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Lyme borreliosis (LB) is the most common tick-transmitted infection on the northern hemisphere and is caused by bacteria in the Borrelia burgdorferi sensu lato (Bbsl)-complex. The diagnosis is partially based on serology and clinicians often take follow-up serum samples to look for seroconversion or an increase in IgG-antibody levels. In this registry-based study, we proposed a method for determining actual changes in IgG and examined antibody reactivity and decay.

Ongoing surveillance will improve understanding of the incidence, clinical severity, and public health role of this emerging disease. …

by Dashdavaa Ganbold, Bayarsaikhan Uudus, Naranbat Nyamdavaa, Yeruult Chultemsuren, Amarbayasgalan Zagd, Mungunzaya Tangad, Agarzandan Bayarmaa, Rolomjav Lkunrev, Uyanga Baasandagva, Tsogbadrakh Nyamdorj, Myadagsuren Narankhajid Borrelia burgdorferi sensu lato and Rickettsia spp. are worldwide causes of tick-borne infections. We aimed to estimate the seroprevalence of immunoglobulin G (IgG) antibodies against different tick-borne diseases (TBDs) and determine risk factors among Mongolians from 2016 to 2020. Blood samples were obtained from voluntary participants with a history of suspected tick bite who visited our hospital, and IgG antibodies against Rickettsia and Borrelia were detected using enzyme-linked immunosorbent assay (ELISA). The IgG antibody seropositivity rate against Rickettsia was 21.8% (1032/4724), while 3.4% (162/4724) of participants tested positive for serum IgG antibodies against Borrelia by ELISA.Binary logistic regression analysis was performed to evaluate risk factors for tick-borne rickettsiosis (TBR) and tick-borne borreliosis (TBB) using IgG serum sample. Age, occupation, and residence were significantly associated with these diseases; however, sex did not show any significant association. Seroprevalence was significantly higher among herders (40.6%, 95% confidence interval [CI]: 35.5–45.8; odds ratio [OR] 0.61; P < 0.001) and students (32.8%, 95% CI: 30.2–35.4; OR 0.75; P < 0.001) than among individuals with other occupations. The 25–29 age group had a slightly higher seroprevalence (35.1%, 95% CI: 28.1–42.6; OR 0.61; P < 0.006) than those in other age groups. Province was a stronger predictor of TBR than occupation and age group. In univariate subgroup analysis by age group, occupation, and residence were significantly associated with TBR seroprevalence, whereas age and province were associated with TBB seroprevalence. Thus, risk factors for TBD include residence, occupation, and age group. This study was conducted using samples from all Mongolian provinces and the capital city, and the risk factors and prevalence of Rickettsia and Borreliaare highlighted.

by Ivar Tjernberg, Malin Lager, Guro Furset Jensen, Randi Eikeland, Dag Nyman, Lars Brudin, Anna J. Henningsson Objectives Lyme serology does not readily discriminate an active Lyme borreliosis (LB) from a previous Borrelia infection or exposure. Here, we aimed to investigate a large number of immunological protein biomarkers to search for an immunological pattern typical for active LB, in contrast to patterns found in healthy blood donors, a proportion of whom were previously exposed to Borrelia. Methods Serum samples from well-characterised adult patients with ongoing LB and healthy blood donors were included and investigated using a proximity extension assay (provided by Olink®) by which 92 different immune response-related human protein biomarkers were analysed simultaneously. Results In total, 52 LB patients and 75 healthy blood donors were included. The blood donors represented both previously Borrelia exposed (n = 34) and not exposed (n = 41) based on anti-Borrelia antibody status. Ten of the examined 92 proteins differed between patients and blood donors and were chosen for further logistic regression (p…

Lyme borreliosis is the most prevalent vector-borne disease in Europe and North America [1]; an estimated ≈232,000 cases in Western Europe [2] and ≈476,000 cases in the US [3] are diagnosed per year and erythema migrans is its most frequent clinical presentation, occurring in ≥80% of cases [1,4]. In solitary erythema migrans (SEM), the skin manifestation remains localised to the site of inoculation of borreliae, whereas multiple erythema migrans (MEM) represent hematogenous dissemination of borreliae, which may occur in 13.4% to 27% of US cases [5‒7] and less frequently (up to 7%) in Europe [4,6].

Abstract Background Lyme neuroborreliosis (LNB), due to infection of the nervous system by the spirochete Borrelia burgdorferi, occurs in 15% of Lyme disease cases. However, neurovascular involvement is uncommon, especially recurrent stroke related to cerebral vasculitis in the absence of CSF pleocytosis. Case presentation We report the case of a 58-year-old man without any medical history who exhibited recurrent strokes in the same vascular territory (left internal carotid). Multiple biological screening, neuroimaging methods, and cardiovascular examinations failed to provide a diagnosis and treatment that could have prevented recurrences. Finally, B. burgdorferi sensu lato serology testing in blood and cerebrospinal fluid enabled diagnosis of LNB, in relation to a cerebral vasculitis. The patient experienced no further stroke after four weeks of doxycycline treatment. Conclusion B. burgdorferi central nervous system infection must be considered in case of unexplained recurrent and/or multiple strokes, especially if cerebral vasculitis is suspected or demonstrated on neuroimaging. …

Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 5 Pages: 968-976 …

Dispatch - Borrelia miyamotoi Infection in Immunocompromised Man, California, USA, 2021…

Infection and Immunity, Ahead of Print.

