Lyme Borreliosis in Children: A Tertiary Referral Hospital–Based Retrospective Analysis
This study aims to estimate the incidence of LB among children with a clinical suspicion for Lyme in a tertiary referral center in the Netherlands. Patient chart data on medical history, clinical signs and symptoms, diagnostic test results and diagnoses were collected using standardized case record forms. Patients were categorized based on clinical and laboratory findings using a modified, previously published classification system. We included 325 children, with a median age of 11.9 years, of whom 61.8% were female. LB was diagnosed in 38 of the referred children (11.7%). However, of the 85 patients who were specifically referred to the Lyme clinic, 28 (32.9%) were diagnosed with LB. Of the specifically referred Lyme-positive patients, 11 (39.3%) had a definitive LB diagnosis. Twelve children had a posttreatment LB syndrome. In line with previous reports in adults, only a small proportion of children referred with a suspicion of LB were diagnosed with definite or probable LB, which illustrates the difficulty in diagnosing LB by the general practitioner or pediatrician in a district hospital.
Publication date: Available online 14 December 2018Source: Ticks and Tick-borne DiseasesAuthor(s): George Psevdos, Teresa Khoo, Robert Chow, Christopher L Romano, Scott CampbellAbstractIn North America, Lyme disease (LD) is caused predominantly by the spirochete Borrelia burgdorferisensu stricto, and is transmitted by blacklegged ticks. Long Island, New York, is highly endemic for the disease. The C6 peptide (C6P) is currently used as a screening test for LD in our institution. Our objective was to examine how screening with C6P concorded with diagnosis of LD at the Veterans Affairs Medical Center, Northport, Long Island. ...
AbstractBackgroundThe clinical course of children with advanced heart block secondary to Lyme disease has not been well characterized.ObjectiveTo review the presentation, management, and time to resolution of heart block due to Lyme disease in previously healthy children.MethodsAn IRB approved single-center retrospective study was conducted of all patients
We describe a case of late neuroborreliosis in an Erasmus programme student living in Porto. We discuss the importance of the epidemiological suspicion, the clinical approach, the diagnostic criteria and the most adequate treatment. PMID: 30332376 [PubMed - in process]
Publication date: Available online 26 September 2018Source: Ticks and Tick-borne DiseasesAuthor(s): R. Dersch, A. Sarnes, M. Maul, O. Minakowski, T. Hottenrott, O. Stich, S. RauerAbstractAbout 5–20% of the general population in endemic areas have seroprevalence for anti-borrelial antibodies. Previous studies have shown a high rate of 25–97% of persisting anti-borrelial antibodies in patients with treated Lyme neuroborreliosis (LNB) at follow-up. These studies used immunoblots with antigens from whole-cell sonicates, which could be less specific than modern recombinant antigens. We assessed the seroprevalence of...
This study assessed cost-effectiveness of a potential anti-tick vaccine that would protect against both Lyme borreliosis (LB) and tick-borne encephalitis (TBE) in a highly endemic setting of Slovenia.A Markov model was developed to estimate cost-effectiveness of a vaccine with potential combined protection against LB and TBE from the societal perspective. The model expressed time in annual cycles, followed a target population through their lifetime, and applied an annual discounting of 3%. A target population entered the model in a susceptible state, with time dependent probabilities to acquire LB/TBE. Disease manifestatio...
Lyme disease is the most common vector-borne illness in North America, with the majority of cases occurring in the Northeast and upper Midwest. Lyme arthritis is the most prevalent manifestation of late-stage Lyme disease. Lyme arthritis typically presents as a monoarthritis or oligoarthritis in large joints such as the knee. Accompanying positive 2-tier Lyme serologies or polymerase chain reaction from synovial fluid/tissue is considered diagnostic for patients from an endemic area. The mainstay of initial treatment is a prolonged course of oral antibiotics.
Conclusions: Our results confirm national trends suggesting increasing rates of TBI and substantially increased testing. This may reflect a greater incidence of TBI in our region and/or increased awareness of these infections. PMID: 30032283 [PubMed - as supplied by publisher]
This study shows that humus type can be indicative of nymph abundance. Three types of humus were observed: (1) moder, (2) mull, and (3) mull-moder humus. One of them, moder humus, which is characterized by a thick layer of fragmented leaves, was found in multivariate analyses to be strongly associated with the nymph abundance. This study demonstrates that factors such as saturation deficit do not suffice to explain the differences in nymph abundance among sites. The composition of the soil and especially the type of humus should also be taken into consideration when assessing acarological risk.
We examined incidence rate trends of first Lyme disease diagnosis among 384,652 Maryland Medicaid members enrolled from July 2004-June 2011. Age, gender, county, season, and year-specific incidence rates were calculated, and mixed effects multiple logistic regression models were used to study the relationship between diagnosis and these variables. The incidence rate in our sample was 97.65 per 100,000 person-years (95% confidence interval (CI): 91.53, 104.06), and there was a 13% average annual increase in odds of diagnosis (odds ratio: 1.13, 95% CI: 1.09, 1.17, P
The objectives of this study were to use data from client-owned cats in an Ixodes scapularis endemic area to evaluate for clinical associations with diagnostic test results for Anaplasma phagocytophilum and Borrelia burgdorferi and to provide information from a group of cats with possible borreliosis as the cause of clinical manifestations of disease. All cases were evaluated at one clinic, medical records were evaluated, and sera from all cats were tested using one of two commercially available assays labeled for the use with dog sera (SNAP ® 4Dx® or SNAP® 4Dx® Plus; IDEXX Laboratories, Westbrook, ME).