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Lyme borreliosis is a public health concern in India. The prevalence of the disease is still undetermined with major entomological and epidemiological gaps. The present study was conducted to determine the seropositivity of Borrelia burgdorferi in Sikkim and Arunachal Pradesh, India. A cross-sectional serosurvey was conducted in Sikkim and Arunachal Pradesh. Data collection tools were developed and standardized for the collection of clinico-socio-demographic data. Sample size for each site was calculated using the formula for the estimation of a single proportion. Qualitative detection of IgG antibodies in serum samples was done using NovaLisa™ Lyme Borrelia IgG ELISA kit. A total of 793 participants were enrolled, 484 (61%) from Arunachal Pradesh and 309 (39%) from Sikkim. Out of 793 participants, 21 (2.7%), 22 (2.8%), 6 (0.8%), 29 (3.7%), 44 (5.5%), and 16 (2.1%) gave history of tick bite, rash, erythema migrans , migratory muscle pain, migratory joint pain, and numbness, respectively, in the past one year. The adjusted seroprevalence (for sensitivity and specificity of kit) for the study is 3.7 (2.4–5.2). No signs or symptoms were found to be associated with IgG ELISA positivity. The state-wise distribution of seropositivity for Arunachal Pradesh and Sikkim was 4.1 (95% CI: 2.5–6.3) and 2.3 (95% CI: 0.9–4.6), respectively. This study establishes the state of Sikkim as a new endemic area in India of Lyme disease besides its already reported endemicity in Arunachal Pradesh. No association was conclusively established between symptoms of Lyme and IgG seropositivity emphasizing the need for detailed history taking and clinical suspicion in endemic areas. [ABSTRACT FROM AUTHOR]

Snowshoe hares (Lepus americanus) in the Upper Peninsula (UP) of Michigan, USA, occupy the southern periphery of the species' range and are vulnerable to climate change. In the eastern UP, hares are isolated by the Great Lakes, potentially exacerbating exposure to climate-change–induced habitat alterations. Climate change is also measurably affecting distribution and prevalence of vector-borne pathogens in North America, and increases in disease occurrence and prevalence can be one signal of climate-stressed wildlife populations. We conducted a serosurvey for vector-borne pathogens in snowshoe hares that were captured in the Hiawatha National Forest in the eastern UP of Michigan, USA, 2016–2017. The most commonly detected antibody response was to the mosquito-borne California serogroup snowshoe hare virus (SSHV). Overall, 24 (51%) hares screened positive for SSHV antibodies and of these, 23 (96%) were confirmed positive by plaque reduction neutralization test. We found a positive association between seroprevalence of SSHV and live weight of snowshoe hares. Additionally, we detected a significant effect of ecological land type group on seroprevalence of SSHV, with strong positive support for a group representing areas that tend to support high numbers of hares (i.e., acidic mineral containing soils with cedar, mixed swamp conifers, tamarack and balsam fir as common overstory vegetation). We also detected and confirmed antibodies for Jamestown Canyon virus and Silverwater virus in a single hare each. We did not detect antibodies to other zoonotic vector-borne pathogens, including Lacrosse encephalitis virus, West Nile virus, Borrelia burgdorferi, Powassan virus, and Francisella tularensis. These results provide a baseline for future serological studies of vector-transmitted diseases that may increase climate vulnerability of snowshoe hares in the UP of Michigan, as well as pose a climate-related zoonotic risk. [ABSTRACT FROM AUTHOR]

Lyme disease (LD) is a major public health problem in the United States. Given its incidence and geographic expansion, nurse practitioners (NPs) will likely encounter patients with this condition. NPs were invited to participate in an electronic survey via email, newsletter, and social media posts. The 31-question survey collected information on provider characteristics, clinical scenario decisions, resources used, and vaccine sentiment for LD. Survey participants (n = 606) were primarily cisgender female (75%) and aged 30–49 years (62%). Responding to six hypothetical clinical scenarios, only 31% of participants answered most questions correctly. If an LD vaccine becomes available, 39% said they would incorporate it into practice; 48% would seek further information before deciding. Additional education on LD prevention, diagnosis, and treatment is needed for NPs. Increasing provider awareness of current guidelines and developing tailored resources for NPs may improve patient care. [ABSTRACT FROM AUTHOR]

Lyme borreliosis is caused by the Gram-negative spirochetes Borrelia spp., particularly Borrelia burgdorferi sensu lato complex. The disease is transmitted through the bite of the infected black-legged Ixodes tick. Lyme borreliosis extensively occurs in the Northern Hemisphere, mainly in the United States. Lyme borreliosis cases are also detected in Asian countries including Korea, Nepal, China, Taiwan, and Japan. However, there is an inadequate understanding of Lyme borreliosis in the Southeast Asian region. Hence, this review aims to provide a brief update on the prevalence of Lyme borreliosis infection in Southeast Asia based on the latest literature on this issue. Lyme borreliosis has been discovered in human serum in Indonesia, Malaysia, and Singapore. The human serum samples were mainly examined with ELISA test using Borrelia spp. IgG and IgM antigens. Borrelia spp. also has been detected in ticks found on host animals such as Sundamys muelleri and Python in Malaysia, Thailand, and Laos. Polymerase chain reaction (PCR) is used to detect the presence of Borrelia DNAs in the samples. The published studies have demonstrated that Borrelia spp. exists in Southeast Asia and although the incidence is relatively low, it is believed that Lyme disease cases are under-reported. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Croatica is the property of Croatian Academy of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Antemortem diagnosis of neuroborreliosis in horses has been hindered by both the low sensitivity of PCR testing for Borrelia burgdorferi in CSF and the low specificity of serum:CSF ELISA ratios used to determine intrathecal antibody production against the bacterium. PCR testing of the CSF of an adult horse with acute neurologic disease for the B. burgdorferi flagellin gene was negative. However, we enriched B. burgdorferi DNA through nucleic acid hybrid capture, followed by next-generation sequencing, and identified B. burgdorferi in the CSF of the horse, confirming a diagnosis of neuroborreliosis. [ABSTRACT FROM AUTHOR]

• Serum Borrelia burgdorferi (Bb) seropositivity is not associated with heart failure. • Being tested for Bb antibodies was associated with heart failure. • Individuals tested for Bb antibodies differ from background population due to bias. • Bb seropositive individuals should be compared with Bb seronegative individuals. Lyme borreliosis is a tick-borne disease caused by the bacterium Borrelia burgdorferi (Bb) sensu lato complex. Previous studies have suggested an association between Lyme borreliosis and heart failure, which have been suggested to be a possible manifestation of Lyme carditis. We aimed to investigate the risk of heart failure among individuals tested for serum Bb antibodies, and serum Bb seropositive individuals. We performed a matched nationwide cohort study (Denmark, 1993–2020) and included 52,200 Bb seropositive individuals, and two age- and sex-matched comparison cohorts: 1) 104,400 Bb seronegative comparison cohort members, and 2) 261,000 population controls. We investigated the risk associated with 1) being tested for serum Bb antibodies, and 2) being Bb seropositive. Outcomes were: 1) a composite of heart failure, cardiomyopathy, and/or myocarditis diagnosis, and 2) redemption of cardiovascular medicine used for treatment of heart failure. We calculated short-term odds ratios (aOR) (within 1 month) and long-term hazard rates (aHR) (after 1 month) adjusted for age, sex, diabetes, pre-existing heart failure, and kidney disease. Compared with the population controls, individuals tested for Bb antibodies, regardless of the test result, had increased short-term risk of heart failure, cardiomyopathy, and myocarditis (aOR 8.3, 95 %CI: 6.7–10.2), and both increased short- and long-term risk of redemption of cardiovascular medicine (aOR 4.3, 95 %CI: 3.8–4.8, aHR 1.13, 95 % CI: 1.11–1.15). The Bb seropositive individuals had no increased short- or long-term risk of any outcome compared with Bb seronegative comparison cohort members. In conclusion, Bb antibody tests seemed to be performed in the diagnostic work-up of heart failure, but Bb seropositivity was not associated with heart failure. [ABSTRACT FROM AUTHOR]

