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Frahier H, Klopfenstein T, Brunel AS, Chirouze C, Bouiller K. Characteristics of patients consulted for suspected Lyme neuroborreliosis in an endemic area. Ticks Tick Borne Dis 2024; 15:102353. [PMID: 38761786 DOI: 10.1016/j.ttbdis.2024.102353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 05/20/2024]
Abstract
INTRODUCTION Some patients with unexplained neurological symptoms sought care for presumed Lyme neuroborreliosis (LNB). We aimed to compare patients' characteristics with and without LNB. MATERIAL AND METHODS All patients consulting for LNB suspicion and having a lumbar puncture between 2014 and 2020 in a high endemic area of Lyme borreliosis were included in the study. RESULTS One hundred fifty-five patients were included. Forty-five patients (29 %) had LNB (mean age: 57.6 years, 28.9 % of women) including 17 with isolated intrathecal synthesis. One hundred and ten patients had no LNB (mainly neurological (29 %) and rheumatological diseases (19 %)). Non-neurological symptoms were similar in patients with LNB and patients with no LNB (asthenia, 31 % vs. 46 %, p = 0.14, arthralgia 20 % vs. 31 %, p = 0.14) with the exception of myalgia, which was less frequent in patients with LNB (4.4 % vs. 19.1 % p = 0.02). In multivariable analysis, factors associated with LNB were presence of facial nerve palsy (OR = 5.7), radiculopathy (OR = 11.3), positive Lyme serology (OR = 5.4) and duration of symptoms less than 3 months (OR = 4.48). Patients with isolated intrathecal synthesis had a longer duration of symptoms (3 vs 1 months) than patients with pleocytosis. Asthenia (5.9 % vs. 32.1 %), headaches (0 % vs. 39.3 %) neuropathic pain (17.6 % vs. 50 %) and facial palsy (11.8 % vs. 39.3 %) were less frequent in patients with isolated intrathecal synthesis than patients with pleocytosis. The presence of isolated subjective neurological symptoms (paresthesia, memory disorders, insomnia, irritability, asthenia, headaches) was reported in 7/17 (41 %) of patients with isolated intrathecal synthesis, 2/28 (7.1 %) in patients with pleocytosis and 75/110 (68 %) in patients without LNB (p < 0.001). CONCLUSION More than one quarter of patients consulted for suspected LNB had non-neurologic symptoms, whether or not they have a LNB. Concerning patients with isolated intrathecal synthesis, the question of presence of sequelae with a spontaneously cured disease or an active Lyme borreliosis requiring antibiotic remain.
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Affiliation(s)
- Hélène Frahier
- Besançon University Hospital, Department of Infectious and Tropical Diseases, F-25000 Besançon, France
| | - Timothée Klopfenstein
- Nord Franche-Comté Hospital, Department of Infectious Diseases, 90400, Trevenans, France
| | - Anne-Sophie Brunel
- Besançon University Hospital, Department of Infectious and Tropical Diseases, F-25000 Besançon, France
| | - Catherine Chirouze
- Franche-Comté university, CHU Besançon, UMR-CNRS 6249 Chrono-environnement, Department of Infectious and Tropical Diseases, F-25000 Besançon, France
| | - Kevin Bouiller
- Franche-Comté university, CHU Besançon, UMR-CNRS 6249 Chrono-environnement, Department of Infectious and Tropical Diseases, F-25000 Besançon, France.
