Actualización acerca de Borrelia burgdorferi sensu lato y enfermedad de Lyme / Update on Borrelia burgdorferi sensu lato and Lyme disease

Introducción: Borrelia burgdorferi sensu lato es el agente etiológico de la enfermedad de Lyme, zoonosis emergente de difícil diagnóstico, prevención y control, reportada fundamentalmente en el hemisferio norte. Objetivo: facilitar información actualizada acerca de Borrelia burgdorferi. Métodos: se realizó una revisión de la literatura científica y especializada sobre los principales aspectos relacionados con este agente y su enfermedad; como son las características de las borrelias y el ciclo de vida, epidemiología, manifestaciones clínicas en humanos, diagnóstico de laboratorio, definición actual de caso, tratamiento, profilaxis, prevención y control. Resultados: se expone información actualizada y valiosa sobre los temas seleccionados, útil para el personal interesado en las enfermedades infecciosas transmitidas por vectores. Se muestra además información sobre los estudios realizados en Cuba. Conclusiones: se aporta información de utilidad para el manejo epidemiológico, clínico y microbiológico de casos con sospechas de la infección por Borrelia burgdorferi sensu lato

Introduction: Borrelia burgdorferi sensu lato is the causative agent of Lyme disease, an emerging zoonosis, whose diagnosis, prevention and control are difficult and it is mainly reported in the northern hemisphere. Objective: to provide updated information about Borrelia burgdorferi. Methods: a review of scientific and specialized literature on the key aspects of this agent and the disease such as characteristics and life cycle of borrelias, epidemiology, clinical manifestations in humans, laboratory diagnosis, current case definition, treatment, prophylaxis, prevention and control. Results: current valuable information on selected items was set forth, which is useful for the personnel involved in vector-borne infectious diseases. Additionally, information about studies conducted in Cuba was provided. Conclusions: this paper offers updated information for the epidemiological, clinical and microbiological management of suspected cases of infection with Borrelia burgdorferi sensu lato

Profile of patients with Baggio-Yoshinari Syndrome admitted at "Instituto de Infectologia Emilio Ribas" / Perfil dos pacientes com Síndrome Baggio-Yoshinari admitidos no "Instituto de Infectologia Emilio Ribas"

The aim of this study was to evaluate the epidemiological, clinical and laboratorial profile of patients with Baggio-Yoshinari Syndrome (BYS), who underwent internment at the Instituto de Infectologia Emilio Ribas in São Paulo, Brazil, during the period from July 1990 to July 2006. BYS is a new Brazilian tick-borne disease caused by Borrelia burgdorferi sensu lato microorganisms that resembles features of Lyme disease (LD), except for its epidemiological, clinical and laboratorial particularities. From 60 patients' records with positive serology to B. burgdorferi done by ELISA and Western-blotting methods, 19 cases were diagnosed as having BYS, according to criteria adopted at LIM-17 HCFMUSP, the Brazilian Reference Laboratory for the research of BYS. The other 41 remaining patients displayed miscellaneous infections or auto-immune processes. The beginning of symptoms in BYS group varied from one day to six years, from the onset of the disease. Four of 19 patients were included in acute disease stage, and 15 in latent. General unspecific symptoms were identified in almost all cases, with high frequencies of fever (78.9 percent) and lymphadenomegaly (36.8 percent). Six patients had skin lesions (31.5 percent); six arthralgia or arthritis (31.5 percent) and eight neurological symptoms (42 percent). Interestingly, two patients showed antibodies directed to B. burgdorferi exclusively in cerebrospinal fluid. Since BYS is a new emergent Brazilian zoonosis and its diagnosis is sometimes complex, all the new knowledge about BYS must be scattered to Brazilian Medical specialists, aiming to teach them how to diagnose this amazing tick-borne disease and to avoid its progression to chronic irreversible sequels.

