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Forsberg, Pia
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Hoornstra, D., Stukolova, O. A., van Eck, J. A., Sokolova, M. I., Platonov, A. E., Hofhuis, A., . . . Hovius, J. W. (2024). Exposure, infection and disease with the tick-borne pathogen Borrelia miyamotoi in the Netherlands and Sweden, 2007-2019. Journal of Infection, 89(6), Article ID 106326.
Open this publication in new window or tab >>Exposure, infection and disease with the tick-borne pathogen Borrelia miyamotoi in the Netherlands and Sweden, 2007-2019
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2024 (English)In: Journal of Infection, ISSN 0163-4453, E-ISSN 1532-2742, Vol. 89, no 6, article id 106326Article in journal (Refereed) Published
Abstract [en]

The impact of the emerging tick-borne pathogen Borrelia miyamotoi is not fully understood. We utilised a protein array to investigate B. miyamotoi seroreactivity in various human populations in the Netherlands and Sweden. The IgM/IgG seroprevalence in Dutch healthy (2·5%, 95%CI 1·5–4·1) and population controls (2·0%, 95%CI 0·9–4·4) was lower (p = 0·01 and p = 0·01) compared to the tick-bite cohort (6·1%, 95%CI 3·9–9·5). In accordance, the Swedish healthy controls (1·0%, 95%CI 0·1–6·9) revealed a lower (p = 0·005 and p < 0·001) IgM/IgG seroprevalence compared to the tick-bite (8·9%, 95%CI 5·7–13·7) and fever after tick-bite cohort (16·5%, 95%CI 10·6–24·8). Altogether, 15 of 2175 individuals had serologic evidence of early B. miyamotoi infection. The risk of infection with B. miyamotoi was 0·7% (95%CI 0·3–1·4) in tick-bitten individuals, and of disease 7·3% (95%CI 2·6–12·8) in those with a febrile illness after tick-bite. Our findings provide insights into the risk of infection and disease with this pathogen in Europe.

Place, publisher, year, edition, pages
W B SAUNDERS CO LTD, 2024
Keywords
Borrelia miyamotoi; Relapsing fever Borrelia; Borrelia miyamotoi disease; Hard tick-borne relapsing fever; Serology
National Category
Infectious Medicine
Identifiers
urn:nbn:se:liu:diva-210139 (URN)10.1016/j.jinf.2024.106326 (DOI)001361678600001 ()39454832 (PubMedID)
Note

Funding Agencies|Dutch ZonMw ('Zorg Onderzoek Nederland Medische Wetenschappen') through the European Regional Development Fund [5220-03-007]; Interreg North Sea Region Programme as part of the NorthTick project [38-2-7-19]; Medical Research Council of Southeast Sweden (FORSS) [931010]

Available from: 2024-12-03 Created: 2024-12-03 Last updated: 2024-12-11
Tijani, M. K., Svensson, J., Adlerborn, P., Danielsson, L., Teleka, A., Ljungqvist Lövmar, M., . . . Persson, K. E. M. (2024). How to Detect Antibodies Against Babesia divergens in Human Blood Samples. OPEN FORUM INFECTIOUS DISEASES, 11(2), Article ID ofae028.
Open this publication in new window or tab >>How to Detect Antibodies Against Babesia divergens in Human Blood Samples
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2024 (English)In: OPEN FORUM INFECTIOUS DISEASES, ISSN 2328-8957, Vol. 11, no 2, article id ofae028Article in journal (Refereed) Published
Abstract [en]