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Nuttens C, Duret S, Bessou A, Baux E, Faucher JF, Pilz A, Moïsi JC, Stark JH. Evolution of Lyme Borreliosis Epidemiology in Primary Care and Hospital Settings in France During the COVID-19 Pandemic. Vector Borne Zoonotic Dis 2024. [PMID: 39013022 DOI: 10.1089/vbz.2024.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024] Open
Abstract
Background: Lyme borreliosis (LB) remains a public health concern in France despite improved patient management and medical care. Stay-at-home restrictions during the COVID-19 pandemic, which affected participation in outdoor recreational activities and disrupted access to health care services, may have impacted the risk of developing LB. Methods: We analyzed data from two general practitioner networks in France (Sentinel Network and an electronic medical records database [EMR]) and the national hospital discharge database to describe LB epidemiology in 2020-2021 and compare it to previous years. Google Trends' search volume was used to evaluate the association between the population's interest in LB and the evolving epidemiology. Results: Annual LB incidence rates in primary care decreased from 104 cases/100,000 population in 2018 to 71/100,000 in 2021 and from 82/100,000 to 60/100,000 according to Sentinel Network and EMR, respectively. Google Trends' search volume for "Lyme" followed a similar trend, one year earlier. Annual hospitalizations were stable from 2012-2019 (1.6/100,000 on average) and declined to 1.3/100,000 in 2020 and 1.1/100,000 in 2021. This decline was observed primarily in adults (e.g., 3.4/100,000 in 2017-2019 to 1.8/100,000 in 2020-2021 for 70-79 years of age). Changes in regional incidence rates in primary care from 2017-2019 to 2020-2021 ranged from -75% to 208%. Hospitalizations decreased in all regions except in Bretagne. Conclusions: The estimated LB incidence decreased in 2020 and 2021 compared with previous years but this change may not be related to COVID-19. The incidence decrease observed in primary care could result from reduced population interest in LB, leading to lower care-seeking behavior. The decrease in LB hospitalizations may be explained by changes in clinical practice. Surveillance systems are critical to understand the evolution of LB epidemiology. However, external factors impacting incidence estimates should be considered.
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Affiliation(s)
- Charles Nuttens
- Vaccines/Antivirals & Evidence Generation, Pfizer PIO, Paris, France
| | | | | | - Elisabeth Baux
- Service des maladies infectieuses et tropicales, Centre de Référence des Maladies Vectorielles à Tiques, Région Est, CHU de Nancy, Nancy, France
| | | | - Andreas Pilz
- Vaccines/Antivirals & Evidence Generation, Pfizer Corporation Austria GmbH, Vienna, Austria
| | - Jennifer C Moïsi
- Vaccines/Antivirals & Evidence Generation, Pfizer PIO, Paris, France
| | - James H Stark
- Vaccines/Antivirals & Evidence Generation, Pfizer Inc, Collegeville, Pennsylvania, USA
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Hamadou L, Buteau F, Petrosyan E, Martineau D, Sauvat L, Audibert M, Lesens O. Costs associated with informal health care pathway for patients with suspected Lyme borreliosis. Infect Dis Now 2024; 54:104841. [PMID: 38012989 DOI: 10.1016/j.idnow.2023.104841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVES To compare the direct and indirect medical costs for patients with suspected Lyme borreliosis according to whether or not they had used an informal care pathway. PATIENTS AND METHODS We retraced the care pathways of participating patients by a prospective questionnaire survey and a retrospective analysis of care records. Direct and indirect costs were estimated using a micro-costing method from different perspectives. We compared the costs of patients who had consulted a "Lyme Doctor" (informal care pathway) with those who had only used the formal care pathway. Non-parametric tests were appraised the significance of the differences between the two groups of patients. RESULTS Out of 103 eligible patients, 49 (including 12 having used an informal health care pathway) agreed to be investigated. Five expenditure items entirely borne by patients were significantly higher for patients following an informal care pathway: productivity loss (3041 ± 6580 vs 194 ± 1177 euros, p = 0.01), alternative therapies (3484 ± 7308 vs 369 ± 956 euros), biological tests sent abroad (571 ± 1415 vs 17 ± 92 euros, p < 0.01), self-medication (918 ± 1998 vs 133 ± 689, p = 0.02) and transport (3 094 ± 3456 vs 1 123 ± 1903p = 0.01). CONCLUSIONS From the patient's standpoint, the informal care pathway involving consultation with a Lyme Doctor is far more expensive than the formal care pathway. More specifically, the patient has to bear the costs of alternative treatments and repeated, non-recommended examinations.
