Clinical/serological outcome in humans bitten by Babesia species positive Ixodes ricinus ticks in Sweden and on the Åland Islands.

The risk of contracting babesiosis after a tick bite in Sweden and on the Åland Islands, Finland, is unknown. We investigated clinical and serological outcomes in people bitten by Ixodes ricinus ticks positive for Babesia species. Ticks, blood and questionnaires were obtained from study participants in Sweden and on the Åland Islands. Sixty-five of 2098 (3.1 %) ticks were positive by real-time PCR. Three Babesia species were detected, Babesia microti (n = 33), B. venatorum (n = 27) and B. capreoli (n = 5), the latter species not known to cause human infection. Half (46 %) of the Babesia PCR-positive ticks also contained Borrelia spp. Fifty-three participants bitten by a Babesia PCR-positive tick and a control group bitten by a Babesia PCR-negative tick were tested for B. microti IgG antibodies by IFA. The overall seroprevalence was 4.4 %, but there was no significant difference between the groups. None of the participants seroconverted and no participant with a Babesia PCR-positive tick sought medical care or reported symptoms suggestive of babesiosis. Given the prevalence of Babesia in I. ricinus ticks in southern Sweden and on the Åland Islands, babesiosis should be considered a possible diagnosis in symptomatic residents who seek medical care following tick exposure.

The distribution limit of the common tick, Ixodes ricinus, and some associated pathogens in north-western Europe.

In north-western Europe, the common tick, Ixodes ricinus, is widely established, its distribution appears to be increasing and the spread of tick-borne diseases is of increasing concern. The project 'Flått i Nord' (Ticks in northern Norway) commenced in spring 2009 with the intention of studying the tick's distribution and that of its pathogens in northern Norway. Several methods were used: cloth-dragging, collecting from trapped small mammals, and collecting from pets. Since 2010, the occurrence of ticks in the region of northern Norway was determined directly by cloth-dragging 167 times in 109 separate locations between the latitudes of 64 °N and 70 °N (included seven locations in the northern part of Trøndelag County). The northernmost location of a permanent I. ricinus population was found to be Nordøyvågen (66.2204 °N, 12.59 °E) on the Island of Dønna. In a sample of 518 nymphal and adult ticks, the Borrelia prevalence collected close to this distribution limit varied but was low (1-15 %) compared with the locations in Trøndelag, south of the study area (15-27 %). Five specimens (1 %) were positive for Rickettsia helvetica. The length of the vegetation growing season (GSL) can be used as an approximate index for the presence of established populations of I. ricinus. The present study suggests that the threshold GSL for tick establishment is about 170 days, because the median GSL from 1991 to 2015 was 174-184 days at sites with permanent tick populations, showing a clear increase compared with the period 1961-1990. This apparent manifestation of climate change could explain the northward extension of the range of I. ricinus.

Tooth-implant supported fixed prostheses: a retrospective multicenter study.

PURPOSE: The purpose of this retrospective multicenter study on implants combined with natural teeth was to investigate the implant survival rate and loss of marginal bone, as well as indications and complications pertinent to this form of implant therapy. MATERIALS AND METHODS: The study comprised 185 implants in 111 patients from six different clinics in Sweden. Gathering of data, which were taken from patient records, followed a strict protocol. The registrations included indications for treatment, failure of implants, radiographs from baseline and follow-up, and information on complications. RESULTS: The cumulative implant survival was found to be 95.4% (standard error 4.5%) up to 3 years of follow-up. The marginal bone level at baseline was lower in the maxilla compared with the mandible (P = .015), but any further loss did not differ between the jaws. The most severe complication other than loss of osseointegration (6/185) or periimplant infections (4/183) was intrusion of the abutment teeth, which occurred in 5% of the cases. In all instances, the intrusion was seen in constructions with nonrigid forms of connection between the implants and teeth. CONCLUSION: The tooth-implant supported prosthesis using the Brånemark system is in the short term an equally predictable treatment as the completely implant-supported prosthesis concerning implant survival and loss of marginal bone. When combining implants and teeth, a rigid form of connection should be used to prevent tooth intrusion.