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Borreliosis and Other Tick-Borne Diseases in the Northern and Southern Hemispheres

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A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Parasitology".

Deadline for manuscript submissions: 30 September 2024 | Viewed by 4474

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Special Issue Editor

Prof. Dr. Giusto Trevisan

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Guest Editor

Department of Medical Sciences, University of Trieste, 34151 Trieste, Italy
Interests: Lyme borreliosis; tick-borne infections; Adamantiades–Behçet disease; dermatomyositis; melanoma
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Borreliosis is divided into three groups: the Borrelia Lyme group (LG), echidna–reptile group (RepG), and relapsing fever group (RFG). According to current knowledge, only the Borrelia LG and RFG lead to infections in humans. There are several aspects that need to be clarified.

The current indirect diagnosis provides information on whether there has been an infection with the Borrelia LG, but it is less reliable in determining whether the infection is still microbiologically active or not. Therefore, innovative tests will be analyzed, which could provide us with more information concerning the presence or absence of active Borrelia, in addition to what the mechanisms are that can allow Borrelia to resist antibiotic treatment. A cultural examination in BSK or Kelly Pettenkhofer is the gold standard; however, this type of examination has a very high specificity but very low sensitivity, and it is therefore not frequently used in the clinic.

The Borrelia LG is widespread in the Northern Hemisphere, while little is known about the distribution of this disease in the Southern Hemisphere, where the Borrelia RFG is more frequent. New studies on Borrelia in Argentina, which will be published in this Special Issue, are ongoing, and a general survey will be carried out on the current knowledge of borreliosis in the Southern Hemisphere.

Prof. Dr. Giusto Trevisan
Guest Editor

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Keywords

lyme disease
borrelia
diagnosis
tick-borne infections
relapsing fever

Published Papers (4 papers)

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Research

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10 pages, 364 KiB

Open AccessArticle

Pediatric Lyme Disease in Northern Italy: An 18-Year Single-Center Case Series

by Federica Forlanini, Raffaella Di Tonno, Roberta Caiazzo, Daniela David, Maria Sole Valentino, Sara Giordana Rimoldi, Gian Vincenzo Zuccotti, Giusto Trevisan, Francesca Wanda Basile and Vania Giacomet

Microorganisms 2024, 12(3), 455; https://doi.org/10.3390/microorganisms12030455 - 23 Feb 2024

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Abstract

Tracing the profile of pediatric Lyme borreliosis (LB) in Europe is difficult due to the interregional variation in its incidence and lack in notifications. Moreover, the identification of LB can be challenging. This study is an 18-year case series of 130 children and adolescents aged under 18 years referred to the Pediatric Infectious Diseases Unit at L. Sacco Hospital, Milan, with suspicion of LB, between January 2005 and July 2023. The routine serological workup consisted of a two-step process: an initial screening test followed by Western blot (WB). Forty-four (34%) patients were diagnosed with LB. The median age was six years, and 45% were females. Of the children with erythema migrans (EM), 33 (57%) were confirmed as having true EM, and, of these, 4 (12%) were atypical. Ten (23%) patients had early disseminated/late diseases, including facial nerve palsy (n = 3), early neuroborreliosis (n = 1), arthritis (n = 3), relapsing fever (n = 2), and borrelial lymphocytoma (n = 1). No asymptomatic infections were documented. Over seventy percent of confirmed LB cases (n = 31/44) recalled a history of tick bites; in this latter group, 19 (61%) were from the area of the Po River valley in Lombardy. Almost half of the children evaluated for LB complained of non-specific symptoms (fatigue, musculoskeletal pain, skin lesions/rash, and persistent headache), but these symptoms were observed in only two patients with confirmed LB. Most LB cases in our study were associated with EM; two-tier testing specificity was high, but we found frequent non-adherence to international recommendations with regard to the timing of serology, application of the two-step algorithm, and antibiotic over-prescription. Most children were initially assessed for a tick bite or a skin lesion suggestive of EM by a family pediatrician, highlighting the importance of improving awareness and knowledge around LB management at the primary healthcare level. Finally, the strengthening of LB surveillance at the national and European levels is necessary. Full article

(This article belongs to the Special Issue Borreliosis and Other Tick-Borne Diseases in the Northern and Southern Hemispheres)

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10 pages, 372 KiB

Open AccessArticle

Microbiologic Findings in a Cohort of Patients with Erythema Migrans

by Eva Ružić-Sabljić, Vera Maraspin, Petra Bogovič, Tereza Rojko, Katarina Ogrinc, Martina Jaklič and Franc Strle

Microorganisms 2024, 12(1), 185; https://doi.org/10.3390/microorganisms12010185 - 17 Jan 2024