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Affiliation(s)
- Lamriss Hamadou
- Infectious and Tropical Disease Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environmental Microorganism Laboratory, Clermont Auvergne University, Clermont-Ferrand, France; Centre d'Etudes et de Recherche sur le Développement International (CERDI), Foundation for studies and Research on International Development (FERDI), Université Clermont Auvergne, CNRS, IRD, Clermont-Ferrand, France
| | - Fantine Buteau
- Infectious and Tropical Disease Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environmental Microorganism Laboratory, Clermont Auvergne University, Clermont-Ferrand, France; Centre d'Etudes et de Recherche sur le Développement International (CERDI), Foundation for studies and Research on International Development (FERDI), Université Clermont Auvergne, CNRS, IRD, Clermont-Ferrand, France
| | - Evelina Petrosyan
- Infectious and Tropical Disease Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environmental Microorganism Laboratory, Clermont Auvergne University, Clermont-Ferrand, France
| | - Delphine Martineau
- Infectious and Tropical Disease Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environmental Microorganism Laboratory, Clermont Auvergne University, Clermont-Ferrand, France
| | - Léo Sauvat
- Infectious and Tropical Disease Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environmental Microorganism Laboratory, Clermont Auvergne University, Clermont-Ferrand, France
| | - Martine Audibert
- Centre d'Etudes et de Recherche sur le Développement International (CERDI), Foundation for studies and Research on International Development (FERDI), Université Clermont Auvergne, CNRS, IRD, Clermont-Ferrand, France
| | - Olivier Lesens
- Infectious and Tropical Disease Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environmental Microorganism Laboratory, Clermont Auvergne University, Clermont-Ferrand, France; Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana.
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Perthame E, Chartier L, George JC, Varloud M, Ferquel E, Choumet V. Case presentation and management of Lyme disease patients: a 9-year retrospective analysis in France. Front Med (Lausanne) 2024; 10:1296486. [PMID: 38298513 PMCID: PMC10829333 DOI: 10.3389/fmed.2023.1296486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/06/2023] [Indexed: 02/02/2024] Open
Abstract
Introduction Lyme borreliosis (LB) is the most common vector disease in temperate countries of the northern hemisphere. It is caused by Borrelia burgdorferi sensu lato complex. Methods To study the case presentation of LB in France, we contacted about 700 physicians every year between 2003 and 2011. An anonymous questionnaire was established allowing the collection of 3,509 cases. The information collected was imported or directly entered into databases and allowed identifying variables that were validated in a multiple correspondence analysis (MCA). Results Sixty percent of the cases were confirmed, 10% were probable, 13.5% doubtful, 10.2% asymptomatic seropositive and 6.3% were negative. The clinical manifestations reported were cutaneous (63%), neurological (26%), articular (7%), ocular (1.9%) and cardiac (1.3%). Almost all patients were treated. When focusing more particularly on confirmed cases, our studies confirm that children have a distinct clinical presentation from adults. There is a gender effect on clinical presentation, with females presenting more often with erythema migrans or acrodermatitis chronica atrophicans than males, while males present more often with neurological signs or arthritis than females. Discussion This is the first time that a comprehensive study of suspected Lyme borreliosis cases has been conducted over several years in France. Although we were not able to follow the clinical course of patients after treatment, these results suggest the interest of refining the questionnaire and of following up a cohort of patients over a sufficiently long period to obtain more information on their fate according to different parameters.
