Enfermedad de Lyme: a propósito de un caso clínico importado / Lyme disease: about an imported case report

Resumen Presentamos el caso clínico de una mujer norteamericana que consultó en nuestro país por un eritema migrans múltiple, diagnosticándose una enfermedad de Lyme. Este cuadro infeccioso es causado por espiroquetas del complejo Borrelia burgdorferi sensu lato (Bbsl) y es transmitido por la mordedura de garrapatas. Tradicionalmente Bbsl había sido detectada en garrapatas sólo en el hemisferio norte. Sin embargo, desde el 2013 ha habido reportes en Sudamérica. En Chile, recientemente se describió Borrelia chilensis, la cual no tiene una enfermedad asociada en humanos. Se discuten aspectos del agente infeccioso, su epidemiología, sus vectores y nuevos hallazgos en Sudamérica. Además, se plantean los criterios diagnósticos clínicos, de laboratorio y tratamiento, de acuerdo a la etapa en su historia natural.

This is a case report of an american woman who consulted in our country for multiple erythema migrans, from which a Lyme disease was diagnosed. This infectious disease is caused by spirochetes from the Borrelia burgdorferi sensu lato complex (Bbsl) and is transmitted by the bite of ticks. Traditionally Bbsl had been detected in ticks only in the Northern Hemisphere. However, since 2013 there have been reports in South America. In Chile, Borrelia chilensis was recently described, which does not have an associated disease in humans. Aspects of the infectious agent, its epidemiology, its vectors and new findings in South America are discussed. Likewise, the clinical diagnostic criteria, laboratory and appropriate treatment are proposed, according to the stage in their natural history.

Brazilian borreliosis with special emphasis on humans and horses

Abstract Borreliosis caused by Borrelia burgdorferi sensu lato is a cosmopolitan zoonosis studied worldwide; it is called Lyme disease in many countries of the Northern Hemisphere and Lyme-like or Baggio-Yoshinari Syndrome in Brazil. However, despite the increasing number of suspect cases, this disease is still neglected in Brazil by the medical and veterinary communities. Brazilian Lyme-like borreliosis likely involves capybaras as reservoirs and Amblyomma and Rhipicephalus ticks as vectors. Thus, domestic animals can serve as key carriers in pathogen dissemination. This zoonosis has been little studied in horses in Brazil. The first survey was performed in the state of Rio de Janeiro, and this Brazilian Borreliosis exhibits many differences from the disease widely described in the Northern Hemisphere. The etiological agent shows different morphological and genetic characteristics, the disease has a higher recurrence rate after treatment with antibiotics, and the pathogen stimulates intense symptoms such as a broader immune response in humans. Additionally, the Brazilian zoonosis is not transmitted by the Ixodes ricinus complex. With respect to clinical manifestations, Baggio-Yoshinari Syndrome has been reported to cause neurological, cardiac, ophthalmic, muscle, and joint alterations in humans. These symptoms can possibly occur in horses. Here, we present a current panel of studies involving the disease in humans and equines, particularly in Brazil.

Seroprevalence of Borrelia burgdorferi in occupationally exposed persons in the Belgrade area, Serbia

Lyme disease (LD) is a natural focal zoonotic disease caused by Borrelia burgdorferi, which is mainly transmitted through infected Ixodes ricinus tick bites. The presence and abundance of ticks in various habitats, the infectivity rate, as well as prolonged human exposure to ticks are factors that may affect the infection risk as well as the incidence of LD. In recent years, 20% to 25% of ticks infected with different borrelial species, as well as about 5,300 citizens with LD, have been registered in the Belgrade area. Many of the patients reported tick bites in city’s grassy areas. The aim of this study was to assess the seroprevalence of B. burgdorferi in high-risk groups (forestry workers and soldiers) in the Belgrade area, and to compare the results with healthy blood donors. A two-step algorithm consisting of ELISA and Western blot tests was used in the study. Immunoreactivity profiles were also compared between the groups. The results obtained showed the seroprevalence to be 11.76% in the group of forestry workers, 17.14% in the group of soldiers infected by tick bites and 8.57% in the population of healthy blood donors. The highest IgM reactivity was detected against the OspC protein, while IgG antibodies showed high reactivity against VlsE, p19, p41, OspC, OspA and p17. Further investigations in this field are necessary in humans and animals in order to improve protective and preventive measures against LD.