Background: Emergent and re-emergent canine tick-borne infections are attracting increasing attention worldwide. The rise in pet ownership and the close relationship between dogs and their owners are the most concerning factors because dogs may act as competent reservoirs for human tick-transmitted infectious agents. Objectives: This study contributes to the epidemiological surveillance of canine ticktransmitted infections with zoonotic risk in the Republic of Korea (ROK) by investigating the seroprevalence of the pathogens, Anaplasma spp., Borrelia burgdorferi, and Ehrlichia canis. Methods: Four hundred and thirty whole blood samples from domestic dogs were collected in seven metropolitan cities and nine provinces in the ROK and tested using SensPERT Ab test kits (VetAll Laboratories®) to detect seroreactive animals. Results: The seroprevalence rates identified were 9.8% (42/430) for Anaplasma spp., 2.8% (12/430) for B. burgdorferi, and 1.4% (6/430) for E. canis. The risk factors evaluated in this study that could be associated with the development of a humoral immune response, such as sex, age, and history of tick exposure, were similar. There was only one exception for dogs seroreactive to Anaplasma spp., where the risk factor “tick exposure” was statistically significant (p = 0.047). Conclusions: This serological survey exhibited the widespread presence of Anaplasma spp., B. burgdorferi, and E. canis throughout the ROK. Hence, dogs may play a key role as the sentinel animals of multiple zoonotic infectious agents in the country. [ABSTRACT FROM AUTHOR]

Although Lyme disease is currently classified as exotic in Mexico, recent studies have suggested that it might be endemic there. We assessed the potential risk for the establishment of Borrelia burgdorferi transmission in Mexico. To identify the potential routes of B. burgdorferi spread, Complex Inference Networks were used initially to identify potential vectorhost interactions between hard ticks (Ixodes) and migratory birds in the U.S., and a model for predicting the most important potential bird hosts of hard ticks was then obtained. By using network metrics, keystone-vectors were identified as those species with highest connectivity within and between network communities and had the potential to keep the pathogen circulating with many birds and to be dispersed to several regions. The climatic profile where these interactions occur in the U.S. was characterized and a geographic model for each keystone-vector was built. The accuracy of these models to predict areas where hard ticks have been reported positive for B. burgdorferi allows one to identify areas of greater risk of Lyme disease emergence. These hard tick-bird interactions and their climatic profile were mapped into the winter ranges of birds in Mexico. Thus, those regions in Mexico with the highest potential for becoming endemic areas of Lyme disease through the arrival of hard ticks and birds infected by B. burgdorferi were identified. These areas are candidates for future surveillance programs. [ABSTRACT FROM AUTHOR]

The blacklegged tick (Ixodes scapularis), which transmits Borrelia burgdorferi, the causative agent of Lyme disease, has undergone rapid range expansion in Ontario. In horses, Lyme disease remains an enigmatic disease, with limited understanding of the pathogenesis and many issues pertaining to selection and interpretation of laboratory tests. We evaluated B. burgdorferi seropositivity in naturally exposed horses over a 12-mo period and compared paired samples with 2 common serologic tests. Serum samples were collected in 2017, ~1 y after initial testing, from a cohort of 22 horses that were seropositive in a 2016 seroprevalence study. Samples were tested using a C6 ELISA and a multiplex ELISA targeting outer surface proteins A, C, and F. 1 y after initial testing, 14 of 22 (64%) horses remained seropositive; 7 (32%) were positive on the multiplex ELISA, 2 (9%) on C6 ELISA, and 5 (23%) on both tests. Repeatability was 100% for the C6 ELISA, and 95% for the multiplex ELISA, with no significant difference between paired sample multiplex titer values. Our results indicate strong intra-test reliability, although further investigation is required to determine the clinical significance of serologic testing. [ABSTRACT FROM AUTHOR]

Borrelia burgdorferi is a tick-borne spirochete that causes Lyme disease in humans. The host immune system controls the abundance of the spirochete in the host tissues. Recent work with immunocompetent Mus musculus mice strain C3H/HeJ found that males had a higher tissue infection prevalence and spirochete load compared to females. The purpose of this study was to determine whether host sex and acquired immunity interact to influence the prevalence and abundance of spirochetes in the tissues of the commonly used mouse strain C57BL/6. Wildtype (WT) mice and their SCID counterparts (C57BL/6) were experimentally infected with B. burgdorferi via tick bite. Ear biopsies were sampled at weeks 4, 8, and 12 post-infection (PI) and five tissues (left ear, ventral skin, heart, tibiotarsal joint of left hind leg, and liver) were collected at necropsy (16 weeks PI). The mean spirochete load in the tissues of the SCID mice was 260.4x higher compared to the WT mice. In WT mice, the infection prevalence in the ventral skin was significantly higher in males (40.0 %) compared to females (0.0 %), and the spirochete load in the rear tibiotarsal joint was significantly higher (4.3x) in males compared to females. In SCID mice, the spirochete load in the ventral skin was 200.0x higher in males compared to females, but there were no significant sex-specific difference in spirochete load in the other tissues (left ear, heart, tibiotarsal joint, or liver). Thus, the absence of acquired immunity greatly amplified the spirochete load in the ventral skin of male mice. It is important to note that the observed sex-specific differences in laboratory mice cannot be extrapolated to humans. Future studies should investigate the mechanisms underlying the male bias in the abundance of B. burgdorferi in the mouse skin. [ABSTRACT FROM AUTHOR]

To study the polymorphism in P66 and its human B-cell epitopes of Borrelia burgdorferi strains in China. Polymerase chain reaction (PCR) and sequencing were used to obtain the P66 sequences of 59 Chinese B. burgdorferi. Then the sequences were analyzed by MEGA 5.10 software and compared with the human B-cell epitope sequences from the Immune Epitope Database (IEDB) based on the reference strain of each genotype. Results showed that genetic and amino acid diversity presented in the 66 kD protein of all 59 Chinese strains, especially in Borrelia garinii (B.g) and Borrelia afzelii (B.a) strains. B.g strains were divided into three subclusters and two scattered strains JC1-7 and JC2-2 according to the amino acid sequences of P66. The P66 sequences of 15 Xinjiang strains represented by XI91-12 in the B.g subcluster 1, changed from CAA to TAA codon at 508aa position, resulting in early termination. Bases A and C were inserted at sequence position 1 523 bp of strains FP1, LB20, LB21, and SZ21 in the B.a genotype, which resulted to early termination at position 511 aa. G base was inserted at 438 bp of LIP94-11 strain, which led to early termination at position 172 aa. In P66 of 59 Chinese strains, polymorphisms were widely distributed. More importantly, the P66 amino acid sequences of B.g strains had a certain regional character. One of the characteristics of Xinjiang B.g isolates might be the variation at the 508aa location in 15 Xinjiang B.g strains, which may be related to the strains' pathogenicity in this area. [ABSTRACT FROM AUTHOR]