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Abstract

Erythema migrans (EM) is the initial and the most frequent clinical manifestation of Lyme borreliosis (LB). Herein, we report on the capacity of culture and serology for the demonstration of Borrelia infection in a cohort of 292 patients diagnosed with typical EM at a single medical center. The median duration of EM at diagnosis was 12 days, and the largest diameter was 16 cm; 252 (86.3%) patients presented with solitary EM, whereas 40 (13.7%) had multiple EM. A total of 95/292 (32.5%) patients had positive IgM, and 169 (57.9%) had positive IgG serum antibodies; the Borrelia isolation rate was 182/292 (62.3%). The most frequent species by far was B. afzelii (142/148, 95.9%) while B. garinii (2.7%) and B. burgdorferi s.s. (1.4%) were rare. IgM seropositivity was associated with a younger age, multiple EM and the absence of underlying chronic illness; IgG seropositivity was associated with the duration of EM at diagnosis, the diameter of the EM, having had a previous episode of LB and the absence of symptoms at the site of the EM. Furthermore, the Borrelia isolation rate was statistically significantly lower in patients with positive Borrelia IgM antibodies. Although microbiologic analyses are not needed for the diagnosis of typical EM, they enable insights into the etiology and dynamics of the immune response in the course of early LB. Full article

(This article belongs to the Special Issue Borreliosis and Other Tick-Borne Diseases in the Northern and Southern Hemispheres)

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12 pages, 1863 KiB

Open AccessArticle

Estimated Incidence of Symptomatic Lyme Borreliosis Cases in Lublin, Poland in 2021

by Emily Colby, Julia Olsen, Frederick J. Angulo, Patrick Kelly, Kate Halsby, Andreas Pilz, Urszula Sot, Tomasz Chmielewski, Katarzyna Pancer, Jennifer C. Moïsi, Luis Jodar and James H. Stark

Microorganisms 2023, 11(10), 2481; https://doi.org/10.3390/microorganisms11102481 - 3 Oct 2023

Cited by 1 | Viewed by 985

Abstract

Lyme borreliosis (LB), the most common tick-borne disease in Europe, is endemic to Poland. Despite public health surveillance with mandatory reporting of LB cases by physicians and laboratories, many symptomatic LB cases are not included in surveillance in Poland. We estimated the extent of the under-ascertainment of symptomatic LB cases via surveillance in the Polish province of Lublin to better understand Poland’s LB burden. The number of incident symptomatic LB cases in Lublin in 2010 was estimated from two seroprevalence studies conducted among adults in Lublin, as well as estimates of the proportion of asymptomatic LB cases and the duration of LB antibody persistence. The estimated number of incident symptomatic LB cases was compared to the number of surveillance-reported cases in Lublin to derive an under-ascertainment multiplier. This multiplier was applied to the number of surveillance-reported cases in 2021 to estimate the number and population-based incidence of symptomatic LB cases in Lublin in 2021. We estimate that there are 5.9 symptomatic LB cases for every surveillance-reported LB case in Lublin. Adjusting for under-ascertainment, the estimated number of symptomatic LB cases in Lublin in 2021 was 6204 (population-based incidence: 467.6/100,000). After adjustment for under-ascertainment, the incidence of symptomatic LB in Lublin, Poland, is high. Full article

(This article belongs to the Special Issue Borreliosis and Other Tick-Borne Diseases in the Northern and Southern Hemispheres)

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Review

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13 pages, 573 KiB

Open AccessReview

Lyme Disease: A Review with Emphasis on Latin America

by Vanina Lucca, Sandra Nuñez, María Belen Pucheta, Nilda Radman, Teresita Rigonatto, Graciela Sánchez, Beatriz Del Curto, Dolores Oliva, Betina Mariño, Giuliana López, Serena Bonin, Giusto Trevisan and Nestor Oscar Stanchi

Microorganisms 2024, 12(2), 385; https://doi.org/10.3390/microorganisms12020385 - 13 Feb 2024

Viewed by 1686

Abstract

The spirochete Borrelia burgdorferi sensu lato (Lyme Group) is the causative agent of Lyme disease, transmitted to humans through tick bites carrying the bacteria. Common symptoms include fever, headache, fatigue, and the characteristic erythema migrans skin rash. If left untreated, the infection can affect joints, the cardiac system, and the nervous system. Diagnosis relies on symptoms, clinical signs (such as the rash), and potential exposure to infected ticks, with laboratory tests proving valuable when appropriately employed with validated methods. Most cases of Lyme disease respond effectively to a few weeks of antibiotic treatment. In Latin America, knowledge of Lyme disease is limited and often confounded, underscoring the significance of this review in aiding medical professionals in recognizing the disease. This study delves explicitly into Lyme disease in Argentina, neighboring countries, and other Latin American nations. Full article

(This article belongs to the Special Issue Borreliosis and Other Tick-Borne Diseases in the Northern and Southern Hemispheres)

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