Prevalence of antibodies to Borrelia burgdorferi sensu stricto in humans from a Cuban village

Lyme disease has not been officially reported in Cuba. However, clinical cases have been serologically reported. Seroprevalence survey of Borrelia burgdorferi sensu stricto antibodies in humans in the country has not been conducted. OBJECTIVE: To estimate the prevalence of borrelial antibodies in inhabitants of a village with historically high level of tick infestation. METHODS: Serum specimens from 247 persons randomly selected from the population of the village were examined by IgG Western blot using B31 strain for estimating the prevalence of antibodies profile. RESULTS: A seroprevalence value interval (95 percent CI) of 0.6 percent-7.2 percent was estimated for the studied population. The prevalent borrelial protein bands on immunoblots were 41, 72, 90/93, 34, 47, 60, 58, 56, 65/66 and 31 kDa in a decreasing order of significance. CONCLUSION: These results support the previous serological findings, suggesting the presence of this borreliosis in Cuba.

Detection of anti-Borrelia burgdorferi antibodies in buffaloes (Bubalus bubalis) in the state of Pará, Brazil / Detecção de anticorpos anti-Borrelia burgdorferi em búfalos (Bubalus bubalis) no estado do Pará, Brasil

This study aimed to investigate the frequency of homologous antibodies of IgG class against Borrelia burgdorferi in buffaloes in the state of Pará, Brazil. Blood serum samples from 491 buffaloes were analyzed by means of the indirect ELISA test, using crude antigen produced from a cultivar of the North American strain G39/40 of B. burgdorferi. There were 412 positive samples (83.91%), and there was no statistically significant difference in the proportions of positive animals between the 81.69% (232/284) originating from Marajó Island and the 86.96% (180/207) from the continental area of the state of Pará. In all the municipalities studied, the frequency of positive findings of antibodies against B. burgdorferi among the animals ranged from 63.6% to 92.9%. The high numbers of seropositive animals can be explained by the frequent presence of the tick Rhipicephalus (Boophilus)microplus, and by the possible existence of spirochetes of the genus Borrelia infecting buffaloes in the region studied, although specific studies are needed to confirm this relationship. These factors suggest that a cross-reaction exists between the North American strain G39/40 of B. burgdorferi, which is used as an antigenic substrate, and the species of Borrelia spp. that possibly infects buffaloes in the state of Pará.

Este estudo teve como objetivo investigar a frequência de anticorpos homólogos da classe IgG contra Borrelia burgdorferi em búfalos do estado do Pará. Amostras de soro de 491 búfalos foram analisadas por meio do teste ELISA indireto, utilizando antígeno bruto produzido a partir do cultivo da cepa norte americana G39/40 de B. burgdorferi. Foram encontrados 412 soros positivos (83,91%), não havendo diferença estatística significativa entre os 81,69% (232/284) animais positivos provenientes da Ilha de Marajó e os 86,96% (180/207) da base continental do estado do Pará. Em todos os municípios estudados os animais apresentaram frequência de anticorpos contra B. burgdorferi, com positividade variando de 63,6% a 92,9%. O alto número de soropositivos pode ser explicado pela frequente presença do carrapato Rhipicephalus (Boophilus) microplus e pela possível existência de espiroquetas do gênero Borrelia infectando búfalo na região estudada, embora novos estudos sejam necessários para a confirmação desta relação. Estes fatos sugerem reação cruzada entre a cepa americana G39/40 de B. burgdorferi utilizada como substrato antigênico e a espécie de Borrelia spp. que possivelmente infecta bubalinos no estado do Pará.