O objetivo do estudo foi avaliar o perfil epidemiológico, clínico e laboratorial dos pacientes com Síndrome Baggio-Yoshinari (SBY), internados no Instituto de Infectologia Emilio Ribas, São Paulo, Brasil, no período de julho de 1990 a julho de 2006. SBY é uma nova doença transmitida por carrapatos, causada pela Borrelia burgdorferi sensu lato, que se assemelha a Doença de Lyme (DL), exceto pelas particularidades epidemiológicas, clínicas e laboratoriais. A partir dos registros de 60 pacientes com sorologia positiva para B. burgdorferi pelos métodos de ELISA e Western-blotting, 19 casos foram diagnosticados como SBY, de acordo com critérios adotados pelo LIM-17 HCFMUSP, laboratório de referência para a pesquisa de SBY no Brasil. Os outros 41 pacientes restantes foram classificados como tendo infecções diversas ou processos auto-imunes. O início dos sintomas no grupo SBY variou de um dia a seis anos. Quatro dos 19 pacientes foram incluídos na fase aguda da doença e 15 na fase latente. Os sintomas gerais inespecíficos foram identificados em quase todos os casos, com altas freqüências de febre (78,9 por cento) e linfoadenomegalia (36,8 por cento). Seis pacientes tiveram lesões de pele (31,5 por cento); seis artralgia ou artrite (31,5 por cento) e oito sintomas neurológicos (42 por cento). Curiosamente, dois pacientes apresentaram anticorpos para B. burgdorferi exclusivamente no líquido cefalorraquidiano. Uma vez que a SBY é uma zoonose emergente brasileira e seu diagnóstico é complexo, todo o conhecimento novo sobre SBY deve ser difundido para os médicos brasileiros, com o objetivo de ensiná-los a diagnosticar esta surpreendente doença transmitida por carrapatos, evitando-se a sua progressão para sequelas crônicas irreversíveis.

Borrelia recurrentis as a cause of high grade fever in Rawalakot, Azad Kashmir

A descriptive study was conducted at Combined Military Hospital Rawalakot, Azad Kashmir to determine the frequency of Borrelia recurrentis. Both out door and indoor cases were included. A total of 80 febrile patients with temperature above 1000C were studied. Cases showing any other cause of fever on routine / available tests were excluded. Borrelia recurrentis was sought by Giemsa stain. All positive cases were treated with Doxycycline. Nine cases were positive [11.25%]. Treatment response was 100%. Borrelia recurrentis is found in a significant number of febrile cases at Rawalakot Azad Kashmir

Seasonal abundance of Ornithodoros [O.] Savignyi and prevalence of infection with borrelia spirochetes in Egypt

The seasonal dynamics of Ornithodoros [O.] savignyi and infection with Borrelia sp. in tick, domestic animals and man were investigated. The tick population densities of adults and immatures were high during the period from June to October with maximum levels in August and September, respectively. Adults predominated [58.6% - 80.0%] in October to May with the highest abundance in January, while immatures prevailed [51.3% - 65.8%] during the rest of the year reaching a peak in September. Of 1202 tick examined, the spirochetes were detected in 427. The annual infection rate in adults and immatures varied from 34.4% to 36.9% with no significant difference among larvae, nymphs, males and females. Of 1396 sera from man and 553 sera from host animals tested; 309 and 157, respectively, were reactive for antibody to Borrelia sp. Antigen with the highest infection rate in camel [47.8%], followed by sheep [23.8%], goat [18.0%] and cow [16.0%], then the least in buffalo [10.9%]. Changes in prevalence of Borrelia infection in the tick population correlated positively with changes in antibody prevalence in man and camel and with changes in tick population density

Borreliosis en las alturas del Perú / Borreliosis in high altitude in Peru

Realizamos un estudio Clínico-epidemiológico en base a 60 pacientes que presentaron Fiebre Recurrente, en comunidades que viven por encima de los 3,800 mts. s.n.m.; donde el bajo nivel socioeconómico, cultural y los malos hábitos higiénicos permitieron la infestación por Pediculus humanus, siendo éste el principal vector de la Borrelia Recurrentis. Comprobamos que la población más afectada fue la infantil (75%), de mayor incidencia en el sexo femenino (73%); la forma de contagio más frecuente en el sexo femenino fue la ingesta de pediculos (68%) y en el masculino el aplastamiento de estos (62.5%). El síntoma más constante es la Fiebe Recurrente (100%), seguido de cefaleas (51%), mialgias, el exantema sólo pudo observarse en el 12%. Para verificar el diagnóstico etiológico se hizo frotis sanguíneo colorado con solución de Wright con la técnica conocida, encontrándose en el 60% de los casos la presencia de Borrelia recurrentis