Background Today only indirect fluorescent antibody assays (IFAs) are commercially available to detect antibodies against Babesia divergens in humans. IFA is subjective and requires highly experienced staff. We have therefore developed an enzyme-linked immunosorbent assay (ELISA)-based method for measuring anti-B. divergens immunoglobulin G antibodies in human blood samples.Methods Crude merozoite extract from in vitro cultures of a new B. divergens isolate was used in ELISA to detect antibodies in different sets of samples: Borrelia burgdorferi-positive samples, healthy individuals, tick-bitten individuals including follow-up samples 3 months later, positive control samples from patients with an active Babesia infection, and samples from malaria-endemic regions. As a reference, IFA was used to detect antibodies in the tick-bitten samples. Western blot was used to evaluate reactions against specific bands in extracts with/without parasites.Results Using IFA as the reference method, the sensitivity and specificity of the ELISA were 86% (12/14) and 100% (52/52). There was a very high correlation (r = -0.84; P = .0004) between IFA dilution factors and ELISA absorbances among the samples classified as positive. Five percent of the B. burgdorferi-positive samples were judged as weakly positive and 5% as strongly positive in our ELISA. Western blot showed that the immunodominant antigens (similar to 120 kDa) were from merozoites and not from erythrocytes.Conclusions This ELISA can detect antibodies directed against B. divergens, and it can be a useful and easy assay to handle compared with IFA. The ELISA can also measure high and low levels of antibodies, which could give insight into the recency of a B. divergens infection.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS INC, 2024
Keywords
antibody; Babesia; blood transfusion; divergens; ELISA
National Category
Infectious Medicine
Identifiers
urn:nbn:se:liu:diva-201690 (URN)10.1093/ofid/ofae028 (DOI)001158399700006 ()38328497 (PubMedID)
Note

Funding Agencies|Governmental Avtal om Lakarutbildning och Forskning; Region Skane/Lund University; SUS fonder; Soedra Sjukvardsregionen; Alfred OEsterlunds Stiftelse; Stiftelsen Sigurd och Elsa Goljes Minne; O. E. och Edla Johanssons Stiftelse; Crafoordska Stiftelsen; European Union through the European Regional Development Fund; Interreg North Sea Region Programme [38-2-7-19]; Swedish Research Council [K2008-58X-14631-06-3]

Available from: 2024-03-19 Created: 2024-03-19 Last updated: 2025-02-03
Carlströmer Berthén, N., Tompa, E., Olausson, S., Nyberg, C., Nyman, D., Ringbom, M., . . . Nordberg, M. (2023). The AxBioTick Study: Borrelia Species and Tick-Borne Encephalitis Virus in Ticks, and Clinical Responses in Tick-Bitten Individuals on the Aland Islands, Finland. Microorganisms, 11(5), Article ID 1100.
Open this publication in new window or tab >>The AxBioTick Study: Borrelia Species and Tick-Borne Encephalitis Virus in Ticks, and Clinical Responses in Tick-Bitten Individuals on the Aland Islands, Finland
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2023 (English)In: Microorganisms, E-ISSN 2076-2607, Vol. 11, no 5, article id 1100Article in journal (Refereed) Published
Abstract [en]

The AxBioTick Study: Borrelia Species and Tick-Borne Encephalitis Virus in Ticks, and Clinical Responses in Tick-Bitten Individuals on the Aland Islands, Finlandby  Nellie Carlströmer Berthén 1,2,*,† , Eszter Tompa 3,† , Susanne Olausson 1,2, Clara Nyberg 1, Dag Nyman 1,2, Malin Ringbom 1,4, Linda Perander 1,4, Joel Svärd 3, Per-Eric Lindgren 3,5, Pia Forsberg 3, Peter Wilhelmsson 3,5,‡, Johanna Sjöwall 3,6,‡  and Marika Nordberg 1,4,‡  1Borrelia Research Group of the Aland Islands, 22100 Mariehamn, The Aland Islands, Finland2Bimelix AB, 22100 Mariehamn, The Aland Islands, Finland3Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection, Linkoping University, 581 83 Linkoping, Sweden4The Aland Islands Healthcare Services, 22100 Mariehamn, The Aland Islands, Finland5Clinical Microbiology, Laboratory Medicine, County Hospital Ryhov, 551 85 Jonkoping, Sweden6Department of Infectious Diseases, Vrinnevi Hospital, 603 79 Norrkoping, Sweden*Author to whom correspondence should be addressed.†These authors contributed equally to the study.‡These authors contributed equally to the study.Microorganisms 2023, 11(5), 1100; https://doi.org/10.3390/microorganisms11051100Received: 30 March 2023 / Revised: 17 April 2023 / Accepted: 19 April 2023 / Published: 22 April 2023(This article belongs to the Special Issue Research on Ticks and Tick-Borne Pathogens)

