The expanding Lyme Borrelia complex--clinical significance of genomic species?

Institute for Hygiene and Applied Immunology, Medical University of Vienna, Vienna, Austria.
Clinical Microbiology and Infection (Impact Factor: 5.77). 04/2011; 17(4):487-93. DOI: 10.1111/j.1469-0691.2011.03492.x
Source: PubMed


Clin Microbiol Infect 2011; 17: 487–493
Ten years after the discovery of spirochaetes as agents of Lyme disease in 1982 in the USA, three genomic species had diverged from the phenotypically heterogeneous strains of Borrelia burgdorferi isolated in North America and Europe: Borrelia afzelii, B. burgdorferi sensu stricto (further B. burgdorferi), and Borrelia garinii. Whereas B. burgdorferi remained the only human pathogen in North America, all three species are aetiological agents of Lyme borreliosis in Europe. Another seven genospecies were described in the 1990s, including species from Asia (Borrelia japonica, Borrelia turdi, and B. tanukii), North America (Borrelia andersonii), Europe (Borrelia lusitaniae and Borrelia valaisiana), and from Europe and Asia (Borrelia bissettii). Another eight species were delineated in the years up to 2010: Borrelia sinica (Asia), Borrelia spielmanii (Europe), Borrelia yangtze (Asia), Borrelia californiensis, Borrelia americana, Borrelia carolinensis (North America), Borrelia bavariensis (Europe), and Borrelia kurtenbachii (North America). Of these 18 genomic species B. afzelii, B. burgdorferi and B. garinii are the confirmed agents of localized, disseminated and chronic manifestations of Lyme borreliosis, whereas B. spielmanii has been detected in early skin disease, and B. bissettii and B. valaisiana have been detected in specimens from single cases of Lyme borreliosis. The clinical role of B. lusitaniae remains to be substantiated.

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    • "In most cases, an early symptom of a Borrelia infection is the localized skin manifestation erythema migrans (EM), which usually appears at the site of the tick bite and expands within days to weeks after infection. Disseminated Borrelia infections may involve neurologic, joint and/or skin manifestations and occur weeks to months after the primary infection (Stanek et al., 2011). However , we and others have earlier shown that most people infected seem to remain asymptomatic (Fryland et al., 2011; Huegli et al., 2011). "
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    ABSTRACT: Lyme borreliosis (LB) is a common and increasing tick-borne disease in Europe. The risk of acquiring a Borrelia infection after a tick bite is not fully known. Therefore, we investigated the incidence of Borrelia infection after a bite by a Borrelia-infected tick and if the Borrelia load and/or the duration of tick-feeding influenced the risk of infection. During 2008-2009, ticks and blood samples were collected from 1546 tick-bitten persons from Sweden and the Åland Islands, Finland. Follow-up blood samples were taken 3 months after the tick bite. The duration of tick feeding was microscopically estimated and Borrelia was detected and quantified in ticks by real-time PCR. Anti-Borrelia antibodies were detected in sera using ELISA tests and immunoblot. Five percent (78/1546) of the study participants developed Borrelia infection (LB diagnosis and/or seroconversion) after a tick bite (45% bitten by Borrelia-infected ticks and 55% bitten by uninfected ticks). Of these, 33 developed LB (whereof 9 also seroconverted) while 45 participants seroconverted only. Experience of non-specific symptoms was more frequently reported by Borrelia-infected participants compared to uninfected participants. All who seroconverted removed "their" ticks significantly later than those who did not. The Borrelia load in the ticks did not explain the risk of seroconversion. Regional and sex differences in the Borrelia seroprevalence were found. The risk of developing a Borrelia infection after a bite by a Borrelia-infected tick is small but increases with the duration of tick feeding. Copyright © 2015 Elsevier GmbH. All rights reserved.
    Ticks and Tick-borne Diseases 08/2015; DOI:10.1016/j.ttbdis.2015.08.009 · 2.72 Impact Factor
    • "Lyme borreliosis (LB) is a tick-borne bacterial infection with manifestations from different organ systems (Stanek et al., 2011, 2012). The diagnosis of LB is based on clinical features, supported by detection of specific IgG and IgM antibodies. "
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    ABSTRACT: A multiplex bead based assay for the detection of serum antibodies to Borrelia burgdorferi sensu lato was evaluated. The assay contains 13 different antigens in both the IgG and the IgM assay, thus a total of 26 measurement results were available from each sample. 49 Danish patients with Lyme neuroborreliosis (LNB), 218 blood donor controls, a set of 61 Swedish patients with LNB and 139 non-LNB patients investigated for suspected LNB were used. There are four parts developed in the study: A characterization of the sero-epidemiological antibody response pattern, the construction of a diagnostic score, evaluation of the scoring method using an independent dataset and an assessment of the analytical quality of the multiplex assay. The VlsE IgG had the highest diagnostic value with an AUC of 96% on the ROC curve. The OspC IgM had AUC's just above 80%. All the other antigens had both low quantitative reactivity and lower contrast in the patients with LNB compared to controls. The diagnostic value of the assay may be improved by using a logistic model which gave a sensitivity of 90% and 79% calibrating the specificities at 92% and 98% respectively. Overall the patients with LNB have serum reactivity in IgG VlsE but modest antibody reactivity in the remaining 12 IgG and 13 IgM antibody measurements. Using a logistic regression model with 5 IgG and 2 IgM antigens, the sensitivity and specificity of the assay was improved. But the IgG VlsE component alone contributed most of the diagnostic contrast.
    Journal of Medical Microbiology 01/2015; 64(Pt_3). DOI:10.1099/jmm.0.000009 · 2.25 Impact Factor
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    • "B. burgdorferi s.l. is a worldwide complex of spirochaetes containing several genomic species. Some are recognized as human pathogens and cause Lyme borreliosis (Stanek and Reiter 2011). Here we present the MIR for B. burgdorferi in I. ricinus ticks in the natural and the urban ecosystms in the Czech Republic in order to assess the risk of acquiring the disease. "
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    ABSTRACT: A total of 1279 field-collected Ixodes ricinus ticks were screened for Borrelia burgdorferi sensu lato (s.l.) in a natural and an urban ecosystem of Ostrava city (Czech Republic) by using molecular methods. Minimal prevalence rate for Borrelia burgdorferi s.l. in ticks for the urban park Bělský les was found to be 13.8% (17.6% in males, 17.8% in females and 11.7% in nymphs), similarly for the natural site Proskovice was minimal prevalence 15% (12.5% in males, 20% in females and 14.9% in nymphs). Six proven human pathogenic genomic species have been recorded in the study: B. afzelii, B. garinii, B. burgdorferi s.s., B. valaisiana, B. lusitaniae, and B. spielmanii. Emerging B. spielmanii was detected for the first time in Ixodes ricinus ticks in the region. Our results highlight the need for surveillance of zoonotic tick-borne pathogens even in urban areas.
    Acta Parasitologica 10/2014; 59(4). DOI:10.2478/s11686-014-0296-1 · 0.91 Impact Factor
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