Seroprevalencia de Borreliosis, o Enfermedad de Lyme, en una Población Rural Expuesta de Córdoba, Colombia / Seroprevalence of Lyme borreliosis in workers from Cordoba, Colombia

Objetivo El objetivo de este estudio fue el de establecer la seroprevalencia de enfermedad de Lyme en trabajadores del agro. Material y métodos La población la constituyeron 152 sujetos de los municipios de Montería, Cereté, Lorica y Cotorra, del Departamento de Córdoba, Colombia. La presencia de anticuerpos IgG específicos anti-Borrelia burgdorferi se estableció por ELISA y confirmados por Western blot. RPR (rapid plasma reagin) para Treponema pallidum (sífilis) y ELISA para leptospirosis IgM se utilizo para descartar reacciones cruzadas. Resultados Por ELISA se detectaron 30 (20 por ciento) sueros con anticuerpos IgG para Borrelia. Los 30 sueros fueron RPR negativos. Por Western Blot se escogieron al azar 25 sueros positivos, siete se confirmaron como positivos para Borrelia burgdorferi, seroprevalencia del 4,6 por ciento. Conclusión La seroprevalencia sugiere infección por B. burgdorferi en la población estudiada. Se deben realizar futuros estudios clínicos, serológicos y sobre todo ecológicos que determinen la presencia de Borrelia burgdorferi en las garrapatas de nuestras regiónes.

Objective Establishing the seroprevalence of Lyme disease in workers from Cordoba. Material and methods Representative serum samples (152) were taken from the cities of Montería, Cereté, Lorica and Cotorra in the Córdoba department in Colombia. Borrelia burgdorferi antibodies were detected by ELISA and confirmed by western blot anti-Borrelia blot assay. RPR (rapid plasma regain) test for Treponema pallidum (syphilis) and ELISA for leptospirosis IgM were carried out to discard cross-reactivity. Results A total of 152 serum samples were tested; 30 (20 percent) were positive by ELISA. The 30 positive sera were RPR negative. Seven sera were confirmed by western blot; seroprevalence was 4.6 percent. Reactivity against p41, p58, p75, OspA, p30, OspC, p17, VLsE and p83/100 were detected. Conclusions Our results revealed antigenic evidence of Borrelia in the rural area of Cordoba. Identifying clinical, ecological and serological cases, linked to searching for Borrelia burgdorferi in infected tick vectors must be carried out in rural parts of Colombia.

Características clínico-epidemiológicas da doença Lyme-símile em crianças / Epidemiological characteristics of Lyme-like disease in children

OBJETIVO: Determinar a prevalência, distribuição etária, sazonalidade, características clínicas da doença Lyme-símile em menores de 15 anos. MÉTODOS: De julho/1998 a dezembro/2000 foi conduzido um estudo transversal em 333 pacientes, com exantema e febre. Foram coletadas amostras pareadas de sangue para a identificação de patógenos. Somente em 193 amostras, negativas aos outros patógenos (Parvovirus B19, Herpesvírus 6 humano, Sarampo, Rubéola, Dengue, Escarlatina e Enterovírus), foram realizadas a pesquisa da borreliose pelos métodos de Enzyme-Linked Immunosorbent Assay e Western-blotting. Outras variáveis clínicas, socioeconômicas, demográficas e climáticas foram estudadas. RESULTADOS: A prevalência da doença foi de 6,2 por cento(12/193). Das variáveis estudadas, houve predomínio em <6anos(83,2 por cento); sexo feminino (66,7 por cento); procedência da cidade de Franco da Rocha (58,3 por cento); com sazonalidade no outono-verão. O intervalo de atendimento foi de quatro dias. Sinais e sintomas com significância estatística: prurido, ausência da fissura labial e bom estado clínico. Outros dados presentes foram: irritabilidade (80 por cento); febre (?38ºC) (58,3 por cento) com duração de um a três dias. O exantema foi do tipo máculo-papular (33,3 por cento), urticariforme (25 por cento) e escarlatiniforme (16,7 por cento); predominando em tronco (60 por cento). Não houve apresentação clínica característica para diagnóstico da doença de Lyme-símile nestes pacientes. A sensibilidade e especificidade para o diagnóstico clínico contraposta com o diagnóstico laboratorial foi zero. O acompanhamento de 10 casos durante dois anos não evidenciou complicações cardiológicas ou neurológicas. Este é o primeiro estudo desta doença em crianças brasileiras. CONCLUSÃO: A prevalência da doença Lyme-símile foi baixa, não tendo sido lembrada no diagnóstico inicial dos exantemas, mas seu conhecimento é necessário, necessitando maior atenção médica.