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AbstractThe AxBioTick study was initiated to investigate the prevalence of ticks and tick-borne pathogens and their impact on antibody and clinical responses in tick-bitten individuals on the Aland Islands. This geographical area is hyperendemic for both Lyme borreliosis (LB) and Tick-borne encephalitis (TBE). Blood samples and ticks were collected from 100 tick-bitten volunteers. A total of 425 ticks was collected, all determined to Ixodes ricinus using molecular tools. Of them 20% contained Borrelia species, of which B. garinii and B. afzelii were most common. None contained the TBE virus (TBEV). Blood samples were drawn in conjunction with the tick bite, and eight weeks later. Sera were analyzed for Borrelia- and TBEV-specific antibodies using an ELISA and a semiquantitative antibody assay. In total 14% seroconverted in Borrelia C6IgG1, 3% in TBEV IgG, and 2% in TBEV IgM. Five participants developed clinical manifestations of LB. The high seroprevalence of both Borrelia (57%) and TBEV (52%) antibodies are likely attributed to the endemic status of the corresponding infections as well as the TBE vaccination program. Despite the similar prevalence of Borrelia spp. detected in ticks in other parts of Europe, the infection rate in this population is high. The AxBioTick study is continuing to investigate more participants and ticks for co-infections, and to characterize the dermal immune response following a tick bite.

Place, publisher, year, edition, pages
MDPI, 2023
Keywords
Borrelia; tick-borne encephalitis virus; Ixodes ricinus; tick bite; clinical; prospective study; ELISA; antibody responses; clinical responses
National Category
Infectious Medicine
Identifiers
urn:nbn:se:liu:diva-194108 (URN)10.3390/microorganisms11051100 (DOI)000997517600001 ()37317075 (PubMedID)2-s2.0-85160802998 (Scopus ID)
Note

Funding agencies: The Wilhelm and Else Stockmann foundation, The foundation for medical research of the Åland cultural foundation, The Jubilee foundation from the provincial government of the Aland Island (Borrelia Research Group of the Aland Islands), Region Östergötland (ALF Grant, RÖ968220) (J.S. (Johanna Sjöwall)), the Medical Research Council of Southeast Sweden (FORSS, 931010) (P.W.), the Division of Laboratory Medicine, Region Jönköping County, and the European Union through the European Regional Development Fund and the Interreg North Sea Region Program 2014–2020 as part of the NorthTick project (reference number J-No.: 38-2-7-19) (P.-E.L.).

Available from: 2023-05-26 Created: 2023-05-26 Last updated: 2025-02-27
Wass, L., Quarsten, H., Lindgren, P.-E., Forsberg, P., Skoog, E., Nilsson, K., . . . Wennerås, C. (2022). Cytokine responses of immunosuppressed and immunocompetent patients with Neoehrlichia mikurensis infection. Medical Microbiology and Immmunology, 211, 133-141
Open this publication in new window or tab >>Cytokine responses of immunosuppressed and immunocompetent patients with Neoehrlichia mikurensis infection
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2022 (English)In: Medical Microbiology and Immmunology, ISSN 0300-8584, E-ISSN 1432-1831, Vol. 211, p. 133-141Article in journal (Refereed) Published
Abstract [en]

Purpose

The tick-borne bacterium Neoehrlichia mikurensis causes the infectious disease neoehrlichiosis in humans. Vascular endothelium is one of the target cells of the infection. Neoehrlichiosis patients with compromised B cell immunity present with more severe inflammation than immunocompetent patients. The aim of this study was to compare the cytokine profiles of immunocompetent and immunosuppressed patients with neoehrlichiosis.

Methods

Blood samples from Swedish and Norwegian immunosuppressed (N = 30) and immunocompetent (N = 16) patients with neoehrlichiosis were analyzed for the levels of 30 cytokines, using a multiplex cytokine assay and ELISA. A gender-matched healthy control group (N = 14) was analyzed in parallel. Data were analyzed using the multivariate method OPLS-DA.

Results

The multiplex cytokine analyses generated more cytokine results than did the uniplex ELISA analyses. Multivariate analysis of the multiplex cytokine results established that increased levels of FGF2, GM-CSF, CXCL10, and IFNγ were associated with immunosuppressed patients, whereas increased levels of IL-15 and VEGF were associated with immunocompetent neoehrlichiosis patients. When multivariate analysis findings were confirmed with uniplex ELISA, it was found that both groups of patients had similarly elevated levels of VEGF, FGF2 and IFNγ. In contrast, the immunosuppressed patients had clearly elevated levels of CXCL10, CXCL13 and BAFF, whereas the immunocompetent patients had the same levels as healthy controls.