Human cases of TBDs in Europe have increased steadily over the past decades [1]. Well-known pathogens such as Borrelia burgdorferi sensu lato and tick-borne encephalitis virus (TBEV) have expanded their distribution, while several others, such as Borrelia miyamotoi, have only recently been identified as human pathogens [2–4]. Although this upsurge can in part be explained by improved medical diagnostics and awareness, human demographics, and human behavior, it is also a consequence of environmental and climatic changes [5–7].

Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 108 Issue: 3 Pages: 510-512 …

Infection and Immunity, Ahead of Print.

Infection and Immunity, Ahead of Print.

Abstract Background Lyme borreliosis (LB) is the most common tick-borne infectious disease in the northern hemisphere. The diagnosis of LB is usually made by clinical symptoms and subsequently supported by serology. In Europe, a two-step testing consisting of an enzyme-linked immunosorbent assay (ELISA) and an immunoblot is recommended. However, due to the low sensitivity of the currently available tests, antibody detection is sometimes inaccurate, especially in the early phase of infection, leading to underdiagnoses. Methods To improve upon Borrelia diagnostics, we developed a multiplex Borrelia immunoassay (Borrelia multiplex), which utilizes the new INTELLIFLEX platform, enabling the simultaneous dual detection of IgG and IgM antibodies, saving further time and reducing the biosample material requirement. In order to enable correct classification, the Borrelia multiplex contains eight antigens from the five human pathogenic Borrelia species known in Europe. Six antigens are known to mainly induce an IgG response and two antigens are predominant for an IgM response. Results To validate the assay, we compared the Borrelia multiplex to a commercial bead-based immunoassay resulting in an overall assay sensitivity of 93.7% (95% CI 84.8–97.5%) and a specificity of 96.5% (95%CI 93.5–98.1%). To confirm the calculated sensitivity and specificity, a comparison with a conventional 2-step diagnostics was performed. With this comparison, we obtained a sensitivity of 95.2% (95% CI 84.2–99.2%) and a specificity of 93.0% (95% CI 90.6–94.7%). Conclusion Borrelia multiplex is a highly reproducible cost- and time-effective assay that enables the profiling of antibodies against several individual antigens simultaneously. …

Clinical Microbiology Reviews, Ahead of Print. …

Infection and Immunity, Ahead of Print. …

Lyme borreliosis, caused by members of the Borrelia burgdorferi sensu lato (Bbsl) complex, is the most common vector-borne disease in Europe and the USA, with over 600 000 cases estimated to occur annually in these regions since 2010.1,2 Given this impressive global burden, it is remarkable that there are still substantial diagnostic gaps for Lyme borreliosis, including the absence of reliable assays for acute infection, difficulty in differentiating past disease from current disease, and an inability to monitor treatment response.

by Samuel D. Mason, Samuel C. R. Sherratt, Samantha M. Kruguer, Michael Muthersbaugh, Jonathan P. Harris, Wayne C. Gatlin, Justin D. Topp, Gregory S. Keller

Habitat fragmentation and heterogeneity transform otherwise contiguous tracks of forest into smaller patches in the northeastern U.S. and likely impact abundances, movement patterns, and disease transmission pathways for small-mammal communities at multiple scales. We sought to determine the structure of a small-mammal community in terms of mammal abundance and infection prevalence of Borrelia burgdorferi sensu stricto (s.s.), Anaplasma phagocytophilum, and Babesia microti within a fragmented landscape in Essex County, Massachusetts, USA. We studied communities at multiple spatial scales, including vegetation, edge type, and landscape (including 200-m, 500-m, and 1000-m radii) scales. A total of 16 study sites were chosen to represent four edge types: interior forest, pasture edge, natural edge, and residential edge. At each site, we trapped small mammals and conducted vegetation surveys and GIS analysis. Upon capture, a tissue sample was collected to analyze for presence of pathogens. Northern short-tailed shrew (Blarina brevicauda) abundance did not differ based on edge type, whereas abundance of the white-footed mouse (Peromyscus leucopus) was greatest at pasture edges, although the relationship was relatively weak. White-footed mouse abundance was negatively associated with amount of forested area within a 500-m radius, whereas northern short-tailed shrew abundance demonstrated a positive relationship with fragmentation indices at the 200-m radius. White-footed mice captured at interior-forest habitat were more likely be infected with B. burgdorferi (s.s.) than individuals from edge habitat. Greater prevalence of B. burgdorferi infection of white-footed mice in forest interiors compared to edge habitats counters previous studies. Reasons for this and implications are discussed.

Clinical guidelines disagree on the diagnostic usefulness of Borrelia burgdorferi (Bb) serum antibodies (serum-Bb) in investigation of Lyme neuroborreliosis (LNB). We investigated the association between serum-Bb and Bb intrathecal antibody index (Bb-AI) and rates of seroconversion and seroreversion after LNB.

by Patrick Pearson, Olivia Skaltsis, Chu-Yuan Luo, Guang Xu, Zachary Oppler, Dustin Brisson, Stephen M. Rich

Borrelia burgdorferi is an important tickborne human pathogen comprising several strains based on nucleotide sequence of the outer surface protein C (ospC) gene. Detection and characterization of different ospC genotypes is vital for research on B. burgdorferi and the risk it poses to humans. Here we present a novel, multiplex assay based on Luminex xMAP technology for the detection of B. burgdorferi ospC genotypes. The assay has five major steps: amplification of the ospC gene, hydrolyzation of surplus primers and nucleotides, incorporation of biotinylated nucleotides into the template DNA, hybridization to Luminex microspheres, and detection of fluorescent signals corresponding to each ospC genotype. We validated the protocol by comparing results obtained from our method against results from an established ospC genotyping method. This protocol can be used for the characterization of ospC genotypes in B. burgdorferi infected ticks, reservoir hosts, and/or clinical samples.

Case report…