BACKGROUND: To determine the prevalence, age distribution, seasonality and clinical characteristics of Lyme-simile disease in Brazilians less than 15 years of age. METHODS. From July, 1998 to November, 2000, a cross-sectional study was conducted in 333 patients with skin rash and fever. Paired blood samples were collected for identification of the pathogens. Only 193 samples which were negative for other pathogens (Parvovirus B19 Human, Herpesvirus 6 Human, Measles, Rubella, Dengue, Scarlet fever and Enterovirus), were tested for borreliosis by Enzyme-Linked Immunosorbent Assay and Western-blotting. Other clinical, socioeconomic, demographic and climatic variables were studied. RESULTS: Prevalence of the disease was 6.2 percent(12/193). Of the variables studied, there was predominance in: <6 years old (83.2 percent); females (66.7 percent); being from the city of Franco da Rocha (58.3 percent); and a summer/fall seasonality. The duration of care was 4 days. Signs and symptoms with statistical significance were itching; absence of lip notch and ocular pain; irritability and good clinical condition. Other clinical data presented were: pruritus (90 percent), irritability (80 percent) and fever (?38ºC) (58.3 percent) with a duration of 1 to 3 days. Erythema was maculo-papular (40 percent), urticaria-like (25 percent) and scarlatiniform (16.7 percent), occurring predominately on the trunk (60 percent). There were no primary clinical evidences of Lyme-simile disease in the patients under study. The sensitivity and specificity of the clinical diagnosis as opposed to the laboratory diagnosis was zero. There was no initial clinical suspicion of the disease in the 10 cases studied and followed up for two years that showed no evidence of cardiologic or neurological complications. This is the first study of Lyme-simile in Brazilian children. CONCLUSION: Prevalence of Lyme-simile disease was low, and it was not remembered at the initial diagnosis ...

Frequency of antibodies to Babesia bigemina, B. bovis, Anaplasma marginale, Trypanosoma vivax and Borrelia burdgorferi in cattle from the northeastern region of the state of Pará, Brazil / Freqüência de anticorpos para Babesia bigemina, B. bovis, Anaplasma marginale, Trypanosoma vivax e Borrelia burgdorferi em bovinos do nordeste do Estado do Pará, Brasil

Babesiosis, anaplasmosis, and trypanosomosis are relevant diseases, potentially causing morbidity in cattle, leading to economic losses. Borreliosis is import as a potential zoonosis. The objective of this study was to determine, by indirect enzyme-linked immunosorbent assay (ELISA), the frequency of seropositive cattle to Babesia bigemina, B. bovis, Anaplasma marginale, Trypanosoma vivax and Borrelia burgdorferi in cattle from the Northeastern region of Pará, Brazil. Sera samples from 246 female adult cattle from municipalities of Castanhal and São Miguel do Guamá were used. Crude antigens ELISAs were used to detect antibodies to all agents, except to A. marginale, to which an indirect ELISA with recombinant major surface 1a protein (MSP1a) antigen was used. Overall frequencies of seropositive animals were: B. bigemina - 99.2 percent; B. bovis - 98.8 percent; A. marginale - 68.3 percent; T. vivax - 93.1 percent and B. burgdorferi - 54.9 percent. The frequencies of seropositive cattle to B. bovis and B. bigemina suggest a high rate of transmission of these organisms by tick in the studied region, which can be classified as enzootically stable to these hemoprotozoans. The low frequency of seropositive cattle to A. marginale may be attributed to a lower sensitivity of the recombinant antigen ELISA utilized or a distinct rate of inoculation of this rickettsia by ticks, as compared with Babesia sp. transmission. The high frequency of seropositive cattle to T. vivax indicates that this hemoprotozoan is prevalent in herds from the Northeastern region of Pará. The rate of animal that showed homologues antibodies to B. burgdorferi indicates the presence of the tickborne spirochaetal agent in the cattle population in the studied region.