Conclusion

Pro-angiogenic and type 1 cytokines were produced as part of the host response of neoehrlichiosis independent of immune status, whereas immunosuppressed neoehrlichiosis patients produced cytokines required for B cell-mediated defense.

Place, publisher, year, edition, pages
Springer, 2022
Keywords
Neoehrlichia mikurensis; Neoehrlichiosis; Tick-borne disease; Immunosuppression; B cell; Cytokines
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-184687 (URN)10.1007/s00430-022-00737-6 (DOI)000783035900001 ()35430702 (PubMedID)2-s2.0-85128229755 (Scopus ID)
Note

Funding Agencies: University of Gothenburg; European Union through the European Regional Development Fund, European Commission; Interreg North Sea Region Programme [J-No.: 38-2-7-19]; Swedish government; county councils; ALF-agreement ALF Research Fund [ALFGBG-827291]; Cancer and Allergy Foundation [2020-10154]; Swedish Research Council, European Commission [K200858X-14631-06-3, 2020-01287]

Available from: 2022-05-06 Created: 2022-05-06 Last updated: 2025-02-18Bibliographically approved
Jonsson Henningsson, A., Aase, A., Bavelaar, H., Flottorp, S., Forsberg, P., Kirkehei, I., . . . Aaberge, I. (2021). Laboratory Methods for Detection of Infectious Agents and Serological Response in Humans With Tick-Borne Infections: A Systematic Review of Evaluations Based on Clinical Patient Samples. Frontiers in Public Health, 9, Article ID 580102.
Open this publication in new window or tab >>Laboratory Methods for Detection of Infectious Agents and Serological Response in Humans With Tick-Borne Infections: A Systematic Review of Evaluations Based on Clinical Patient Samples
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2021 (English)In: Frontiers in Public Health, E-ISSN 2296-2565, Vol. 9, article id 580102Article, review/survey (Refereed) Published
Abstract [en]

Background: For the most important and well-known infections spread by Ixodes ticks, Lyme borreliosis (LB) and tick-borne encephalitis (TBE), there are recommendations for diagnosis and management available from several health authorities and professional medical networks. However, other tick-borne microorganisms with potential to cause human disease are less known and clear recommendations on diagnosis and management are scarce. Therefore, we performed a systematic review of published studies and reviews focusing on evaluation of laboratory methods for clinical diagnosis of human tick-borne diseases (TBDs), other than acute LB and TBE. The specific aim was to evaluate the scientific support for laboratory diagnosis of human granulocytic anaplasmosis, rickettsiosis, neoehrlichiosis, babesiosis, hard tick relapsing fever, tularemia and bartonellosis, as well as tick-borne co-infections and persistent LB in spite of recommended standard antibiotic treatment. Methods: We performed a systematic literature search in 11 databases for research published from 2007 through 2017, and categorized potentially relevant references according to the predefined infections and study design. An expert group assessed the relevance and eligibility and reviewed the articles according to the QUADAS (diagnostic studies) or AMSTAR (systematic reviews) protocols, respectively. Clinical evaluations of one or several diagnostic tests and systematic reviews were included. Case reports, non-human studies and articles published in other languages than English were excluded. Results: A total of 48 studies fulfilled the inclusion criteria for evaluation. The majority of these studies were based on small sample sizes. There were no eligible studies for evaluation of tick-borne co-infections or for persistent LB after antibiotic treatment. Conclusions: Our findings highlight the need for larger evaluations of laboratory tests using clinical samples from well-defined cases taken at different time-points during the course of the diseases. Since the diseases occur at a relatively low frequency, single-center cross-sectional studies are practically not feasible, but multi-center case control studies could be a way forward.

