Clinical-epidemiologic and serologic characteristics of Lyme disease in the Zaporizhzhia region (a retrospective analysis for 2015–2019 according to the Municipal Institution “Regional Infectious Hospital” of Zaporizhzhia Regional Council)

Authors

DOI:

https://doi.org/10.14739/2310-1210.2022.4.256223

Keywords:

Lyme disease, clinic, serodiagnosis

Abstract

The aim of the work is to clarify the clinical and laboratory features of Lyme disease in the Zaporizhzhia region on the basis of a retrospective clinical, epidemiological and serological analysis of this disease cases in the period from 2015 to 2019.

Materials and methods. A retrospective analysis of 62 medical cards of stationary patients with Lyme disease for the period from 2015 to 2019 was carried out. The age of the patients ranged from 18 to 79 years. There were 38 men and 24 women. All the patients were given a traditional complex clinical-laboratory examination; ELISA was used to defined serum IgM and IgG to Borrelia burgdorferi.

Results. According to the study results it was found that Lyme disease in the Zaporizhzhia region had a clear seasonal prevalence in summer (56.5 %) and spring (25.8 %). The vast majority of patients (80.6 %) clearly indicated the tick bite. The disease was mostly acute (90.3 %) with a predominance of erythema (94.6 %). In the acute course of the disease, patients were seropositive in 75.0 % of cases with simultaneous detection of both IgM and IgG to Borrelia burgdorferi, and positive IgM in the absence of IgG. Seronegative 25.0 % of patients required clear clinical and epidemiological data to confirm the diagnosis. Under prolonged and chronic conditions, patients had positive IgG to Borrelia burgdorferi (100 %) and IgM (50.0 %).

Certain clinical and laboratory features at different course of Lyme disease were revealed. So, the acute course was characterized by the predominance of erythema (94.6 %), mild or no manifestations of general intoxication syndrome, lack of pathological changes in the hemogram in most patients (80.4 %). In the prolonged and chronic course, there was no history of erythema, clinical symptoms were polymorphic, half of the patients had increased erythrocyte sedimentation rate in the absence of changes in blood count, mild cytolytic syndrome and hyperbilirubinemia.

Conclusions. As a result of the retrospective analysis of Lyme disease cases in the period from 2015 to 2019, certain patterns of epidemiological, clinical and serological changes in different courses of this infection in the Zaporizhzhia region were revealed, namely the clear seasonality of the disease, in the acute course – the predominance of erythema and different variants of serological profile in patients, and in prolonged and chronic course – polymorphism of all clinical symptoms and no history of erythema.

Author Biographies

O. O. Furyk, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Associate Professor of the Department of Infectious Diseases

K. A. Pak, Zaporizhzhia State Medical University, Ukraine

MD, Senior Laboratory Assistant of the Department of Infectious Diseases

O. V. Riabokon, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor, Head of the Department of Infectious Diseases

D. A. Zadyraka, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Associate Professor of the Department of Infectious Diseases

Yu. Yu. Riabokon, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor of the Department of Children Infectious Diseases

References

Schutzer, S. E., Body, B. A., Boyle, J., Branson, B. M., Dattwyler, R. J., Fikrig, E., Gerald, N. J., Gomes-Solecki, M., Kintrup, M., Ledizet, M., Levin, A. E., Lewinski, M., Liotta, L. A., Marques, A., Mead, P. S., Mongodin, E. F., Pillai, S., Rao, P., Robinson, W. H., Roth, K. M., … Branda, J. A. (2019). Direct Diagnostic Tests for Lyme Disease. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 68(6), 1052-1057. https://doi.org/10.1093/cid/ciy614

Steere, A. C., Strle, F., Wormser, G. P., Hu, L. T., Branda, J. A., Hovius, J. W. R., Li X., Mead, P. S. (2016). Lyme borreliosis. Nature Reviews Disease Primers, 2. https://doi.org/10.1038/nrdp.2016.90

Sykes, R. A., & Makiello, P. (2017). An estimate of Lyme borreliosis incidence in Western Europe†. Journal of public health, 39(1), 74-81. https://doi.org/10.1093/pubmed/fdw017

Centers for Disease Control and Prevention (2013, August 19). CDC Provides Estimate of Americans Diagnosed with Lyme Disease Each Year. http://www.cdc.gov/media/releases/2013/p0819-lyme-disease.html