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Affiliation(s)
- Emeline Perthame
- Bioinformatics and Biostatistics Hub, Institut Pasteur, Université Paris Cité, Paris, France
| | - Loïc Chartier
- LYSARC, Centre Hospitalier Lyon-Sud, Pierre-Bénite Cedex, France
| | | | | | - Elisabeth Ferquel
- Unité Environnement et Risques Infectieux, Institut Pasteur, Université Paris Cité, Paris, France
| | - Valérie Choumet
- Unité Environnement et Risques Infectieux, Institut Pasteur, Université Paris Cité, Paris, France
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Cartau T, Eldin C, Le Turnier P, Eskenazi A, Walter G, Coignard C, Schrooten W, Caumes E, Djossou F, Epelboin L. Is there Lyme borreliosis in French Guiana? Descriptive study among patients referred for a suspected Lyme borreliosis in an Amazonian hospital between 2010 and 2022. Ticks Tick Borne Dis 2024; 15:102255. [PMID: 37734165 DOI: 10.1016/j.ttbdis.2023.102255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/25/2023] [Accepted: 09/01/2023] [Indexed: 09/23/2023]
Abstract
Lyme borreliosis (LB) existence in South America is debated, especially in the Amazon region. The infection with Lyme borreliae has never been reported in French Guiana where Borrelia burgdorferi sensu lato is not found in ticks. We describe the final diagnosis and presumed place of acquisition in patients consulting for suspicion of LB. We retrospectively collected data from all consecutive patients consulting for a suspicion of LB between 2010 and 2021 at Cayenne Hospital, French Guiana. Patients were classified by an adjudication committee as confirmed LB if they met the criteria of the French consensus, as possible LB if they had compatible symptoms and a good outcome after appropriate treatment, or excluded when a differential diagnosis was found. The place of acquisition was discussed in case of possible or confirmed case. Twenty-six patients were included. Rheumatologic symptoms were the most reported (88 %) followed by neurological symptoms (61 %). Twenty-four (92 %) of these patients were born out of French Guiana. Diagnosis of LB was considered as confirmed in 2 patients (8 %), for whom the place of acquisition was likely mainland France, and as possible in 3 patients (11 %) with early localized LB presumably acquired in French Guiana. Functional somatic disorders were diagnosed in 13 (50 %) patients whereas 9 (35 %) were found with another disease. This study did not confirm the acquisition of LB in French Guiana. However, three possible autochthonous cases encourage clinicians working in the Amazon area to stay aware of LB.
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Affiliation(s)
- Tom Cartau
- Department of Infectious Diseases, Hospital of Cayenne, rue des Flamboyants, 97306, Cayenne, France.
| | - Carole Eldin
- Unité des virus émergents, Aix Marseille University, AP-HM, Chemin des Bourrely, 13015, Marseille, France
| | - Paul Le Turnier
- Department of Infectious Diseases, Hospital of Cayenne, rue des Flamboyants, 97306, Cayenne, France; CIC Inserm 1424, Hospital of Cayenne, rue des Flamboyants, 97306, Cayenne, France
| | - Anaïs Eskenazi
- Department of Internal Medicine, Hospital of Cayenne, rue des Flamboyants, 97306, Cayenne, France
| | - Gaëlle Walter
- Department of Infectious Diseases, Hospital of Cayenne, rue des Flamboyants, 97306, Cayenne, France
| | - Catherine Coignard
- Medical Biologist, Eurofins Biomnis, 78 avenue de Verdun, 94208, Ivry-sur-Seine, France
| | - Ward Schrooten
- Department of Medical Information, Hospital of Cayenne, rue des Flamboyants, 97306, Cayenne, France; Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium
| | - Eric Caumes
- Department of Infectious Diseases, Hospital Hotel Dieu, 1 place du Parvis Notre Dame, 75004, Paris, France
| | - Félix Djossou
- Department of Infectious Diseases, Hospital of Cayenne, rue des Flamboyants, 97306, Cayenne, France
| | - Loïc Epelboin
- Department of Infectious Diseases, Hospital of Cayenne, rue des Flamboyants, 97306, Cayenne, France; CIC Inserm 1424, Hospital of Cayenne, rue des Flamboyants, 97306, Cayenne, France
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Prudhomme J, Depaquit J, Fite J, Quillery E, Bouhsira E, Liénard E. Systematic review of hematophagous arthropods present in cattle in France. Parasite 2023; 30:56. [PMID: 38084937 PMCID: PMC10714678 DOI: 10.1051/parasite/2023059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
The arrival of pathogens, whether zoonotic or not, can have a lasting effect on commercial livestock farms, with dramatic health, social and economic consequences. However, available data concerning the arthropod vectors present and circulating on livestock farms in France are still very imprecise, fragmentary, and scattered. In this context, we conducted a systematic review of the hematophagous arthropod species recorded on different types of cattle farms in mainland France (including Corsica). The used vector "groups" studied were biting flies, biting midges, black flies, fleas, horse flies, lice, louse flies, mosquitoes, sand flies, and ticks. A large number of documents were selected (N = 9,225), read (N = 1,047) and analyzed (N = 290), allowing us to provide distribution and abundance maps of different species of medical and veterinary interest according to literature data. Despite the large number of documents collected and analyzed, there are few data provided on cattle farm characteristics. Moreover, data on all arthropod groups lack numerical detail and are based on limited data in time and/or space. Therefore, they are not generalizable nor comparable. There is still little information on many vectors (and their pathogens) and still many unknowns for most studied groups. It appears necessary to provide new, updated and standardized data, collected in different geographical and climatological areas. Finally, this work highlights the lack of entomologists, funding, training and government support, leading to an increased risk of uncontrolled disease emergence in cattle herds.