Importance: The association of Lyme neuroborreliosis with the development of psychiatric disease is unknown and remains a subject of debate.Objective: To investigate the risk of psychiatric disease, the percentage of psychiatric hospital inpatient and outpatient contacts, and the receipt of prescribed psychiatric medications among patients with Lyme neuroborreliosis compared with individuals in a matched comparison cohort.Design, Setting, and Participants: This nationwide population-based matched cohort study included all residents of Denmark who received a positive result on an intrathecal antibody index test for Borrelia burgdorferi (patient cohort) between January 1, 1995, and December 31, 2015. Patients were matched by age and sex to a comparison cohort of individuals without Lyme neuroborreliosis from the general population of Denmark. Data were analyzed from February 2019 to March 2020.Exposures: Diagnosis of Lyme neuroborreliosis, defined as a positive result on an intrathecal antibody index test for B burgdorferi.Main Outcomes and Measures: The 0- to 15-year hazard ratios for the assignment of psychiatric diagnostic codes, the difference in the percentage of psychiatric inpatient and outpatient hospital contacts, and the difference in the percentage of prescribed psychiatric medications received among the patient cohort vs the comparison cohort.Results: Among 2897 patients with Lyme neuroborreliosis (1646 men [56.8%]) and 28 970 individuals in the matched comparison cohort (16 460 men [56.8%]), the median age was 45.7 years (interquartile range [IQR], 11.5-62.0 years) for both groups. The risk of a psychiatric disease diagnosis and the percentage of hospital contacts for psychiatric disease were not higher among patients with Lyme neuroborreliosis compared with individuals in the comparison cohort. A higher percentage of patients with Lyme neuroborreliosis compared with individuals in the comparison cohort received anxiolytic (7.2% vs 4.7%; difference, 2.6%; 95% CI, 1.6%-3.5%), hypnotic and sedative (11.0% vs 5.3%; difference, 5.7%; 95% CI, 4.5%-6.8%), and antidepressant (11.4% vs 6.0%; difference, 5.4%; 95% CI, 4.3%-6.6%) medications within the first year after diagnosis, after which the receipt of psychiatric medication returned to the same level as the comparison cohort.Conclusions and Relevance: In this population-based matched cohort study, patients with Lyme neuroborreliosis did not have an increased risk of developing psychiatric diseases that required hospital care or treatment with prescription medication. The increased receipt of psychiatric medication among patients with Lyme neuroborreliosis within the first year after diagnosis, but not thereafter, suggests that most symptoms associated with the diagnosis subside within a short period. [ABSTRACT FROM AUTHOR]

Copyright of Revista Veterinaria is the property of Universidad Nacional del Nordeste and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We characterized the antibody response to decorin-binding protein A (DbpA) or DbpB from immune serum samples collected from 27 dogs infected with Borrelia burgdorferi by Ixodes scapularis ticks. Immunoglobulin M (IgM) antibodies to DbpA or DbpB were rarely detected, but high levels of IgG antibodies to DbpA were detected in 16 of 27 of the immune sera collected 1 mo after infection, 20 of 25 of the sera collected after 2 mo, and each of the 23, 17, or 11 serum samples evaluated after 3, 4, or 5 mo, respectively. In addition, IgG antibodies to DbpB were detected in 22 of 27 (p = 0.005) tested dogs after 1 mo, and the frequency of detecting the antibodies thereafter closely mimicked the antibody responses to DbpA. Moreover, antibodies to DbpA or DbpB were not produced by dogs vaccinated with a whole-cell B. burgdorferi bacterin; removing the antibodies to DbpA by adsorption to recombinant DbpA (rDbpA) did not affect the reactivity detected by a rDbpB ELISA. Therefore, the findings from our preliminary study showed that antigenically distinct antibodies to DbpA or DbpB are produced reliably during canine infection with B. burgdorferi, and the response is not confounded by vaccination with a Lyme disease bacterin. Larger studies are warranted to more critically evaluate whether detecting the antibody responses can improve serodiagnostic confirmation of canine Lyme disease. [ABSTRACT FROM AUTHOR]

Lyme borreliosis is the most commonly reported vector-borne disease in the United States and Europe. It is caused by a group of spirochete bacteria belonging to the Borrelia burgdorferi sensu lato complex. These pathogens are transmitted among vertebrate reservoir hosts through the bite of hard-bodied ticks. While the enzootic cycle of Borrelia transmission is well understood in its primary reservoir, the white-footed mouse, Peromyscus leucopus , far less is known about other reservoir hosts, particularly in grassland ecosystems. This study assessed the prevalence of B. burgdorferi s. l. among four non- Peromyscus rodents in a prairie ecosystem in the Midwestern United States over a four-year period. We found high prevalences of the bacteria in all four species studied. Our results help to support the roles of Microtus species as reservoirs of B. burgdorferi and add to the literature that suggests Zapus hudsonius may also be a reservoir. Additionally, we identified a previously unknown possible reservoir, Ictidomys tridecemlineatus. Our study also identifies the need to study the dynamics of Lyme borreliosis in habitats and areas outside of the typical range of P. leucopus. [ABSTRACT FROM AUTHOR]

Objective: To determine the association of Borrelia burgdorferi infection with Alzheimer's disease or mild cognitive impairment (MCI) in older adults. Methods: Case–control study. Patients older than 60 years, both sexes, were included. Three groups were created: with probable Alzheimer's disease cases with NINCDS–ADRDA criteria, MCI cases in those not meeting NINCDS–ADRDA criteria for dementia, but who had an abnormal cognitive evaluation and independence in instrumental activities of daily living (IADL), cognitively healthy controls were diagnosed with normal cognitive evaluation and independence in IADL were identified in the community. Western blot IgG against B. burgdorferi in serum was done in all the participants. Non-conditional logistic regression was applied to estimate the association of Alzheimer's disease or MCI and seropositive to B. burgdorferi. Results: Thirty-eight patients with Alzheimer's disease, mean age of 75.6 ± 3.4 years, 69% were females, education 8.3 ± 4.8 years. 39 patients with MCI, mean age of 72.2 ± 6.8 years, 85% were females, education 11.2 ± 4.2 years. A total of 11/38 (29%) were positive to B. burgdorferi with Alzheimer's disease, 9/39 (23%) with MCI, and 11/108 (10%) of controls. In patients with Alzheimer's disease, an adjusted odds ratio (aOR) = 3.65 (95% CI 1.2–11.1) adjusted for education and a history of cerebrovascular disease (CVD) was estimated, and in patients with MCI an aOR = 3.2 (95% CI 1.1–9.1) for a history of diabetes mellitus and CVD was estimated. Conclusions: In our study, there was an increased risk of Alzheimer's disease and MCI in seropositive IgG patients to B. burgdorferi. Key Summary Points: Aim: Establish if Borrelia burgdorferi infection is associated with Alzheimer's disease and/or mild cognitive impairment (MCI) in older adults. Findings: In patients with Borrelia burgdorferi infection and Alzheimer's disease, an adjusted Odds Ratio (AOR) = 3.65 (95% CI = 1.2−11.1) was estimated, which was similar to that of patients with Borrelia burgdorferi infection and MCI with an AOR = 3.2 (95% CI = 1.1−9.1). Message: In our study, there was an increased risk of Alzheimer's disease and MCI in seropositive IgG patients to B. burgdorferi. [ABSTRACT FROM AUTHOR]