Place, publisher, year, edition, pages
Frontiers Media SA, 2021
Keywords
systematic review; tick-borne infections; co-infections; human; laboratory; diagnostic; clinical evaluation
National Category
Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:liu:diva-180292 (URN)10.3389/fpubh.2021.580102 (DOI)000703112700001 ()34616701 (PubMedID)
Note

Funding Agencies|Norwegian Directorate of Health; European Union through the European Development fund; Interreg Oresund-Kattegat-Skagerrak; InterregNorthSea Region Programme 2014-2020 , ScandTick Innovation project [2015-29 000167]; InterregNorthSea Region Programme 2014-2020 , NorthTick project [38-2-7-19]

Available from: 2021-10-15 Created: 2021-10-15 Last updated: 2025-02-20
Ocias, L. F., Wilhelmsson, P., Sjöwall, J., Henningsson, A. J., Nordberg, M., Jorgensen, C. S., . . . Lindgren, P.-E. (2020). Emerging tick-borne pathogens in the Nordic countries: A clinical and laboratory follow-up study of high-risk tick-bitten individuals. Ticks and Tick-borne Diseases, 11(1), Article ID UNSP 101303.
Open this publication in new window or tab >>Emerging tick-borne pathogens in the Nordic countries: A clinical and laboratory follow-up study of high-risk tick-bitten individuals
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2020 (English)In: Ticks and Tick-borne Diseases, ISSN 1877-959X, E-ISSN 1877-9603, Vol. 11, no 1, article id UNSP 101303Article in journal (Refereed) Published
Abstract [en]

Despite the presence of several microorganisms, other than Borrelia burgdorferi sensu lato (Bbsl) and TBE virus, in Ixodes ricinus ticks from the Nordic countries, data is lacking on their pathogenic potential in humans. In this study, we wanted to investigate the aetiology and clinical manifestations of tick-transmitted infections in individuals seeking medical care following a tick-bite. The sampling frame was participants of a large-scale, prospective, multi-centre, follow-up study of tick-bitten volunteers recruited in Sweden, Finland and Norway in the years 2007-2015. Participants who sought medical care during the three-month follow-up period and from whom blood samples were collected during this healthcare visit (n=92) were tested, using PCR, for exposure to spotted fever group (SFG) Rickettsia spp., Anaplasma phagocytophilum and Babesia spp. Moreover, 86 of these individuals had two serum samples, collected three months apart, tested serologically for six tick-borne microorganisms. The selected organisms-Bbsl, SFG rickettsiae, Anaplasma phagocytophilum, TBE virus, Babesia microti and Bartonella henselae-have all been detected in field-collected ticks from the Nordic countries. Medical records were reviewed and questionnaires were completed to determine clinical manifestations. We found Lyme borreliosis to be the most common tick-transmitted infection as seen in 46 (54%) of the 86 participants with available medical records. Among the 86 participants with paired sera, serological or molecular evidence of recent exposure to other microorganisms than Bbsl could be demonstrated in eight (9%). Five participants (6%) exhibited serological evidence of recent concomitant exposure to more than one tick-borne microorganism. Clinical presentations were mild with one exception (TBE). In conclusion, our data suggest a low risk of infection with tick-borne microorganisms, other than Bbsl, in immunocompetent tick-bitten persons from the examined regions, a low occurrence of co-infection and mostly mild or no overt clinical signs of infection in immunocompetent persons exposed to the studied agents.

Place, publisher, year, edition, pages
ELSEVIER GMBH, 2020
Keywords
Tick-transmitted infections; Vector-borne infections; Public health; Emerging infections; Tick-borne pathogens; Co-infections
National Category
Infectious Medicine
Identifiers
urn:nbn:se:liu:diva-162487 (URN)10.1016/j.ttbdis.2019.101303 (DOI)000497952700007 ()31631052 (PubMedID)
Note

Funding Agencies|EUEuropean Union (EU) [20200422]; Swedish Research Council Branch of MedicineSwedish Research Council [K2008-58X-14631-06-3]; Medical Research Council of Southeast Sweden; County Council of Ostergotland [LIO-56191]; Independent Research Fund Denmark [8020-00344B]; Wilhelm and Else Stockmann Foundation; Foundation for Aland Medical Research of the Aland Culture Foundation

Available from: 2019-12-16 Created: 2019-12-16 Last updated: 2021-12-29
Gyllemark, P., Forsberg, P., Ernerudh, J. & Henningsson, A. J. (2017). Intrathecal Th17- and B cell-associated cytokine and chemokine responses in relation to clinical outcome in Lyme neuroborreliosis: a large retrospective study.. Journal of Neuroinflammation, 14(1)
Open this publication in new window or tab >>Intrathecal Th17- and B cell-associated cytokine and chemokine responses in relation to clinical outcome in Lyme neuroborreliosis: a large retrospective study.
2017 (English)In: Journal of Neuroinflammation, E-ISSN 1742-2094, Vol. 14, no 1Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: B cell immunity, including the chemokine CXCL13, has an established role in Lyme neuroborreliosis, and also, T helper (Th) 17 immunity, including IL-17A, has recently been implicated.

