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Emerging tick-borne pathogens in the Nordic countries: A clinical and laboratory follow-up study of high-risk tick-bitten individuals
Statens Serum Inst, Denmark; Rigshosp, Denmark.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology, Infection and Inflammation. Linköping University, Faculty of Medicine and Health Sciences. Cty Hosp Ryhov, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology, Infection and Inflammation. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Infectious Diseases.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology, Infection and Inflammation. Linköping University, Faculty of Medicine and Health Sciences. Cty Hosp Ryhov, Sweden.
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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. Vol. 11, no 1, article id UNSP 101303
Keywords [en]
Tick-transmitted infections; Vector-borne infections; Public health; Emerging infections; Tick-borne pathogens; Co-infections
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:liu:diva-162487DOI: 10.1016/j.ttbdis.2019.101303ISI: 000497952700007PubMedID: 31631052OAI: oai:DiVA.org:liu-162487DiVA, id: diva2:1379025
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: 2020-02-26

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Wilhelmsson, PeterSjöwall, JohannaJonsson Henningsson, AnnaForsberg, PiaLindgren, Per-Eric
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Division of Microbiology, Infection and InflammationFaculty of Medicine and Health SciencesDepartment of Infectious Diseases
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Ticks and Tick-borne Diseases
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