AWARENESS OF LYME BORRELIOSIS OF THE PATIENTS OF TERNOPIL REGIONAL TB DISPENSARY

Background. Lyme disease has many clinical features similar tothose in sarcoidosis and tuberculosis. Epidemiological data in the world, in particular in Ukraine, proves the increase in Lyme borreliosis incidence. Ternopil region is endemic with Lyme borreliosis.Objective. The research was aimed to investigate the prevalence of infection with Borrelia burgdorferi and epidemiology features of borreliosis among the patients of Ternopil Regional TB Dispensary.Methods. In total, 29 patients were admitted to Departments of Differential Diagnostic, TB Therapy and TB Surgery of Ternopil Regional TB Dispensary in October 2016-January 2017. All the surveyed answered the questions of an integrated international questionnaire, where they noted the area and a number of tick bites, described the removal method, noted the survey for borreliosis pathogen and complaints after tick bites.Results. It was established that 5 respondents had a history of tick bites episodes, but only in one case the patient was examined of borreliosis. Tick bites were noticed in 3 patients with sarcoidosis and 1 with tuberculosis (TB) and exudative pleurisy, respectively.Conclusions. The absence of appeals for medical care, lack of sufficient information on Lyme borreliosis and disuse of preventive measures for tick bites by the interviewed patients of Ternopil regional TB dispensary departments proves the need of improvement of health education on Lyme borreliosis (LB) among this category of population. 24 (82.7%) of 29 respondents did not remember the tick bite. The symptoms of (LB) are similar to those in sarcoidosis and tuberculosis (pleural lesions, heart, joints, nervous system, skin), and the presence of tick bites gives the reasons to examine these patients of Borrelia burgdorferi senso lato

Exposure to ticks and seroprevalence of Borrelia burgdorferi among a healthy young population living in the area of southern Podlasie, Poland

Objectives. The objective of the study was assessment of risk of infection with Borrelia burgdorferi in the area of southern Podlasie in Poland, near the border with Belarus, by analysis of post-exposure procedure, and evaluation of asymptomatic infection in adolescents bitten by a tick, confirmed by serologic tests. Material and methods. The study was conducted among 128 healthy individuals aged 16–20 who declared being bitten by a tick. The level of IgM and IgG class antibodies was determined using the immunoenzymatic test (Borrelia 14 kD + OspC IgM ELISA and Borrelia IgG + VlsE ELISA, DRG Diagnostics). Positive and doubtful results were confirmed using the Western blot method (EUROLINE-WB, EUROIMMUN). Results. In the study group, the largest number of respondents (59.4%) declared tick bite in the region of the lower extremities, most often in the knee pit. Among the methods for removing the tick the largest number of respondents indicated removing it with the use of tweezers, with a simple, swift steady movement (29.7%), and pulling it out with the fingers (22.7%). In the ELISA test, a positive or doubtful result in at least one class was observed in 25.0% of respondents (n=32/128): in IgM class – 23.4% (n=30/128), and in IgG class – 4.7% (n=6/128). After verification with the Western blot test, infection was confirmed in 5.5% of respondents (n=7/128): in IgM class – 1.6% (n=2/128), in IgG class – 3.9% (n=5/128). In IgM class antibodies, the Western blot test confirmed positive or doubtful results of the ELISA test in 6.7%, while in IgG class antibodies in 83.3%. Conclusion. Evaluation of the actual infection with Borrelia spp. using serologic tests is difficult due to a certain non-specificity of the ELISA test, especially in IgM class antibodies, and difficulties with performance of a wide scope of specific Western blot tests. The variety of methods of tick removal declared by adolescents suggests that a wider education of society concerning appropriate methods of removing the tick should become an especially important element of prophylactic actions in the area of borreliosis

Sytuacja epidemiologiczna boreliozy z Lyme na terenie pogranicza polsko-białoruskiego w latach 2012-2016 (województwo podlaskie i obwód grodzieński)

Lyme borreliosis (LB) is the most common tick-borne disease in Europe and the number of reported cases is constantly rising. An increase in morbidity can be observed both in Poland and Belarus; however, the recorded rates are much higher in Poland. The aim of the article was to analyze the epidemiological situation of Lyme borrelosis in neighbouring territories in the Polish-Belarusian borderland: Grodno Region and Podlasie Province in the years 2012-2016. Differences in the recorded incidence of Lyme borreliosis in the analyzed territories were higher than those noted as national indicators in each consecutive year of the analyzed fiveyear period. In 2016, the incidence rate in Grodno Region was 25.0/100,000 inhabitants, while in Podlasie Province it was over 5 times higher (134.9/100,000 inhabitants). A detailed analysis of the rates in particular districts of the analyzed territories showed that the areas in Podlasie Province directly adjacent to Grodno Region are characterized by high Lyme borreliosis incidence rates, whereas those in Grodno Region bordering with Podlasie Province generally recorded rates close to the indicator for the whole region. Understanding the big differences in the recorded incidence of LB in the neighbouring Polish-Belarusian border areas requires further detailed analyses in order to identify the factors influencing such a situation.Borelioza z Lyme (LB) jest najczęściej rejestrowaną chorobą odkleszczową w Europie i liczba zgłaszanych zachorowań stale rośnie. Zarówno w Polsce, jak i Białorusi obserwujemy wzrost zachorowań; rejestrowane współczynniki zapadalności są jednak wyraźnie wyższe w Polsce. Celem artykułu była analiza sytuacji epidemiologicznej boreliozy z Lyme w sąsiadujących ze sobą regionach na terenie pogranicza polsko-białoruskiego: obwodzie grodzieńskim i województwie podlaskim, w latach 2012-2016. W analizowanych regionach, różnice w rejestrowanej zapadalności na boreliozę z Lyme okazały się jeszcze większe, aniżeli w odniesieniu do wskaźników krajowych w każdym z pięciu analizowanych lat. W roku 2016 wskaźnik zapadalności na boreliozę z Lyme w obwodzie grodzieńskim wyniósł 25,0/100 tys. mieszkańców, podczas gdy w województwie podlaskim był ponad 5-krotnie wyższy (134,9/100 tys. mieszkańców). Szczegółowa analiza wskaźników zapadalności w poszczególnych powiatach i rejonach analizowanych regionów wykazała, iż w województwie podlaskim, powiaty bezpośrednio graniczące z obwodem grodzieńskim charakteryzują się wysokimi wskaźnikami zapadalności na boreliozę z Lyme, podczas gdy rejony obwodu grodzieńskiego graniczące z województwem podlaskim z reguły rejestrowały wskaźniki zapadalności zbliżone do ogólnego wskaźnika w obwodzie grodzieńskim. Bardzo duże zróżnicowanie w rejestrowanej zapadalności na LB w sąsiadujących rejonach pogranicza polsko-białoruskiego, skłaniają do dalszej szczegółowej analizy celem wyłonienia czynników wpływających na taką sytuację