A babesiose, a anaplasmose e a tripanossomose são enfermidades relevantes, potencialmente causadoras de morbidade em bovinos, levando a perdas econômicas. A borreliose assume importância como zoonose potencial. O objetivo desse estudo foi determinar, por meio do ensaio de imunoadsorção enzimática (ELISA), a freqüência de anticorpos para Babesia bigemina, B. bovis, Anaplasma marginale, Trypanosoma vivax e Borrelia burgdorferi em bovinos da região nordeste do Estado do Pará, Brasil. Amostras de soro de 246 vacas dos municípios de Castanhal e São Miguel do Guamá foram usadas. ELISAs com antígeno bruto foram utilizados para detector anticorpos contra todos os agentes, exceto para A. marginale, para o qual um ELISA indireto com proteína principal de superfície 1a (MSP1a) foi usado. As freqüências de bovinos soropositivos foram: B. bigemina - 99,2 por cento; B. bovis - 98,8 por cento; A. marginale - 68,3 por cento; T. vivax - 93,1 por cento and B. burgdorferi -54,9 por cento As freqüências de bovinos soropositivos para B. bovis e B. bigemina sugerem uma alta taxa de transmissão desses organismos por carrapatos, na região estudada, a qual pode ser classificada com sendo de estabilidade enzoótica para os hemoparasitos. A baixa freqüência de bovinos soropositivos para A. marginale pode ser atribuída a uma menor sensibilidade do ELISA com antígeno recombinante, ou uma menor taxa de inoculação da riquétsia pelos carrapatos, quando comparada àquelas observadas para Babesia sp. A alta freqüência de bovinos soropositivos para T. vivax indica que esse hemoprotozoário é prevalente em rebanhos do nordeste do Estado do Pará. O percentual de animais com anticorpos homólogos para B. burgdorferi indica a presenças deste espiroquetídeo transmitido por carrapatos na população de bovinos da região estudada.

Freqüência de anticorpos anti-Erhlichia canis, Borrelia burgdorferi e antígenos de Dirofilaria immitis em cães na microrregião Ilhéus-Itabuna, Bahia, Brasil / Frequency of antibodies anti-Ehrlichia canis, Borrelia burgdorferi and Dirofilaria immitis antigens in dogs from microrregion Ilhéus-Itabuna, State of Bahia, Brazil

Para avaliação de positividade para antígenos de Dirofilaria immitis, anticorpos anti-Borrelia burgdorferi e anti-Ehrlichia canis foram coletadas 200 amostras de sangue de cães, 100 no município de Ilhéus e 100 no de Itabuna. Foi utilizado o "kit" Snap 3DX (IDEXX Laboratories) para realização das sorologias. Não se observou nenhum animal positivo para antígenos de D. immitis. Apenas dois dos cães estavam positivos para anticorpos anti-B. burgdorferi. Do total de amostras analisadas, 72 (36 por cento) estavam positivas para anticorpos anti-E. canis, sendo 43 em Ilhéus e 29 em Itabuna (p=0,027).

In order to detect the positivity to antigens of Dirofilaria immitis, antibodies anti-Borrelia burgdorferi and anti-Ehrlichia canis, 200 canine blood samples were collected as followed: 100 from the municipality of Ilhéus and 100 from Itabuna, State of Bahia. The kit Snap 3DX (IDEXX Laboratories) was used to performe serology. None of the tested animals were positive for antigens of D. immitis. Only two dogs of them were positive for antibodies anti-B. burgdorferi. From all the samples analyzed, 72 (36 percent) were positive for antibodies anti-E. canis, 43 from Ilhéus and 29 from Itabuna (p=0,027).

Description of Lyme disease-like syndrome in Brazil: is it a new tick borne disease or Lyme disease variation?

