Aetiology of Tick-Borne Infections in an Adult Swedish Population: are Co-Infections with Multiple Agents Common?
(English)Manuscript (preprint) (Other academic)
In Scandinavia, tick-borne infections affecting humans include Lyme borreliosis (LB), tickborne encephalitis (TBE) and human granulocytic anaplasmosis (HGA). Each of these infections can present with unspecific symptoms. In this prospective clinical study, we recruited patients based on two independent inclusion criteria; 1) patients with unspecific symptoms, i.e. fever (e38.0°C) or a history of feverishness and/or any combination of headache, myalgia or arthralgia and 2) patients with erythema migrans (EM). A total of 206 patients fulfilled the study. Among these, we could identify 186 cases of LB (174 with EM), 18 confirmed and two probable cases of HGA and two cases of TBE. Thirteen of the HGA cases presented without fever. Furthermore, 22 of the EM patients had a sub-clinical coinfection with Anaplasma phagocytophilum, based on serology. Both TBE cases had coinfections, one with Borrelia burgdorferi and one with Anaplasma phagocytophilum. We conclude that it is important to consider several causative agents and possible co-infections in the clinical management of infectious diseases where ticks may be suspected as vectors.
Epidemiology, Tick-borne infections, Tick-borne encephalitis, Lyme borreliosis, Human granulocytic anaplasmosis
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-80257OAI: oai:DiVA.org:liu-80257DiVA: diva2:546325