METHODS: We analysed a set of cytokines and chemokines associated with B cell and Th17 immunity in cerebrospinal fluid and serum from clinically well-characterized patients with definite Lyme neuroborreliosis (group 1, n = 49), defined by both cerebrospinal fluid pleocytosis and Borrelia-specific antibodies in cerebrospinal fluid and from two groups with possible Lyme neuroborreliosis, showing either pleocytosis (group 2, n = 14) or Borrelia-specific antibodies in cerebrospinal fluid (group 3, n = 14). A non-Lyme neuroborreliosis reference group consisted of 88 patients lacking pleocytosis and Borrelia-specific antibodies in serum and cerebrospinal fluid.

RESULTS: Cerebrospinal fluid levels of B cell-associated markers (CXCL13, APRIL and BAFF) were significantly elevated in groups 1, 2 and 3 compared with the reference group, except for BAFF, which was not elevated in group 3. Regarding Th17-associated markers (IL-17A, CXCL1 and CCL20), CCL20 in cerebrospinal fluid was significantly elevated in groups 1, 2 and 3 compared with the reference group, while IL-17A and CXCL1 were elevated in group 1. Patients with time of recovery <3 months had lower cerebrospinal fluid levels of IL-17A, APRIL and BAFF compared to patients with recovery >3 months.

CONCLUSIONS: By using a set of markers in addition to CXCL13 and IL-17A, we confirm that B cell- and Th17-associated immune responses are involved in Lyme neuroborreliosis pathogenesis with different patterns in subgroups. Furthermore, IL-17A, APRIL and BAFF may be associated with time to recovery after treatment.

National Category
Infectious Medicine
Identifiers
urn:nbn:se:liu:diva-134633 (URN)10.1186/s12974-017-0789-6 (DOI)000397149000001 ()28148307 (PubMedID)
Note

Funding agencies: Medical Research Council of Southeast Sweden (FORSS); Futurum-the Academy for Health and Care; Division of Medical Services, Region Jonkoping County; EU-Interreg project ScandTick Innovation

Available from: 2017-02-20 Created: 2017-02-20 Last updated: 2024-07-04
Wilhelmsson, P., Fryland, L., Lindblom, P., Sjöwall, J., Ahlm, C., Berglund, J., . . . Lindgren, P.-E. (2016). A prospective study on the incidence of Borrelia infection after a tick bite in Sweden and on the Åland Islands, Finland (2008-2009). Ticks and Tick-borne Diseases, 7(1), 71-79
Open this publication in new window or tab >>A prospective study on the incidence of Borrelia infection after a tick bite in Sweden and on the Åland Islands, Finland (2008-2009)
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2016 (English)In: Ticks and Tick-borne Diseases, ISSN 1877-959X, E-ISSN 1877-9603, Vol. 7, no 1, p. 71-79Article in journal (Refereed) Published
Abstract [en]

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 tick bite 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 three 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 assays and immunoblot.

Even though 28 % of the participants were bitten by a Borrelia-positive tick, only 7.5% (32/428) of them developed a Borrelia infection, half of them LB. 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 as well as gender 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.

Place, publisher, year, edition, pages
Elsevier, 2016
Keywords
Borrelia burgdorferi sensu lato; tick bite; incidence of infection; Lyme borreliosis; asymptomatic infection; bacterial load; tick-feeding.
National Category
Infectious Medicine
Identifiers
urn:nbn:se:liu:diva-105475 (URN)10.1016/j.ttbdis.2015.08.009 (DOI)000366953400012 ()
Note

Funding agencies: Swedish Research Council Branch of Medicine [K2008-58X-14631-06-3]; Medical Research Council of South-East Sweden [FORSS-8967, FORSS-12573, FORSS-29021, FORSS-86911]; EU Interreg IV A project ScandTick [167226]; County Council of Ostergotland [LIO-56191];