An emerging clinical entity that reproduces clinical manifestations similar to those observed in Lyme disease (LD) has been recently under discussion in Brazil. Due to etiological and laboratory particularities it is named LD-like syndrome or LD imitator syndrome. The condition is considered to be a zoonosis transmitted by ticks of the genus Amblyomma, possibly caused by interaction of multiple fastidious microorganisms originating a protean clinical picture, including neurological, osteoarticular and erythema migrans-like lesions. When peripheral blood of patients with LD-like syndrome is viewed under a dark-field microscope, mobile uncultivable spirochete-like bacteria are observed. PCR carried out with specific or conservative primers to recognize Borrelia burgdorferi sensu stricto or the genus Borrelia has been negative in ticks and in biological samples. Two different procedures, respectively involving hematoxylin and eosin staining of cerebrospinal fluid and electron microscopy analysis of blood, have revealed spirochetes not belonging to the genera Borrelia, Leptospira or Treponema. Surprisingly, co-infection with microorganisms resembling Mycoplasma and Chlamydia was observed on one occasion by electron microscopy analysis. We discuss here the possible existence of a new tick-borne disease in Brazil imitating LD, except for a higher frequency of recurrence episodes observed along prolonged clinical follow-up.

Freqüência de anticorpos contra Borrelia burgdorferi em cães na região metropolitana do Rio de Janeiro / Frequency of antibodies against Borrelia burgdorferi in dogs from the metropolitan region of Rio de Janeiro

Borreliose de Lyme é uma zoonose cosmopolita causada pelo espiroquetídeo Borrelia burgdorferi e tem como vetores carrapatos ixodídeos. Esta espiroqueta acomete diversas espécies de animais domésticos e silvestres, sendo o cão um importante reservatório no ambiente domiciliar. O quadro clínico da doença envolve as articulações, além de causar alterações em vários sistemas do organismo. Foram analisados 143 soros de cães provenientes dos municípios de Seropédica, Itaguaí e do Rio de Janeiro, Estado do Rio de Janeiro, quanto à ocorrência de anticorpos contra B. burgdorferi latu sensu, através de teste de ELISA indireto. Foram encontrados 48,25 por cento de animais soropositivos, sendo 41,9 por cento em Seropédica, 4,9 por cento em Itaguaí e 1,4 por cento no Rio de Janeiro. Os títulos variaram de 1:400 a 1:6400. Cães com menos de um ano apresentaram menor índice de títulos positivos, sendo a diferença significativa. Entre machos e fêmeas, não houve diferença significativa entre os títulos positivos. O resultado encontrado deve servir como alerta para ocorrência de Borrelia sp nas regiões estudadas, considerando a importância da borreliose de Lyme como zoonose emergente.

Estudio seroepidemiológico de borreliosis de Lyme en la Ciudad de México y el noreste de la República Mexicana / Seroepidemiologic survey of Lyme Borreliosis in Mexico City and the Northeast region of the country

OBJETIVO: Investigar mediante métodos serológicos la infección por B burgdorferi en individuos del Distrito Federal y la zona noreste de México. MATERIAL Y MÉTODOS: Se obtuvo una muestra representativa de sueros del Distrito Federal y la zona noreste de México, obtenidas en la Encuesta Seroepidemiológica Nacional de 1987-1988. Se detectaron anticuerpos IgG vs B burgdorferi por ELISA, confirmados con Western blot. En este trabajo se utilizó estadística descriptiva. RESULTADOS: Fueron estudiados 2 346 sueros; 297 (12.6 por ciento) fueron positivos por inmunoensayo enzimático, y 122/297 fueron confirmados por Western blot. La seroprevalencia fue de 3.43 por ciento en el Distrito Federal y 6.2 por ciento en la zona noreste del país. Tamaulipas fue el estado con la seroprevalencia más alta. CONCLUSIONES: La prevalencia de casos seropositivos sugieren que la infección por B burgdorferi ocurre en el noreste de México y el Distrito Federal. Es necesario identificar casos clínicos y buscar el vector infectado para confirmar la presencia de la enfermedad de Lyme en México