Abstract Cervid babesiosis, caused by the protozoan hemoparasite Babesia odocoilei and transmitted by the blacklegged tick Ixodes scapularis , is an emerging disease of Canadian cervids. This pathogen has not yet been described in humans. Data are lacking on the role of migratory birds in the adventitious spread of Ba. odocoilei -infected ticks, as well as on the infection status of I. scapularis in environments used by susceptible wildlife hosts. Following a high-mortality outbreak of cervid babesiosis at the Toronto Zoo [TZ], the present study was initiated to investigate Ba. odocoilei and other tick-borne pathogens of veterinary and public health importance (Borrelia burgdorferi sensu stricto (s.s.), Anaplasma phagocytophilum , Borrelia miyamotoi , and Babesia microti) in I. scapularis at three sites in southern Ontario, Canada. Blanket dragging for questing ticks yielded I. scapularis from the three sites evaluated: TZ, Point Pelee National Park, and Long Point Bird Observatory [LPBO]. Babesia odocoilei was identified in I. scapularis collected by dragging at the TZ and at LPBO. Borrelia burgdorferi s.s. was identified in I. scapularis at all three sites. Anaplasma phagocytophilum was identified in I. scapularis collected from the TZ. During the springs of 2016 and 2017, 1102 northward-migrating birds were examined for ticks at LPBO. One or more I. scapularis were found on 3.2% of birds (n = 595) in 2016, and 6.7% (n = 507) of birds in 2017. Overall, across both years, 0.2% and 0.5% of birds carried one or more I. scapularis ticks that tested PCR-positive for Ba. odocoilei and Bo. burgdorferi s.s., respectively. These data indicate that Ba. odocoilei- positive I. scapularis are found in southern Ontario, and suggest that bird-borne ticks have the potential to contribute to range expansion of both Ba. odocoilei and Bo. burgdorferi s.s. in Canada. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Croatica is the property of Croatian Academy of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Common variable immunodeficiency (CVID) is a rare condition in adult horses characterized by hypogammaglobulinemia and increased susceptibility to parasitic and bacterial infections, including recurrent respiratory diseases, septicemia, and meningitis. Lyme disease is often included as a differential diagnosis in CVID horses with signs of meningitis; however, the Borrelia burgdorferi organism has not been demonstrated previously within central nervous system tissues of CVID horses with neurologic disease, to our knowledge. We report herein a case of neuroborreliosis in a CVID horse, confirmed by combined immunologic testing, histopathology, real-time PCR assay, fluorescent in situ hybridization, and immunohistochemical staining. Implications of these findings include heightened monitoring of CVID horses for Lyme disease in endemic areas and appropriate therapy in the case of neurologic disease. [ABSTRACT FROM AUTHOR]

Abstract An inverse relationship between biodiversity and human health has been termed the 'dilution effect' paradigm. In the case of tick-borne infections such as Lyme disease, the key assumption is that Borrelia burgdorferi sensu lato abundance is increased by the loss of less competent (dilution) hosts as biodiversity declines. White-tailed deer play a dual role in the pathogen cycle, as key reproductive hosts for adult ticks and incompetent hosts for the pathogen. While the role of deer as hosts of adult ticks is well established, the extent to which deer also feed immature ticks and reduce the proportion infected is unknown because of logistic constraints in measuring this empirically. We estimated the proportion of larvae that fed on deer in an extremely species-poor community on Block Island, RI, where tick nymphal infection prevalence was found to be lower than expected. In 2014, we measured the density, larval tick burdens, and realized reservoir competence of small mammal and bird hosts on Block Island, RI. In 2015, we measured the infection prevalence of host-seeking Ixodes scapularis nymphs resulting from larvae fed on available hosts in 2014. We back-estimated the proportion of larvae expected to have fed on deer in 2014 (the only unknown parameter) to result in the nymphal infection prevalence observed in 2015. Back-estimation predicted that 29% of larval ticks must have fed on deer to yield the observed 30% nymphal infection prevalence. In comparison, the proportion of larvae feeding on mice was 44% and 27% on birds. Our study identified an influential role of deer in reducing nymphal tick infection prevalence and a potential role as dilution hosts if the reduction in nymphal infection prevalence outweighs the role of deer as tick population amplifiers. Because both deer and competent hosts may increase in anthropogenic, fragmented habitats, the links between fragmentation, biodiversity, and Lyme disease risk may be complex and difficult to predict. Furthermore, a nonlinear relationship between deer abundance and Lyme disease risk would reduce the efficacy of deer population reduction efforts to control Lyme disease. [ABSTRACT FROM AUTHOR]

Abstract In North America, different strains of the Lyme disease-causing bacterium Borrelia burgdorferi sensu stricto cluster into phylogenetic groups that are associated with different levels of pathogenicity and, for some, specific rodent reservoir hosts. Here we explore whether landscape connectivity, by impacting host dispersal, influences B. burgdorferi s.s. spread patterns. This question is central to modelling spatial patterns of the spread of Lyme disease risk in the zone of northward range-expansion of B. burgdorferi s.s. in southeastern Canada where the study was conducted. We used multi-locus sequence typing (MLST) to characterise B. burgdorferi s.s. in positive ticks collected at 13 sites in southern Quebec, Canada during the early stages of B. burgdorferi s.s. invasion. We used mixed effects logistic regression to investigate whether landscape connectivity (probability of connectivity; PC) affected the probability that samples collected at different sites were of the same strain (MLST sequence type: ST). PC was calculated from a habitat map based on high spatial resolution (15 m) Landsat 8 imagery to identify woodland habitat that are preferred by rodent hosts of B. burgdorferi s.s. There was a significant positive association between the likelihood that two samples were of the same ST and PC, when PC values were grouped into three categories of low, medium and high. When analysing data for individual STs, samples at different sites were significantly more likely to be the same when PC was higher for the rodent-associated ST1. These findings support the hypothesis that dispersion trajectories of B. burgdorferi s.s. in general, and some rodent-associated strains in particular, are at least partly determined by landscape connectivity. This may suggest that dispersion of B. burgdorferi s.s. is more common by terrestrial mammal hosts (which would likely disperse according to landscape connectivity) than by birds, the dispersal of which is likely less constrained by landscape. This study suggests that accounting for landscape connectivity may improve model-based predictions of spatial spread patterns of B. burgdorferi s.s. The findings are consistent with possible past dispersal patterns of B. burgdorferi s.s. as determined by phylogeographic studies. [ABSTRACT FROM AUTHOR]

Abstract Borrelia burgdorferi sensu lato (s. l.) spirochetes are associated with a wide range of vectors and hosts. Birds are important hosts in the ecology of some hard ticks (Ixodidae) in northwestern Argentina, where B. burgdorferi s.l. have been detected in Ixodes pararicinus. We evaluated Borrelia infection in ticks collected from wild birds by molecular analysis through the presence of Borrelia DNA (by nested-PCR targeting the fla gene). A total of 381 ticks (357 larvae and 24 nymphs) belonging to four species (I. pararicinus , Haemaphysalis juxtakochi , Haemaphysalis leporispalustris and Amblyomma sp.) were collected. Partial sequences of the fla gene of Borrelia (100% identical to Borrelia sp. haplotype I from Argentina) were detected in 9 of 70 tick pools (6 pools of larvae and 1 pool of nymphs of I. pararicinus , and in 2 pools of H. juxtakochi larvae) collected on Turdus rufiventris , Syndactila rufosuperciliata and Troglodytes aedon. The results of this study suggest that resident birds have reservoir capacity for Borrelia sp. haplotype I. [ABSTRACT FROM AUTHOR]

