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Lyme borreliosis (LB) is a common and increasing tick-borne disease in Europe. The risk of acquiring a Borrelia infection after a tick bite is not fully known. Therefore, we investigated the incidence of Borrelia infection after a bite by a Borrelia -infected tick and if the Borrelia load and/or the duration of tick-feeding influenced the risk of infection. During 2008–2009, ticks and blood samples were collected from 1546 tick-bitten persons from Sweden and the Åland Islands, Finland. Follow-up blood samples were taken 3 months after the tick bite. The duration of tick feeding was microscopically estimated and Borrelia was detected and quantified in ticks by real-time PCR. Anti- Borrelia antibodies were detected in sera using ELISA tests and immunoblot. Five percent (78/1546) of the study participants developed Borrelia infection (LB diagnosis and/or seroconversion) after a tick bite (45% bitten by Borrelia -infected ticks and 55% bitten by uninfected ticks). Of these, 33 developed LB (whereof 9 also seroconverted) while 45 participants seroconverted only. Experience of non-specific symptoms was more frequently reported by Borrelia -infected participants compared to uninfected participants. All who seroconverted removed “their” ticks significantly later than those who did not. The Borrelia load in the ticks did not explain the risk of seroconversion. Regional and sex differences in the Borrelia seroprevalence were found. The risk of developing a Borrelia infection after a bite by a Borrelia -infected tick is small but increases with the duration of tick feeding. [ABSTRACT FROM AUTHOR]

Abstract: There has been an emergence of tick-borne encephalitis (TBE) cases in western Sweden over the past 10 years. Human cases cluster in distinct regions around major bodies of water, raising the question of TBE prevalence in ticks within these defined localities. This study was based on a collection of 7120 questing nymphs, 510 questing adults, and 132 fed female ticks from cows in 4 suspected TBE foci, based on human cases, and 2 non-endemic areas of western Gotaland. All tick pools were screened with Real-Time RT-PCR targeting the non-coding 3′-region. Prevalence in ticks in the endemic areas ranged from 0.1% to 0.42%, which is comparable with other more established TBE endemic regions in Europe. Of the 18 positive pools, viral copy numbers ranged from 500 to 3.7×109 copies/pool. Sequence data from a TBE patient in western Gotaland confirmed that the western European subtype of TBEV has spread to western Sweden. [Copyright &y& Elsevier]

• The SEXual health Identification Tool (SEXIT) is an assessment tool for youth clinics. • Systematic assessments ensured consistency and quality in assessing visitors. • SEXIT facilitated for staff to identify young people at risk of sexual ill health. • Using SEXIT was challenged by heavy workload and conflicting routines. • Wider implementation of SEXIT in Swedish youth clinics is feasible. Young people are disproportionally burdened by sexual ill health. The SEXual health Identification Tool (SEXIT) was developed for use at youth clinics, to facilitate identification of visitors exposed to or at risk of sexual ill health. The aim of this study was to explore experiences of using SEXIT among youth clinic staff who participated in a pilot implementation, with a focus on usefulness, implementation determinants, and feasibility of implementing SEXIT at Swedish youth clinics. Four focus group discussions were conducted with youth clinic staff from three clinics. The clinics had used SEXIT systematically in consultations with all visitors for one month. Data were analysed using qualitative analysis designed for focus groups. Most participants experienced that the SEXIT routines were well functioning and that using SEXIT gave a comprehensive picture of the visitor and resulted in more concrete answers, which facilitated the risk assessment. The medical staff experienced that they identified more youth at risk with SEXIT, while the psychosocial staff were less convinced. Existing challenges related to the routines at the clinics and heavy workload during drop-in hours. Staff experience SEXIT as useful for identifying young people exposed to or at risk of sexual ill health. Systematic use ensures consistency and quality in assessing the visitors, which may facilitate implementation. The use of SEXIT is challenged by heavy workload, conflicting routines, and the experience that some visitors identified through SEXIT decline further care. Implementation of SEXIT in Swedish youth clinics is considered feasible. [ABSTRACT FROM AUTHOR]