Positive IgG Western Blot for Borrelia burgdorferi in Colombia

In order to evaluate the presence of specific IgG antibodies to Borrelia burgdorferi in patients with clinical manifestations associated with Lyme borreliosis in Cali, Colombia, 20 serum samples from patients with dermatologic signs, one cerebrospinal fluid (CSF) sample from a patient with chronic neurologic and arthritic manifestations, and twelve serum samples from individuals without clinical signs associated with Lyme borreliosis were analyzed by IgG Western blot. The results were interpreted following the recommendations of the Centers for Diseases Control and Prevention (CDC) for IgG Western blots. Four samples fulfilled the CDC criteria: two serum specimens from patients with morphea (localized scleroderma), the CSF from the patient with neurologic and arthritic manifestations, and one of the controls. Interpretation of positive serology for Lyme disease in non-endemic countries must be cautious. However these results suggest that the putative "Lyme-like" disease may correlate with positivity on Western blots, thus raising the possibility that a spirochete genospecies distinct from B. burgdorferi sensu stricto, or a Borrelia species other than B. burgdorferi sensu lato is the causative agent. Future work will focus on a survey of the local tick and rodent population for evidence of spirochete species that could be incriminated as the etiologic agent

Selorogic evidences suggesting the presence of borrelia burgdorferi infection in Mexico

Background. Lyme disease is the most common vector-borne Human disease in Europe and the United States. In Mexico, clinical cases suggestive of lyme borreliosis have been reported; however, infection was not confirmed by serologic or microbiologic tests. Methods. To study the prevalence of IgG antibodies againts Borrelia burgdorferi among Mexican persons, a community-based sero-survery including all states of Mexico was done. A sample of 2,890 sera representing individuals of all ages and all socioeconomic levels was studied. Antibodies ati-B. burgdorferi were determined by enzyme-linked immunosorbent assay (ELISA) using a whole-cell sonicated extract of B. burgdorferi strain B31. Serum specimens positive for ELISA were further studied by Western blot (WB). A serum sample was considered positive by WB if at least three of the following protein bands were recognized: 18, 24, 28, 31, 34, 39, 41, 45, 58, 62, 66, and 93 KDa. Some WB positive specimens were futher confirmed with an inmmunodot-blot (IDB) test using recombinant and purified B. burgdorferi proteins. Results. Of the 2,890 specimens, 34 were positive for ELISA; nine of these 34 were confirmed as positive by WB. Four of the nine WB positive sera were testd by IDB and all four were positive. The prevalence of WB confirmed cases in the sample studied was 0.3 percent. Positive specimens were from residents of the northeastern and central areas of Mexico. Conclusions. the resological evidences of this study suggest that Borrelia burgdorferi infection is present in the Mexican population. This finding should be confirmed by documenting the infection in clinical cases and in tick vectors

Doenca de Lyme em Mato Grosso do Sul: relato de tres casos clinicos, incluindo o primeiro caso de meningite de Lyme no Brasil / Lyme disease in Mato Grosso do Sul State, Brazil: report of three clinical cases, including the first of Lyme meningitis in Brazil

Os autores relatam a ocorrencia dos tres primeiros casos clinicos da Doenca de Lyme no Estado de Mato Grosso do Sul, incluindo o primeiro caso de meningite de Lyme no Brasil, identificados por criterios clinicos e labopratoriais. A pesquisa de anticorpos anti-Borrelia burgdorferi foi realizada atraves das tecnicas de ELISA e de Western Blotting, sendo que pela primeira tecnica apenas anticorpo da classe IgG foi identificado em um unico caso. Atraves do imunoblotting, encontrou-se no soro: cinco bandas para IgG e duas para IgM no primeiro caso; sete bandas para IgG e duas bandas para IgM no segundo caso; e no terceiro caso, cinco bandas para IgG e seis para IgM...

Does lyme disease exist in the Gulf region? preliminiary serologic evidence of exposure to borrelia burgdorferi in Saudi Arabia

One hundred and sixty four patients with various underlying diseases were screened for the presence of antibodies to the spirochete Borrelia burgdorferi using immunofluorescence antibody [IFA] assay followed, in positive cases, by enzyme-linked immunoassay [ELlSA]. Five patients showed serological evidence of possible exposure to the spirochete. Only one patient had a positive rheumatoid factor and none had a positive rapid plasma reagin [RPR] or Trepenoma pallidum hemagglutination test [TPHA]. Thus, we conclude that there is preliminary serological evidence suggestive of exposure to B. burgdorferi and possibly Lyme disease in Saudi Arabia

Doenca de Lyme: relato de um caso observado no Brasil / Lyme disease: report of a case observed in Brazil