Due to the ongoing expansion of Ixodes scapularis (blacklegged tick) throughout the northeastern and midwestern United States, there is need to identify the role wildlife hosts play in the establishment and maintenance of tick populations. To quantify and synthesize the patterns of I. scapularis and Borrelia burgdorferi sensu stricto and sensu lato prevalence relative to wildlife hosts, we reviewed the findings of independent studies conducted throughout the United States. We performed a comprehensive literature search from 1970 to 2017 using the ISS Web of Science Core Collection and the keywords “ Ixodes scapularis,” “Ixodes dammini” and “ Borrelia burgdorferi.” We identified 116 studies for inclusion in our meta-analysis, with 187,414 individual wildlife hosts captured and examined for I. scapularis and either the host or ticks collected subsequently tested for B. burgdorferi. We found that only 13% of the wildlife mammals sampled comprised species other than Odocoileus virginianus (white-tailed deer) and Peromyscus leucopus (white-footed mouse). To examine whether there were regional differences between the Northeast, Midwest and the Southeast U.S. in I. scapularis infestation rates on wildlife hosts, we used general linear models (glm), with post hoc pairwise comparisons. In most cases, detection of I. scapularis and B. burgdorferi was significantly higher in the Northeast than the Midwest. Using data on host-specific I. scapularis infestation prevalence, B. burgdorferi prevalence in feeding larvae, and host permissiveness, we developed an epizootiological model to determine the relative contributions of individual hosts to B. burgdorferi -infected nymphs. Our model provides additional evidence that wildlife hosts other than P. leucopus may contribute more to Lyme disease risk than commonly thought. To aid in understanding the ecology of Lyme disease, we propose that additional studies sample non- Peromyscus spp. hosts to obtain more detailed tick and pathogen infestation and infection estimates, respectively, for these less frequently sampled wildlife hosts. [ABSTRACT FROM AUTHOR]

Borrelia burgdorferi sensu lato, the agent of Lyme disease, exists in nature through a complex enzootic life cycle that involves both ticks and mammals. The B. burgdorferi genome encodes five Oligopeptide ABC transporters (Opp) that are predicted to be involve in transport of various nutrients. Previously, it was reported that OppA5 is important for the optimal production of OspC, a major virulence factor of B. burgdorferi . In this study, possible role of another Oligopeptide ABC transporter, OppA4 in ospC expression was investigated by construction of an oppA4 deletion mutant and the complemented strain. Inactivation of oppA4 resulted an increased production of OspC, suggesting that OppA4 has a negative impact on ospC expression. Expression of ospC is controlled by Rrp2-RpoN-RpoS, the central pathway essential for mammal infection. We showed that increased ospC expression in the oppA4 mutant was due to an increased rpoS expression. We then further investigated how OppA4 negatively regulates this pathway. Two regulators, BosR and BadR, are known to positively and negatively, respectively, regulate the Rrp2-RpoN-RpoS pathway. We found that deletion of oppA4 resulted in an increased level of BosR. Previous reports showed that bosR is mainly regulated at the post-transcriptional level by other factors. However, OppA4 appears to negatively regulate bosR expression at the transcriptional level. The finding of OppA4 involved in regulation of the Rrp2-RpoN-RpoS pathway further reinforces the importance of nutritional virulence to the enzootic cycle of B. burgdorferi . [ABSTRACT FROM AUTHOR]

Lyme disease continues to be the most common vector-borne disease in the United States with an estimated 330,000 human cases annually. In the eastern United States, the blacklegged tick, Ixodes scapularis , is the primary vector of the Lyme disease spirochete, Borrelia burgdorferi , and the white-footed mouse, Peromyscus leucopus , is a primary reservoir host. In four residential neighborhoods in Connecticut over three years, we tested the effectiveness of different low-toxicity integrated tick management approaches to control larval and nymphal I. scapularis parasitizing P. leucopus . Combinations of white-tailed deer, Odocoileus virginianus , reduction, broadcast application of the entomopathogenic fungus Metarhizium anisopliae , and distribution of fipronil-based rodent-targeted bait boxes were evaluated against an experimental control. Deer reduction with no other intervention likely forced juvenile I. scapularis to obtain blood meals from available reservoir hosts, resulting in increased exposure of P. leucopus to B. burgdorfer i compared to control sites. The M. anisopliae /bait box and the deer reduction/ M. anisopliae /bait box treatment combinations resulted in 94% and 85% reductions in larvae parasitizing P. leucopus that tested positive for B. burgdorferi, respectively, compared to control. Deer reduction alone resulted in only a 3% reduction, likely because parasitizing juvenile I. scapularis were not targeted by bait box-delivered fipronil. Unless there is community support to reduce and maintain deer at very low densities (<5 deer/km 2 ), it is clear that a combination of M. anisopliae /fipronil-based bait boxes offers an effective, localized, low-toxicity option for reducing I. scapularis parasitizing P. leucopus without complications from host switching. [ABSTRACT FROM AUTHOR]

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Historical specimens, when available, can provide new insight into the distribution and evolution of pathogens that may not be discernible from more recent samples. We used ticks collected from hunter-killed white-tailed deer in New Jersey in 2002 to examine the prevalence and distribution of four pathogens transmitted by Ixodes scapularis , the blacklegged tick. Infection with Borrelia burgdorferi sensu stricto, Babesia microti , and Anaplasma phagocytophilum (the agents of Lyme disease, human babesiosis, and human granulocytic anaplasmosis, respectively) was highest in the Coastal Plain and lowest in the northwestern Skylands region. These patterns correspond well with the historically observed northward expansion of I. scapularis within New Jersey and the comparatively recent increase in human cases of these pathogens in the northern part of the state. Additionally, we provide evidence that Borrelia miyamotoi , a relatively new emerging pathogen and agent of relapsing fever, was widespread (though not common) throughout the state in 2002. Our findings highlight the need for enhanced awareness of tick-borne diseases other than Lyme and implementation of large-scale tick surveillance in endemic regions. [ABSTRACT FROM AUTHOR]

Lyme borreliosis (LB) is caused by Borrelia burgdorferi sensu lato ( Bb- sl) and is the most common vector-borne disease in Europe. The objectives of this study were to determine the Bb- sl seroprevalence among the general Finnish adult population and to identify risk factors associated with Bb- sl-seropositive status. Two thousand sera from a nationwide health survey from 2011 were tested by whole-cell sonicate IgG ELISA, C6 peptide ELISA, and recomBead IgG 2.0 and test results were linked to a general health questionnaire. A multivariable logistic regression model was used to identify risk factors. The median age of the study population was 56 years (range 29–97) and the Bb- sl weighted seroprevalence was 3.9% (95% confidence interval (CI) 3.03–5.08). The weighted seroprevalence was significantly higher among males than females (adjusted odds ratio 1.91, 95%CI 1.21–3.04). The seroprevalence was highest in Southern, Central, and Eastern regions. The first Bb- sl seroprevalence study in Finland showed a seroprevalence of 3.9% (regional range 0.87%–6.12%). The results of this study can be used, together with previous data on LB incidence and spatial tick distribution, to target public health communication about preventive measures. [ABSTRACT FROM AUTHOR]

Some patients with a history of Borrelia burgdorferi infection develop a chronic symptomatology characterized by cognitive deficits, fatigue, and pain, despite antibiotic treatment. The pathogenic mechanism that underlines this condition, referred to as post-treatment Lyme disease syndrome (PTLDS), is currently unknown. A debate exists about whether PTLDS is due to persistent infection or to post-infectious damages in the immune system and the nervous system. We present the case of a patient with evidence of exposure to Borrelia burgdorferi sl and a long history of debilitating fatigue, cognitive abnormalities and autonomic nervous system issues. The patient had a positive Western blot for anti-basal ganglia antibodies, and the autoantigen has been identified as γ enolase, the neuron-specific isoenzyme of the glycolytic enzyme enolase. Assuming Borrelia own surface exposed enolase as the source of this autoantibody, through a mechanism of molecular mimicry, and given the absence of sera reactivity to α enolase, a bioinformatical analysis was carried out to identify a possible cross-reactive conformational B cell epitope, shared by Borrelia enolase and γ enolase, but not by α enolase. Taken that evidence, we hypothesize that this autoantibody interferes with glycolysis in neuronal cells, as the physiological basis for chronic symptoms in at least some cases of PTLDS. Studies investigating on the anti-γ enolase and anti-Borrelia enolase antibodies in PTLDS are needed to confirm our hypotheses. [ABSTRACT FROM AUTHOR]

