A prospective study on the incidence of Borrelia burgdorferi sensu lato infection after a tick bite in Sweden and on the Åland Islands, Finland (2008–2009)

Wilhelmsson, Peter; Fryland, Linda; Lindblom, Pontus; Sjöwall, Johanna; Ahlm, Clas; Berglund, Johan; Haglund, Mats; Henningsson, Anna J.; Nolskog, Peter; Nordberg, Marika; Nyberg, Clara; Ornstein, Katharina; Nyman, Dag; Ekerfelt, Christina; Forsberg, Pia; Lindgren, Per-Eric

doi:10.1016/j.ttbdis.2015.08.009

Cited by 80 publications

(74 citation statements)

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“…We observed a 2.6% overall risk of Lyme borreliosis after a tick bite, which is in line with the range of risk estimates of 0.8% to 5.2% that were reported from prospective studies in Sweden, Finland and Switzerland. [13, 28, 29, 31] The relative proportions of Lyme borreliosis diagnoses in the Netherlands have recently been estimated at 95% erythema migrans, and 5% disseminated Lyme borreliosis. [32] Based on these proportions, the currently observed risk of 26 erythema migrans per 1000 recognized tick bites would translate into 1.5 (approximately one or two) additional diagnoses of disseminated Lyme borreliosis per 1000 recognized tick bites.…”

Section: Discussionmentioning

confidence: 99%

“…We further assumed that older study participants report longer tick attachment durations than younger participants (arrow e)[26, 27]. We assumed that the risk of Lyme borreliosis is higher when DNA of Borrelia is detected in the tick (arrow f) [12, 13, 28, 29], and that the probability of a tick carrying Borrelia is associated with the developmental stage of the tick (arrow g) [4–6]. Through explorative analyses of each variable and associations between the variables, several conventional statistical models (e.g.…”

Section: Methodsmentioning

confidence: 99%

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Predicting the risk of Lyme borreliosis after a tick bite, using a structural equation model

et al. 2017

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BackgroundUnderstanding and quantification of the risk of Lyme borreliosis after a tick bite can aid development of prevention strategies against Lyme borreliosis.MethodsWe used 3,525 single tick bite reports from three large prospective studies on the transmission risk of tick-borne pathogens to humans, with 50 reports of Lyme borreliosis during the follow-up period, among 1,973 reports with known outcome. A structural equation model was applied to estimate the risk of Lyme borreliosis after a tick bite, and quantify the influence of: developmental stage of the tick, detection of Borrelia burgdorferi s.l. DNA in the tick by PCR, tick engorgement, patient-estimated duration of tick attachment, and patient age.ResultsThe overall risk of developing Lyme borreliosis after a tick bite was 2.6% (95%CI 1.4–5.1).The risk increased with:- Tick engorgement: 1.4% (95%CI 0.7%-2.3%) for low engorgement to 5.5% (95%CI 2.8%-9.2%) for substantially engorged ticks;- Rising patient-estimated tick attachment duration: 2.0% (95%CI 1.3%-2.8%) after <12 hours, to 5.2% (95%CI 3.0%-8.9%) after ≥4 days;- Detection of Borrelia burgdorferi s.l. DNA in ticks: 6.7% (95%CI 3.6%-13.5%), versus 1.4% (95%CI 0.7%-2.9%) when ticks tested negative.The highest observed risk of Lyme borreliosis was 14.4% (95%CI 6.8%-24.6%) after one tick bite of a substantially engorged tick that tested positive for Borrelia burgdorferi s.l. DNA, which corresponds to one new case of Lyme borreliosis per 7 (95%CI 4–15) of such tick bites.ConclusionsAn individual's risk of Lyme borreliosis after a tick bite can be predicted with tick engorgement, patient-estimated duration of tick attachment, and detection of Borrelia burgdorferi s.l. DNA in the tick.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Predicting the risk of Lyme borreliosis after a tick bite, using a structural equation model

et al. 2017

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“…The Tick-Borne Disease (TBD) STING study is a prospective study following recently tick-bitten individuals for a 3-month study period [24,25]. Individuals ≥ 18 years of age with an observed and recent tick bite were asked through local public media to bring the tick, after detachment, to their Primary Health Care (PHC) centre.…”

Section: Methodsmentioning

confidence: 99%

“…The regions participating in the current study were located in the south central parts of Sweden represented by: Västra Götaland (Lidköping); Östergötland (Söderköping; Kisa; Vikbolandet) Jönköping County (Bankeryd), southernmost Sweden (Kalmar) and the Åland Islands in Finland (Fig 1). These areas were selected because they are known to be high endemic tick areas identified in previous studies [24, 25]. …”

Section: Methodsmentioning

confidence: 99%

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Prevalence of Rickettsia spp. in Ticks and Serological and Clinical Outcomes in Tick-Bitten Individuals in Sweden and on the Åland Islands

et al. 2016

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Tick-transmitted diseases are an emerging health problem, and the hard tick Ixodes ricinus is the main vector for Borrelia spp., tick-borne encephalitis virus and most of the spotted fever Rickettsiae in Europe. The aim of the present study was to examine the incidence of rickettsial infection in the southernmost and south central parts of Sweden and the Åland Islands in Finland, the risk of infection in humans and its correlation with a bite of a Rickettsia-infected tick, the self-reported symptoms of rickettsial disease, and the prevalence of co-infection between Rickettsia spp. and Borrelia spp. Persons with a recent tick bite were enrolled through public media and asked to answer a questionnaire, provide a blood sample and bring detached ticks at enlistment and at follow-up three months later. Blood samples were previously analysed for Borrelia spp. antibodies and, for this report, analysed for antibodies to Rickettsia spp. by immunofluorescence and in 16 cases also using Western Blot. Ninety-six (44.0%) of the 218 participants were seropositive for IgG antibodies to Rickettsia spp. Forty (18.3%) of the seropositive participants had increased titres at the follow-up, indicating recent/current infection, while four (1.8%) had titres indicating probable recent/current infection (≥1:256). Of 472 ticks, 39 (8.3%) were Rickettsia sp. positive. Five (31.3%) of 16 participants bitten by a Rickettsia-infected tick seroconverted. Experience of the self-reported symptoms nausea (p = 0.006) and radiating pain (p = 0.041) was more common among those with recent, current or probable infection compared to those who did not seroconvert. Participants who showed seroreactivity or seroconversion to Rickettsia spp. had more symptoms than those who were seronegative. Seven (3.2%) participants showed seroconversion to Borrelia spp., and three (1.4%) of these showed seroconversion to both Rickettsia spp. and Borrelia spp., in accordance with previous studies in Sweden. Symptoms of rickettsial disease were in most of the cases vague and general that were difficult to differentiate from other tick-borne diseases.

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Lyme Borreliosis

O’Çonnell¹

2019

Harper's Textbook of Pediatric Dermatology

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A prospective study on the incidence of Borrelia burgdorferi sensu lato infection after a tick bite in Sweden and on the Åland Islands, Finland (2008–2009)

Cited by 80 publications

References 41 publications

Predicting the risk of Lyme borreliosis after a tick bite, using a structural equation model

Predicting the risk of Lyme borreliosis after a tick bite, using a structural equation model

Prevalence of Rickettsia spp. in Ticks and Serological and Clinical Outcomes in Tick-Bitten Individuals in Sweden and on the Åland Islands

Lyme Borreliosis

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