of tick bite. Early dispersed stage can lead to multiple lesions of erythema migrans, neuroborreliosis, lymphocytoma, arthritis or carditis. The manifestation at later stage shows acordermatitis chronica atrophicans, arthritis and neurological involvement. Diagnosis is challenging owing the several clinical presentations and could require multiple tests. The antibiotics that are currently under use, help in the clearance of bacteria from the affected host and stop further spread of the disease. Although several antibiotics are being used for Lyme disease, doxycycline is the widely used antimicrobial in early stage of the disease. Several attempts have been made to develop a vaccine against Lyme disease, however, none of them have been successfully marketed. The present review discusses clinical manifestations, and advances in diagnosis and control of Lyme disease.

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Laboratory Diagnosis of Lyme Borreliosis

Clinical Microbiology Reviews ◽

10.1128/cmr.00018-19 ◽

2021 ◽

Vol 34 (2) ◽

Author(s):

John A. Branda ◽

Allen C. Steere

Keyword(s):

Lyme Borreliosis ◽

State Of The Art ◽

Direct Detection ◽

Clinical Manifestations ◽

Infectious Agent ◽

Laboratory Diagnosis ◽

Laboratory Diagnostics ◽

Future Directions ◽

Organ Systems ◽

Made In

SUMMARY Lyme borreliosis is caused by a growing list of related, yet distinct, spirochetes with complex biology and sophisticated immune evasion mechanisms. It may result in a range of clinical manifestations involving different organ systems, and can lead to persistent sequelae in a subset of cases. The pathogenesis of Lyme borreliosis is incompletely understood, and laboratory diagnosis, the focus of this review, requires considerable understanding to interpret the results correctly. Direct detection of the infectious agent is usually not possible or practical, necessitating a continued reliance on serologic testing. Still, some important advances have been made in the area of diagnostics, and there are many promising ideas for future assay development. This review summarizes the state of the art in laboratory diagnostics for Lyme borreliosis, provides guidance in test selection and interpretation, and highlights future directions.

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Epidemiology of Lyme Disease in a Highly Endemic European Zone

Medicina ◽

10.3390/medicina56030115 ◽

2020 ◽

Vol 56 (3) ◽

pp. 115 ◽

Cited By ~ 3

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.

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Lyme borreliosis

Oxford Textbook of Medicine ◽

10.1093/med/9780198746690.003.0137 ◽

2020 ◽

pp. 1181-1187

Author(s):

Gary P. Wormser ◽

John Nowakowski ◽

Robert B. Nadelman

Keyword(s):

United States ◽

Antibiotic Therapy ◽

Lyme Borreliosis ◽

Cutaneous Lesion ◽

Erythema Migrans ◽

Clinical Manifestations ◽

Symptomatic Treatment ◽

The United States ◽

Northern Asia ◽

Successful Resolution

Lyme borreliosis is a zoonotic bacterial infection caused by Borrelia burgdorferi sensu lato, a spirochaetal agent transmitted by certain species of Ixodes ticks. Small rodents and birds serve as reservoirs. It is the most common vector-borne infection in the United States of America and an important infection in many countries throughout the temperate regions of Europe and northern Asia, where a wider variety of borrelia species account for differences in clinical manifestations in Eurasia compared with the United States. The most common and earliest clinical manifestation is erythema migrans, a distinctive cutaneous lesion that occurs at the site of deposition of the spirochaete by the vector tick. Most people treated for Lyme borreliosis respond well to a 2-week course of antibiotic therapy. Symptomatic treatment is recommended for patients who have or develop subjective complaints of unclear aetiology despite successful resolution of the objective manifestation of Lyme borreliosis following antibiotic therapy.

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Lyme borreliosis

Oxford Textbook of Rheumatology ◽

10.1093/med/9780199642489.003.0101_update_003 ◽

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 disseminated manifestations gradual remission of symptoms may take several weeks to months. In rare cases, the pathogen can persist for many years, causing acrodermatitis chronica atrophicans, chronic neuroborreliosis of the central nervous system, or Lyme arthritis. Moreover, the infection may induce a persisting immunopathological response, resulting in ‘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.

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

Expert Reviews in Molecular Medicine ◽

10.1017/s1462399404007276 ◽

2004 ◽

Vol 6 (2) ◽

pp. 1-22 ◽

Cited By ~ 8

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.

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