Introduction. During feeding, the tick sucks blood from the host along with the pathogens that are in the blood, simultaneously exchanging its own pathogens with the host. Humans can also be a host. It is important to understand the most typical circumstances in which people might become infected with Borrelia burgdorferi. This knowledge will help to prepare health education programmes aimed at the prevention of Lyme disease and other tick-borne diseases. Objective. The aim of the study was to determine the percentage of ticks infected with Borrelia burgdorferi sensu lato, depending on the circumstances of getting bitten. Materials and method. The research material consisted of ticks acquired from people who had been bitten, and questionnaires completed by these people. 510 ticks were acquired from 257 females and 253 males. Following delivery of a tick for testing, the stage of its development was determined and a molecular assay of Borrelia burgdorferi DNA performed. Results. A positive result of the nested-PCR test was obtained in 78 ticks, which represents 15.30% of all ticks. The infected ticks were collected from male (41 ticks - 52.56%) and female subjects (37 ticks - 47.44%). The biggest number of infected ticks were collected in autumn (54 ticks - 69.23%) and from people who had been into forests (44 ticks - 56.41%). Among the people from whom the infected ticks were acquired, the dominating group included persons over 16 years of age (53 persons - 67.95%) and children aged 0-5 years (16 persons - 20.51%). One in four infected ticks were acquired from the southwestern (20 ticks - 25.64%) and eastern regions of Poland (21 ticks - 26.92%). Conclusion. Infestation of ticks infected with Lyme disease spirochete in this study proved to be variable and depend on the season, the area of tick attack and the region in Poland. The results of the study clearly show that ticks infected with Borrelia burgdorferi inhabit all regions of Poland. The results are consistent with National Institute of Hygiene data which indicates that Lyme disease cases are recorded in all regions of Poland. [ABSTRACT FROM AUTHOR]

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Lyme borreliosis (LB) is the most important human tick-borne disease, but Borrelia genospecies cause different clinical manifestations. Ticks of the genus Ixodes removed from humans between 2006 and 2012 were analysed for Borrelia burgdorferi sensu lato (sl) infections. The majority of ticks originated from the Greater Hanover region in Northern Germany. The engorgement status varied over the entire spectrum from unengorged (no evidence of started blood feeding) to fully engorged. In the present study, prevalence data for B. burgdorferi sl 2011 and 2012 were obtained by quantitative real-time PCR and compared to those from a former study including years 2006–2010 (Strube et al., 2011) to evaluate B. burgdorferi sl infections in ticks affecting humans over a 7-year period. In 2011, 34.2% (70/205) of adult ticks, 22.2% (94/423) of nymphs, 8.3% of larvae (1/12) as well 3 of 6 not differentiated ticks were Borrelia positive. In 2012, 31.8% (41/129) of adult ticks, 20.4% of nymphs (69/337) as well as 1 of 4 of the not differentiated ticks were determined positive. Total Borrelia infection rates decreased significantly from 23.1% in 2006 to 17.1% in 2010, followed by a significant increase to 26.0% in 2011 and 23.4% in 2012. Furthermore, B. burgdorferi sl genospecies distribution in 2006–2012 was determined in the present study by applying Reverse Line Blot technique. Borrelia genospecies differentiation was successful in 641 (67.3%) out of 953 positive tick samples. The most frequently occurring genospecies was B. afzelii (40.5% of infected ticks), followed by B. garinii / B. bavariensis (12.4%). Amongst the 641 ticks analysed for their genospecies, 74 (11.5%) carried more than one genospecies, of which 69 (10.7%) were double-infected and five (0.8%) were triple-infected. Comparison of genospecies distribution in ticks removed from humans with those from questing ticks flagged in the same geographical area revealed that ticks removed from humans were significantly more frequently infected with B. afzelii (p = 0.0004), but significantly less infected with B. burgdorferi sensu stricto (p = 0.0001). [ABSTRACT FROM AUTHOR]

Summary Despite the importance of immune variation for the symptoms and outcome of Lyme disease, the factors influencing cytokine production during infection with the causal pathogen Borrelia burgdorferi remain poorly understood. Borrelia infection - induced monocyte- and T cell-derived cytokines were profiled in peripheral blood from two healthy human cohorts of Western Europeans from the Human Functional Genomics Project. Both non-genetic and genetic host factors were found to influence Borrelia -induced cytokine responses. Age strongly impaired IL-22 responses, and genetic studies identified several independent QTLs that impact Borrelia -induced cytokine production. Genetic, transcriptomic, and functional validation studies revealed an important role for HIF-1α-mediated glycolysis in the cytokine response to Borrelia . HIF-1α pathway activation and increase in glycolysis-derived lactate was confirmed in Lyme disease patients. In conclusion, functional genomics approaches reveal the architecture of cytokine production induced by Borrelia infection of human primary leukocytes and suggest a connection between cellular glucose metabolism and Borrelia -induced cytokine production. [ABSTRACT FROM AUTHOR]

Borrelia burgdorferi, the spirochete agent of Lyme disease, has evolved within a consistent infectious cycle between tick and vertebrate hosts. The transmission of the pathogen from tick to vertebrate is characterized by rapid replication and a change in the outer surface protein profile. EbfC, a highly conserved nucleoid-associated protein, binds throughout the borrelial genome, affecting expression of many genes, including the Erp outer surface proteins. In B. burgdorferi, like many other bacterial species, ebfC is cotranscribed with dnaX, an essential component of the DNA polymerase III holoenzyme, which facilitates chromosomal replication. The expression of the dnaX-ebfC operon is tied to the spirochete's replication rate, but the underlying mechanism for this connection was unknown. In this work, we provide evidence that the expression of dnaX-ebfC is controlled by direct interactions of DnaA, the chromosomal replication initiator, and EbfC at the unusually long dnaX-ebfC 5' untranslated region (UTR). Both proteins bind to the 5' UTR DNA, with EbfC also binding to the RNA. The DNA binding of DnaA to this region was similarly impacted by ATP and ADP. In vitro studies characterized DnaA as an activator of dnaX-ebfC and EbfC as an antiactivator. We further found evidence that DnaA may regulate other genes essential for replication. IMPORTANCE The dual life cycle of Borrelia burgdorferi, the causative agent of Lyme disease, is characterized by periods of rapid and slowed replication. The expression patterns of many of the spirochete's virulence factors are impacted by these changes in replication rates. The connection between replication and virulence can be understood at the dnaX-ebfC operon. DnaX is an essential component of the DNA polymerase III holoenzyme, which replicates the chromosome. EbfC is a nucleoid-associated protein that regulates the infection-associated outer surface Erp proteins, as well as other transcripts. The expression of dnaX-ebfC is tied to replication rate, which we demonstrate is mediated by DnaA, the master chromosomal initiator protein and transcription factor, and EbfC. [ABSTRACT FROM AUTHOR]

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Lyme Disease is caused by the bacterial pathogen Borrelia burgdorferi , and is transmitted by the tick-vector Ixodes scapularis . It is the most prevalent arthropod-borne disease in the United States. To determine the seroprevalence of B. burgdorferi antibodies in white-tailed deer ( Odocoileus virginianus ) from Texas, we analyzed serum samples (n = 1493) collected during the 2001–2015 hunting seasons, using indirect ELISA. Samples with higher sero-reactivity (0.803 and above) than the negative control group (0.662) were further tested using a more specific standardized western immunoblot assay to rule out false positives. Using ELISA, 4.7% of the samples were sero-reactive against B. burgdorferi , and these originated in two eco-regions in Texas (Edwards Plateau and South Texas Plains). However, only 0.5% of the total samples were sero-reactive by standardized western immunoblot assay. Additionally, both ELISA and standardized western immunoblot assay results correlated with an increased incidence in human Lyme Disease cases reported in Texas. This is the first longitudinal study to demonstrate fluctuation in sero-reactivity of white-tailed deer to B. burgdorferi sensu stricto antigens in southern United States. Future ecological and geographical studies are needed to assess the environmental factors governing the prevalence of Lyme Disease in non-endemic areas of the southern United States. [ABSTRACT FROM AUTHOR]