Mead, P. S. (2015). Epidemiology of Lyme disease. Infectious disease clinics of North America, 29(2), 187-210. https://doi.org/10.1016/j.idc.2015.02.010

Center for Public Health of the Ministry of Health of Ukraine (2020, May 5). Za try misiatsi 2020-ho roku v Ukraini zafiksovano 236 vypadkiv khvoroby Laima [In three months of 2020, 236 cases of Lyme disease were recorded in Ukraine]. https://phc.org.ua/news/za-tri-misyaci-2020-go-roku-v-ukraini-zafiksovano-236-vipadkiv-khvorobi-layma

Nebogatkin, I. V., & Shulhan, A. M. (2021). Epidemiolohichni y epizootychni osoblyvosti khvoroby Laima u 2019 rotsi v Ukraini [Epidemiological and epizootic features of Lyme disease in 2019 in Ukraine]. Aktualna infektolohiia, 8(5-6), 44-48. [іn Ukrainian]. https://doi.org/10.22141/2312-413x.8.5-6.2020.217959

Stone, B. L., Tourand, Y., & Brissette, C. A. (2017). Brave New Worlds: The Expanding Universe of Lyme Disease. Vector borne and zoonotic diseases, 17(9), 619-629. https://doi.org/10.1089/vbz.2017.2127

Cardenas-de la Garza, J. A., De la Cruz-Valadez, E., Ocampo-Candiani, J., & Welsh, O. (2019). Clinical spectrum of Lyme disease. European journal of clinical microbiology & infectious diseases, 38(2), 201-208. https://doi.org/10.1007/s10096-018-3417-1

Strnad, M., Hönig, V., Růžek, D., Grubhoffer, L., & Rego, R. (2017). Europe-Wide Meta-Analysis of Borrelia burgdorferi Sensu Lato Prevalence in Questing Ixodes ricinus Ticks. Applied and environmental microbiology, 83(15), e00609-17. https://doi.org/10.1128/AEM.00609-17

Estrada-Peña, A., Cutler, S., Potkonjak, A., Vassier-Tussaut, M., Van Bortel, W., Zeller, H., Fernández-Ruiz, N., & Mihalca, A. D. (2018). An updated meta-analysis of the distribution and prevalence of Borrelia burgdorferi s.l. in ticks in Europe. International journal of health geographics, 17(1), 41. https://doi.org/10.1186/s12942-018-0163-7

Pritt, B. S., Mead, P. S., Johnson, D., Neitzel, D. F., Respicio-Kingry, L. B., Davis, J. P., Schiffman, E., Sloan, L. M., Schriefer, M. E., Replogle, A. J., Paskewitz, S. M., Ray, J. A., Bjork, J., Steward, C. R., Deedon, A., Lee, X., Kingry, L. C., Miller, T. K., Feist, M. A., Theel, E. S., … Petersen, J. M. (2016). Identification of a novel pathogenic Borrelia species causing Lyme borreliosis with unusually high spirochaetaemia: a descriptive study. The Lancet. Infectious diseases, 16(5), 556-564. https://doi.org/10.1016/S1473-3099(15)00464-8

Stanek, G., Wormser, G. P., Gray, J., & Strle, F. (2012). Lyme borreliosis. Lancet, 379(9814), 461-473. https://doi.org/10.1016/S0140-6736(11)60103-7

Shapiro, E. D. (2014). Clinical practice. Lyme disease. The New England journal of medicine, 370(18), 1724-1731. https://doi.org/10.1056/NEJMcp1314325

Moore, A., Nelson, C., Molins, C., Mead, P., & Schriefer, M. (2016). Current Guidelines, Common Clinical Pitfalls, and Future Directions for Laboratory Diagnosis of Lyme Disease, United States. Emerging infectious diseases, 22(7), 1169-1177. https://doi.org/10.3201/eid2207.151694

Sharma, A., Guleria, S., Sharma, R., & Sharma, A. (2017). Lyme Disease: A Case Report with Typical and Atypical Lesions. Indian dermatology online journal, 8(2), 124-127. https://doi.org/10.4103/2229-5178.202271

National Institute for Health and Care Excellence. (2018, October 17). Lyme disease NICE guideline [NG95]. https://www.nice.org.uk/guidance/ng95

Rebman, A. W., & Aucott, J. N. (2020). Post-treatment Lyme Disease as a Model for Persistent Symptoms in Lyme Disease. Frontiers in medicine, 7, 57. https://doi.org/10.3389/fmed.2020.00057