A doenca de Lyme e uma enfermidade infecciosa, causada pelo espiroqueto Borrelia burgdorferi, transmitida pela picada de carrapatos Ixodideos. A distribuicao geografica desta doenca e universal, porem nao diagnosticada na America do Sul. Relatamos provavel caso em paciente de sexo feminino, residente em favela de Jaguare (SP), que apresentou lesoes cutaneas tipicas de eritema cronico migratorio (EMC), acompanhado de febre, adinamia, cefaleia, mialgia, tosse, dores articulares e radiculite sensitiva no braco esquerdo. a sorologia sequencial pelo metodo ELISA, empregando antigeno sonicado total de Borrelia burgdorferi, cepa americana, foi positiva para IgM no titulo de 1/1600 na fase aguda da doenca. A persistencia de anticorpos em titulo elevado, apos dois meses de evolucao, obrigou a introducao de tetraciclina na dose de duas gramas ao dia, pelo periodo de 10 dias, havendo negativacao da sorologia. O imunoblotting realizado em paralelo com a metodologia ELISA, confirmou presenca de anticorpos anti Borrelia burgdorferi. O presente relato de caso preenche criterio diagnostico para a borreliose de Lyme, adotado pelo Centro de Controle de Doencas, Atlanta (CDC).

Lyme Disease: antibodies against Borrelia burgdorferi in farm workers in Argentina

A doença de Lyme é uma desordem inflamatória, intermediada pelo sistema imunogênico, transmitida por carrapatos (especialmente do Gênero Ixodes) e causada por uma espiroqueta recentemente descoberta, a Borrelia burgdorferi. A técnica de Imunofluorescência Indireta (IF) é, com freqüência, usada para confirmar o diagnóstico da infecçäo por este microrganismo. Embora os métodos práticos tenham limitaçöes, é, no entanto, o único método prático para seu diagnóstico. Devido a näo existência de registros prévios dessa doença na Argentina, foi realizada pesquisa seroepidemiológica para determinar a presença de imunoglobinas nos trabalhadores rurais da Argentina, com sintomas de artrite. Sobre um total de 28 soros analisados, 3 resultaram positivos (o soro número 1 com um título de 1:320 para IgG, embora os soros números 5 e 9 ambos foram reativos a diluiçäo 1:160). Esses mesmos soros foram analisados para a IgM sendo todos eles levemente reativos (1:40), usando IF. Os resultados mostram que anticorpos anti Borrelia burgdorferi se encontram presentes na populaçäo da Argentina. Deve-se ter, portanto, precauçäo na interpretaçäo clínica das artrites até que a presença de Borrelia burgdorferi seja confirmada pelo cultivo nos meios específicos

Diagnóstico serológico (elisa) de borreliosis de lyme en un grupo humano de riesgo, Piura-Perú / Serological diagnosis (elisa) of lyme disease in a risk human group, Piura-Peru

Se realizó un estudio en 35 sueros de agricultores (mayor ó igual a 13 años), residentes en el distrito de Sapillica, provincia de Ayabaca, departamento de Piura, a fin de determinar anticuerpos IgM e IgG a Borrelia burgdorferi utilizando la prueba de ELISA (kig Sigma Diagnostic, MO-USA). 3 (8.57 por ciento) de los 35 sueros fueron positivos con valores de indice de 1.34, 1.78 y 1.08. El descarte de reacción cruzada con otras pruebas: Venereal Disease Research Laboratory, anticuerpos treponémicos fluorescentes (FTA), factor reumatoideo (RF), reacción de aglutinación microscópica (RAM) para leptospira interrogans y biflexa y anticuerpo antinucleares (ANA), fueron negativos en todos los sueros positivos a Borrelia burgdorferi, con excepción de una muestra que fue reactiva a FTA. Los agricultores investigados han sido considerados como grupo de riesgo para Borreliosis de Lyme, por el tipo de actividad laboral que realizan y por la presencia de Haemaphysalis leporispalustris e Ixodes en Piura. Los resultados obtenidos demostraron la presencia IgM e IgG a títulos mayores del valor positivo de corte e índice, que sugieren infección producida por Borrelia burgdorferi