Reducing exposure to ticks can help prevent Lyme disease and other tickborne diseases. Although it is currently recommended to dry clothes on high heat for one hour to kill ticks on clothing after spending time outdoors, this recommendation is based on a single published study of tick survival under various washing conditions and a predetermined one-hour drying time. We conducted a series of tests to investigate the effects of temperature, humidity, and drying time on killing nymphal and adult blacklegged ticks ( Ixodes scapularis ). Muslin bags containing 5 ticks each were washed then dried or dried only with six cotton towels during each drying cycle. All nymphal and adult ticks were killed when exposed to wash cycles when the water temperature reached ≥54 °C (≥130 °F); however, 50% of ticks survived hot water washes when the water temperature was <54 °C. The majority (94%) of ticks survived warm washes [temperature range, 27–46 °C (80–115 °F)] and all ticks survived cold washes [15–27 °C (59–80 °F)]. When subsequently dried on high heat setting [54–85 °C (129–185 °F)], it took 50 min to kill all ticks (95% confidence limit, 55 min). Most significantly, we found that all adult and nymphal ticks died when placed directly in the dryer with dry towels and dried for 4 min on high heat (95% confidence limit, 6 min). We have identified effective, easily implemented methods to rid clothing of ticks after spending time outdoors. Placing clothing directly in a dryer and drying for a minimum of 6 min on high heat will effectively kill ticks on clothing. If clothing is soiled and requires washing first, our results indicate clothing should be washed with water temperature ≥54 °C (≥130 °F) to kill ticks. When practiced with other tick-bite prevention methods, these techniques could further reduce the risk of acquiring tickborne diseases. [ABSTRACT FROM AUTHOR]

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Two different genetic loci, flaB and ospC, were employed to assign genospecies and OspC phylogenetic type to 18 strains isolated from ticks collected in Pisárky, a suburban park in the city of Brno, Czech Republic. The RFLP analysis revealed three different genospecies (B. afzelii, B. garinii, and B. valaisiana). Three samples from the collection contained more than one genospecies. In the other 15 strains, nucleotide sequences of flaB and ospC were determined. The following phylogenetic analysis assigned 12 isolates to genospecies B. garinii and three to B. afzelii. These isolates were further subdivided into seven distinct ospC groups. The most related OspC types were G2, G4, and G5 (B. garinii) and A3 and A8 (B. afzelii). [ABSTRACT FROM AUTHOR]

Background: The diagnosis of acrodermatitis chronica atrophicans (ACA), the late cutaneous manifestation of Lyme borreliosis, can be challenging. Histologic changes in ACA have been described in a few studies from endemic countries, relying on cases documented by serology only.Objectives: We sought to reassess the clinicopathological spectrum of ACA in a series of thoroughly documented cases.Methods: Patients prospectively included in a national prospective study were selected on the basis of positive culture and/or polymerase chain reaction of a skin biopsy sample. The diagnosis of ACA was confirmed by reviewing the clinical and serologic data. Histopathological samples were carefully reviewed.Results: Twenty patients were included. Unusual clinical features (ie, numerous small violaceous patches and equidistant small spinous papules with background faint erythema) were observed in 2 patients. Histopathological examination revealed a classic plasma cell-rich perivascular and interstitial pattern with telangiectases in 16 of 25 samples, whereas strikingly prominent granuloma annulare-like or lichenoid features were observed in 4 and 2 of 25 cases, respectively, and discrete nonspecific minor changes in 3 of 25 cases.Limitations: The small number of patients was a limitation.Conclusions: Genuine culture- and/or polymerase chain reaction-proven ACA can rarely present as numerous violaceous patches or cluster of spinous papules clinically, and as a granuloma annulare-like or lichenoid dermatosis histologically. [ABSTRACT FROM AUTHOR]

Lyme borreliosis is the most prevalent tick-borne disease in Europe. It is caused by spirochaetes of the Borrelia burgdorferi sensu lato (s.l.) complex and transmitted to humans by ticks of the genus Ixodes . Borrelia afzelii , Borrelia garinii , and Borrelia valaisiana are the most common genospecies in Central Europe. In contrast, Borrelia lusitaniae predominates in Mediterranean countries such as Portugal, Morocco, and Tunisia. In Slovakia, its prevalence is low and restricted to only a few sites. The aim of our research was to study the expansion of ticks into higher altitudes in the ecosystem of the Malá Fatra mountains (north Slovakia) and their infection with B. burgdorferi s.l. pathogens. Questing ticks were collected by flagging in seven years (2004, 2006–2011) at three different altitudes: low (630–660 m above sea level (ASL)), intermediate (720–750 m ASL), and high (1040–1070 m ASL). Tick abundance was highest at the lowest altitude and lowest at the highest altitude. The average infection prevalence of B. burgdorferi s.l. in nymphs and adults was 16.8% and 36.2%, respectively. The number of infected ticks decreased from 38.5% at the lowest altitude to 4.4% at the highest altitude. B. lusitaniae was the most frequently found genospecies (>60% of the ticks found positive for B. burgdorferi s.l.) in all sites in all the studied years with the exception of 2008 when B. afzelii predominated (62%). Our study confirms the spread of Ixodes ricinus ticks to higher altitudes in Slovakia. The discovery that our mountain study sites were a natural foci of B. lusitaniae was unexpected because this genospecies is usually associated with lizards and xerothermic habitats. [ABSTRACT FROM AUTHOR]

Only a few reported cases indicate that Rickettsia helvetica and Rickettsia monacensis can cause disease in humans. Exposure to these two spotted fever group (SFG) rickettsiae occurs through bites of Ixodes ricinus , also the primary vector of Lyme borreliosis in Europe. To date, it is unclear how often exposure to these two microorganisms results in infection or disease. We show that of all the Borrelia burgdorferi s.l. -positive ticks, 25% were co-infected with rickettsiae . Predominantly R. helvetica was detected while R. monacensis was only found in approximately 2% of the ticks. In addition, exposure to tick-borne pathogens was compared by serology in healthy blood donors, erythema migrans (EM)-patients, and patients suspected of Lyme neuroborreliosis (LNB). As could be expected, seroreactivity against B. burgdorferi sensu lato was lower in blood donors (6%) compared to EM patients (34%) and suspected LNB cases (64%). Interestingly, seroreactivity against SFG Rickettsia antigens was not detected in serum samples from blood donors (0%), but 6% of the EM patients and 21% of the LNB suspects showed anti-rickettsial antibodies. Finally, the presence of B. burgdorferi s.l. and Rickettsia spp. in cerebrospinal fluid samples of a large cohort of patients suspected of LNB ( n = 208) was investigated by PCR. DNA of B. burgdorferi s.l., R. helvetica and R. monacensis was detected in seventeen, four and one patient, respectively. In conclusion, our data show that B. burgdorferi s.l. and SFG rickettsiae co-infection occurs in Dutch I. ricinus and that Lyme borreliosis patients, or patients suspected of Lyme borreliosis, are indeed exposed to both tick-borne pathogens. Whether SFG rickettsiae actually cause disease, and whether co-infections alter the clinical course of Lyme borreliosis, is not clear from our data, and warrants further investigation. [ABSTRACT FROM AUTHOR]

