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A prospective study on the incidence of Borrelia infection after a tick bite in Sweden and on the Åland Islands, Finland (2008-2009)
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Health Sciences.
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 and Molecular Medicine.
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2016 (English)In: Ticks and Tick-borne Diseases, ISSN 1877-959X, E-ISSN 1877-9603, Vol. 7, no 1, 71-79 p.Article 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. Vol. 7, no 1, 71-79 p.
Keyword [en]
Borrelia burgdorferi sensu lato; tick bite; incidence of infection; Lyme borreliosis; asymptomatic infection; bacterial load; tick-feeding.
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:liu:diva-105475DOI: 10.1016/j.ttbdis.2015.08.009ISI: 000366953400012OAI: oai:DiVA.org:liu-105475DiVA: diva2:707590
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: 2017-05-03Bibliographically approved
In thesis
1. A STING from a Tick: Epidemiology, Ecology and Clinical Aspects of Lyme Borreliosis
Open this publication in new window or tab >>A STING from a Tick: Epidemiology, Ecology and Clinical Aspects of Lyme Borreliosis
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Lyme borreliosis (LB) is the most common tick-borne disease in the Northern Hemisphere and the number of LB cases is increasing. The infection is caused by spirochetes belonging to the Borrelia burgdorferi sensu lato complex, and is, in Europe, transmitted to humans by Ixodes ricinus ticks.

To gain a deeper knowledge of the interactions between ticks, humans and Borrelia bacteria, we investigated temporal differences in exposure to tick bites in different parts of Sweden and the Åland Islands, Finland during the years 2008 and 2009. We also investigated the site of tick attachment on the human body and the time it takes for a person to detected and remove such ticks. Furthermore, the distribution of Borrelia species and the number of Borrelia cells in the ticks were investigated. Sera taken from the tick-bitten persons at study inclusion were analyzed for the presence of Borrelia antibodies. Three months later, the clinical outcome and the serological response of the tick-bitten persons were investigated. A total of 2154 I. ricinus ticks and 1546 participants were included in the studies.

Participants were exposed to tick bites between April and November, but temporal and spatial differences in exposure to ticks was found. The majority of the tick bites were caused by nymphs (70%) and most tick bites took place on the legs (50%). The site of tick attachment on the body as well as the age and gender of the participant influenced how soon a tick was detected. The majority of participants removed “their” ticks later than 24 hours of attachment. Of all ticks, 26% was Borrelia-infected, but the prevalence varied between the life stages of the tick and between the studied areas. Six species of the B. burgdorferi sensu lato complex and one Borrelia species that may cause tick-borne relapsing fever were detected. Adult ticks that had fed more than 36 hours contained a lower number of Borrelia cells than adult ticks that had fed less than 36 hours. The seroprevalence among the participants varied between genders as well as between the studied areas. Of all participants, 2% was diagnosed with LB and 2.5% seroconverted without an LB diagnose. A correlation between seroconversion and duration time of tick attachment was found, but the number of Borrelia cells in the tick, did not explain the risk of infection for the bitten person.

A deeper knowledge and a better understanding of the interactions between ticks, humans and Borrelia bacteria may contribute reducing the risk for tick bites and the risk of developing LB after a tick bite.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2014. 130 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1385
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-105476 (URN)10.3384/diss.diva-105476 (DOI)978-91-7519-460-8 (ISBN)
Public defence
2014-04-24, Berzeliussalen, Campus US, Linköpings universitet, Linköping, 09:00 (English)
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Available from: 2014-03-25 Created: 2014-03-25 Last updated: 2014-04-04Bibliographically approved

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Wilhelmsson, PeterFryland, LindaLindblom, PontusSjöwall, JohannaBerglund, JohanEkerfelt, ChristinaForsberg, PiaLindgren, Per-Eric

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Wilhelmsson, PeterFryland, LindaLindblom, PontusSjöwall, JohannaBerglund, JohanEkerfelt, ChristinaForsberg, PiaLindgren, Per-Eric
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Division of Microbiology and Molecular MedicineFaculty of Health SciencesFaculty of Medicine and Health SciencesDepartment of Infectious DiseasesDivision of Inflammation MedicineDepartment of Infectious Diseases
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