Chemych, M., & Lutai, I. (2020). Lyme disease modern issue condition. Eastern Ukrainian Medical Journal, 8(2), 230-241. [іn Ukrainian]. https://doi.org/10.21272/eumj.2020;8(2):230-241

Tulloch, J., Decraene, V., Christley, R. M., Radford, A. D., Warner, J. C., & Vivancos, R. (2019). Characteristics and patient pathways of Lyme disease patients: a retrospective analysis of hospital episode data in England and Wales (1998-2015). BMC public health, 19(1), 931. https://doi.org/10.1186/s12889-019-7245-8

Hirsch, A. G., Herman, R. J., Rebman, A., Moon, K. A., Aucott, J., Heaney, C., & Schwartz, B. S. (2018). Obstacles to diagnosis and treatment of Lyme disease in the USA: a qualitative study. BMJ open, 8(6), e021367. https://doi.org/10.1136/bmjopen-2017-021367

Knudtzen, F. C., Andersen, N. S., Jensen, T. G., & Skarphédinsson, S. (2017). Characteristics and Clinical Outcome of Lyme Neuroborreliosis in a High Endemic Area, 1995-2014: A Retrospective Cohort Study in Denmark. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 65(9), 1489-1495. https://doi.org/10.1093/cid/cix568

Kannangara, D. W., & Patel, P. (2018). Report of Non-Lyme, Erythema Migrans Rashes from New Jersey with a Review of Possible Role of Tick Salivary Toxins. Vector borne and zoonotic diseases, 18(12), 641-652. https://doi.org/10.1089/vbz.2018.2278

Eldin, C., Jaulhac, B., Mediannikov, O., Arzouni, J. P., & Raoult, D. (2019). Values of diagnostic tests for the various species of spirochetes. Medecine et maladies infectieuses, 49(2), 102-111. https://doi.org/10.1016/j.medmal.2019.01.009

Sanderson, V. P., Mainprize, I. L., Verzijlenberg, L., Khursigara, C. M., & Wills, M. (2020). The Platelet Fraction Is a Novel Reservoir to Detect Lyme Borrelia in Blood. Biology, 9(11), 366. https://doi.org/10.3390/biology9110366

Lacout, A., Mone, Y., Franck, M., Marcy, P. Y., Mas, M., Veas, F., & Perronne, C. (2018). Blood cell disruption to significantly improve the Borrelia PCR detection sensitivity in borreliosis in humans. Medical hypotheses, 116, 1-3. https://doi.org/10.1016/j.mehy.2018.04.012

Ružić-Sabljić, E., & Cerar, T. (2017). Progress in the molecular diagnosis of Lyme disease. Expert review of molecular diagnostics, 17(1), 19-30. https://doi.org/10.1080/14737159.2016.1246959

Waddell, L. A., Greig, J., Mascarenhas, M., Harding, S., Lindsay, R., & Ogden, N. (2016). The Accuracy of Diagnostic Tests for Lyme Disease in Humans, A Systematic Review and Meta-Analysis of North American Research. PloS one, 11(12), e0168613. https://doi.org/10.1371/journal.pone.0168613

Maccallini, P., Bonin, S., & Trevisan, G. (2018). Autoimmunity against a glycolytic enzyme as a possible cause for persistent symptoms in Lyme disease. Medical hypotheses, 110, 1-8. https://doi.org/10.1016/j.mehy.2017.10.024

Crossland, N. A., Alvarez, X., & Embers, M. E. (2018). Late Disseminated Lyme Disease: Associated Pathology and Spirochete Persistence Posttreatment in Rhesus Macaques. The American journal of pathology, 188(3), 672-682. https://doi.org/10.1016/j.ajpath.2017.11.005

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Published

2022-09-06

How to Cite

1.
Furyk OO, Pak KA, Riabokon OV, Zadyraka DA, Riabokon YY. Clinical-epidemiologic and serologic characteristics of Lyme disease in the Zaporizhzhia region (a retrospective analysis for 2015–2019 according to the Municipal Institution “Regional Infectious Hospital” of Zaporizhzhia Regional Council). Zaporozhye Medical Journal [Internet]. 2022Sep.6 [cited 2024Oct.6];24(4):464-9. Available from: http://zmj.zsmu.edu.ua/article/view/256223

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Original research