Over a period of 5 years, 10 pure-bred Boxer puppies, 9–16 weeks old, were presented with a history of sudden death and were diagnosed with pyogranulomatous myocarditis. The myocarditis was characterized by a mixed infiltrate composed predominantly of neutrophils and macrophages. In our retrospective study, original case records and archived materials were examined. All dogs were positive for Borrelia burgdorferi on immunohistochemistry (IHC). There was no evidence of infectious agents in formalin-fixed, paraffin-embedded (FFPE) heart tissue sections stained with hematoxylin and eosin, Ziehl–Neelsen, Gram, Grocott methenamine silver, Warthin–Starry, Von Kossa, and Steiner–Chapman stains. IHC for Chlamydia sp., Toxoplasma gondii, Neospora caninum, West Nile virus, and canine parvovirus also yielded a negative result in all dogs. Polymerase chain reaction testing for vector-borne pathogens on heart tissue from 9 of the dogs (1 frozen and 8 FFPE samples) yielded positive results for 1 dog with B. burgdorferi as well as Anaplasma phagocytophilum in another dog. Subsequently, 2 additional cases were found in a French Bulldog and a French Bulldog–Beagle mix that had identical morphology, test results, age, and seasonality to these 10 Boxer dogs. The similarities in the seasonality, signalment of the affected dogs, and the gross and microscopic lesions suggest a common etiology. Positive IHC and morphologic similarities to human Lyme carditis indicate that B. burgdorferi is likely the agent involved. An additional consideration for these cases is the possibility of a breed-specific autoimmune myocarditis or potential predisposition for cardiopathogenic agents in young Boxers. [ABSTRACT FROM AUTHOR]

Background. Several studies have demonstrated the presence of the Borrelia burgdorferi (Bb) genome in the myocardium of patients with dilated cardiomyopathy (DCM). To further support a causal relationship between the presence of Bb in the heart muscle and the development of DCM, demonstration of the absence of Bb in the myocardium of subjects with normal left ventricular (LV) systolic function is needed. Aim. To determine the prevalence of Bb by polymerase chain reaction (PCR) and electron microscopy (EM) in individuals with normal LV systolic function and no history suggestive of myocarditis. Methods. We investigated 50 patients (67 ± 9 years, 15 women) with normal LV ejection fraction (EF) = 50% undergoing cardiac surgery. During surgery, four samples from the right atrial appendage were obtained and subsequently examined by PCR and EM for the presence of Bb, and by immunohistochemistry to detect inflammatory cells. Serological testing of antibodies against Bb was also performed. Results. Neither PCR nor EM detected Bb in any of the subjects. Immunohistological examination revealed myocardial inflammation in 2 individuals (4%). Serological analysis by enzyme-linked immunosorbent assay demonstrated IgM antibodies against Bb in 4% and IgG antibodies in 12% of the study cohort; Western blot revealed IgM as well as IgG positivity in 14% of patients. Conclusions. The absence of Bb in the myocardium of individuals who undergo cardiac surgery and have normal LV systolic function supports the idea of Bb pathogenicity in the development of DCM. [ABSTRACT FROM AUTHOR]

Patterns of seasonal activity and density of host-seeking western blacklegged ticks, Ixodes pacificus , were investigated in central and southern California. Weekly to monthly drag sampling was undertaken at two sites in Santa Barbara County and one site in Los Angeles County over multiple years. Adult I. pacificus became active in the winter (late November) and were rare or absent by late April to early May. Nymphal ticks became active in early to late February, were absent by early May to early June, and were rarely encountered using the drag method throughout their period of peak seasonal activity. Larval ticks became active earlier in the season, or at the same time as nymphs (early to late February) and were absent by early May. These results suggest a highly truncated period of I. pacificus seasonal questing activity, particularly apparent in the juvenile tick stages, in central and southern California relative to observed patterns in Lyme-endemic northwestern California. Notably, the highly truncated period of questing activity of the juvenile stages has important implications for pathogen transmission dynamics in that there exists only a brief window for horizontally transmitted pathogens to be acquired by one tick cohort and subsequently transmitted, through hosts, to the next tick cohort in this system. The broader patterns observed also suggest low human risk of tick-borne disease in central and southern California, and have implications for reduced tick-borne disease risk in the western US more generally under projected climate change. [ABSTRACT FROM AUTHOR]

Salp15, a 15-kDa salivary gland protein plays an important role in tick blood-feeding and transmission of Borrelia burgdorferi , the causative agent of Lyme borreliosis. The comparative studies reveal that Salp15 is a genetically conserved protein across various Ixodes species. In this study, we have identified a Salp15 homolog, designated as Iaff15, from Ixodes affinis ticks that are the principal enzootic vectors of B. burgdorferi sensu stricto in the southeastern part of the United States. Comparison of the annotated amino acid sequences showed that Iaff15 share 81% homology with I. sinensis Salp15 homolog and 64% homology with I. scapularis Salp15. Phylogenetic analysis revealed that Iaff15 come within the same clade with I. sinensis , I. scapularis , and I. pacificus Salp15 homologs. The bioinformatics analysis of the posttranslational modifications prediction revealed that all the Salp15 family members contain glycosylation sites. In addition, Iaff15 carried a higher number of Casein Kinase II phosphorylation sites in comparison to the other Salp15 family members. Collectively, high sequence conservation distributed over the entire amino acids sequence not only suggests an important role for Iaff15 in I. affinis blood feeding and vector–pathogen interactions but may also lead to the development of an anti-vector vaccine against this group of ticks. [ABSTRACT FROM AUTHOR]

Dusky-footed woodrats are territorial cricetid rodents that individually occupy large stick houses from which they foray to gather food, find mates, and engage in other activities. These rodents are often bitten by Ixodes spp. ticks and are reservoirs of some strains of tick-borne bacterial pathogens such as Anaplasma phagocytophilum and Borrelia burgdorferi . Limited dispersal by hosts and vectors could create fine-scale population structure where related hosts and pathogen exposure are co-distributed in space. To quantify population genetic structure and infection status, we genotyped 167 woodrats using a panel of 15 microsatellite loci from three northern California study sites: Soquel (SD), Cold Canyon (CC), and Quail Ridge (QR). We used quantitative PCR and serology to test for infection with A. phagocytophilum and B. burgdorferi. All three populations maintained similar, moderately high levels of genetic variation. For A. phagocytophilum, the PCR-prevalence was higher at SD (30.0%) than CC (13%) and QR (7%) whereas the seroprevalence was similar at all three sites (13–18%). The B. burgdorferi PCR-prevalence at CC was 11%, no woodrats were PCR-positive at QR, and none were tested at SD. We found a negative correlation between pairwise genetic relatedness and spatial distance with the majority of highest order relatives occurring within 200 m of one another. Related dyads were more likely to be adult females than males, suggesting that adult female residents are the primary source of spatially proximate, high-order relatives in woodrat populations. Despite spatial genetic clustering of hosts, our spatial window test found no significant clustering of pathogens. Woodrats that were seropositive for A. phagocytophilum had higher heterozygosity than seronegative woodrats, which could be consistent with genetically diverse individuals having greater capacity to mount an immune response. Overall, our analyses show that limited dispersal of individual woodrats leads to fine-scale genetic structure within populations. Genetic structure, coupled with the limited dispersal of I. pacificus ticks could result in disease dynamics that are uniquely restricted to small spatial scales. By combining host genetic and disease studies we are able to infer limited dispersal and structured populations among hosts which affect infectious disease clustering and dynamics. [ABSTRACT FROM AUTHOR]