Available from: 2014-03-25 Created: 2014-03-25 Last updated: 2021-12-29Bibliographically approved
Johansson, J., Sahin, C., Pestoff, R., Ignatova, S., Forsberg, P., Edsjö, A., . . . Stenmark Askmalm, M. (2015). A Novel SMAD4 Mutation Causing Severe Juvenile Polyposis Syndrome with Protein Losing Enteropathy, Immunodeficiency, and Hereditary Haemorrhagic Telangiectasia.. Case Reports in Gastrointestinal Medicine, 2015, 1-5, Article ID 140616.
Open this publication in new window or tab >>A Novel SMAD4 Mutation Causing Severe Juvenile Polyposis Syndrome with Protein Losing Enteropathy, Immunodeficiency, and Hereditary Haemorrhagic Telangiectasia.
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2015 (English)In: Case Reports in Gastrointestinal Medicine, ISSN 2090-6528, E-ISSN 2090-6536, Vol. 2015, p. 1-5, article id 140616Article in journal (Refereed) Published
Abstract [en]

Juvenile polyposis syndrome (JPS) is a rare genetic disorder characterized by juvenile polyps of the gastrointestinal tract. We present a new pathogenic mutation of the SMAD4 gene and illustrate the need for a multidisciplinary health care approach to facilitate the correct diagnosis. The patient, a 47-year-old Caucasian woman, was diagnosed with anaemia at the age of 12. During the following 30 years, she developed numerous gastrointestinal polyps. The patient underwent several operations, and suffered chronic abdominal pain, malnutrition, and multiple infections. Screening of the SMAD4 gene revealed a novel, disease-causing mutation. In 2012, the patient suffered hypoalbuminemia and a large polyp in the small bowel was found. Gamma globulin was given but the patient responded with fever and influenza-like symptoms and refused more treatment. The patient underwent surgery in 2014 and made an uneventful recovery. At follow-up two months later albumin was 38 g/L and IgG was 6.9 g/L. Accurate diagnosis is essential for medical care. For patients with complex symptomatology, often with rare diseases, this is best provided by multidisciplinary teams including representatives from clinical genetics. Patients with a SMAD4 mutation should be followed up both for JPS and haemorrhagic hereditary telangiectasia and may develop protein loosing enteropathy and immunodeficiency.

National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:liu:diva-115933 (URN)10.1155/2015/140616 (DOI)25705527 (PubMedID)
Available from: 2015-03-24 Created: 2015-03-24 Last updated: 2025-02-11
Grankvist, A., Labbe Sandelin, L., Andersson, J., Fryland, L., Wilhelmsson, P., Lindgren, P.-E., . . . Wenneras, C. (2015). Infections with Candidatus Neoehrlichia mikurensis and Cytokine Responses in 2 Persons Bitten by Ticks, Sweden. Emerging Infectious Diseases, 21(8), 1462-1465
Open this publication in new window or tab >>Infections with Candidatus Neoehrlichia mikurensis and Cytokine Responses in 2 Persons Bitten by Ticks, Sweden
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2015 (English)In: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 21, no 8, p. 1462-1465Article in journal (Refereed) Published
Abstract [en]

The prevalence of Candidatus Neoehrlichia mikurensis infection was determined in 102 persons bitten by ticks in Sweden. Two infected women had erythematous rashes; 1 was co-infected with a Borrelia sp., and the other showed seroconversion for Anaplasma phagocytophilum. Both patients had increased levels of Neoehrlichia DNA and serum cytokines for several months.

Place, publisher, year, edition, pages
Centers for Disease Control and Prevention, 2015
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-120731 (URN)10.3201/eid2108.150060 (DOI)000358458300031 ()26197035 (PubMedID)
Note

Funding Agencies|ALF-Goteborg [71580]; Cancer and Allergy Foundation [149781]; Vastra Gotaland Region Research and Development [94510]; Laboratory Medicine at Sahlgrenska University Hospital [6333]; Medical Research Council of South-East Sweden [FORSS-297311, FORSS-307591, FORSS-87231]; Swedish Research Council/Medicine [2011-345]; ALF-Ostergotland

Available from: 2015-08-24 Created: 2015-08-24 Last updated: 2017-12-04
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