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Affiliation(s)
- Jorian Prudhomme
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InTheres, University of Toulouse, INRAE, ENVT 31300 Toulouse France
| | - Jérôme Depaquit
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Université de Reims Champagne-Ardenne, Faculté de Pharmacie, EA7510 EpidémioSurveillance et Circulation de Parasites dans les Environnements, and ANSES, USC Pathogènes-Environnement-Toxoplasme-Arthropodes-Réservoirs-bioDiversité Reims France
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Centre Hospitalo-Universitaire, Laboratoire de Parasitologie-Mycologie 51092 Reims France
| | - Johanna Fite
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French Agency for Food, Environmental and Occupational Health & Safety, Risk Assessment Department Maisons-Alfort Cedex France
| | - Elsa Quillery
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French Agency for Food, Environmental and Occupational Health & Safety, Risk Assessment Department Maisons-Alfort Cedex France
| | - Emilie Bouhsira
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InTheres, University of Toulouse, INRAE, ENVT 31300 Toulouse France
| | - Emmanuel Liénard
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InTheres, University of Toulouse, INRAE, ENVT 31300 Toulouse France
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7
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Cambrea SC, Badiu D, Ionescu C, Penciu R, Pazara L, Mihai CM, Cambrea MA, Mihai L. Boutonneuse Fever in Southeastern Romania. Microorganisms 2023; 11:2734. [PMID: 38004746 PMCID: PMC10673018 DOI: 10.3390/microorganisms11112734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Boutonneuse fever (BF) is an eruptive disease and is classified as a spotted fever, which is endemic in the Mediterranean basin (i.e., Marseille fever or Mediterranean spotted fever) and the Black Sea, caused by Rickettsia conorii, with dog ticks being a vector (i.e., Rhipicephalus sanguineus). In Romania, although the first reported outbreak of BF occurred during the summer of 1931 in Constanta, the disease was discovered in 1910. Although the disease has occurred most frequently in the two counties of the Dobruja region (Constanta and Tulcea), a region of the Balkan Peninsula, during the last few years, other counties in southeastern Romania have started to report BF cases. In a period of 9 years, 533 cases were registered in Constanta county, while in a period of 11 years, 339 cases were registered in Bucharest county. In this review, we describe the bacterial tick-borne disease caused by R. conorii in southeastern Romania, focusing on its history and epidemiology, pathophysiology, clinical aspects, diagnosis, treatment and preventive measures in the context of climate changes. Although R. conorii is the principal etiologic agent of BF in southeastern Romania, we should take into consideration that other Rickettsia spp. could be present and involved in disease transmission.
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Affiliation(s)
- Simona Claudia Cambrea
- Faculty of Medicine, “Ovidius” University from Constanta, 900470 Constanta, Romania; (S.C.C.); (R.P.); (L.P.); (C.M.M.); (M.A.C.); (L.M.)
- Clinical Hospital of Infectious Diseases, 900178 Constanta, Romania
| | - Diana Badiu
- Faculty of Medicine, “Ovidius” University from Constanta, 900470 Constanta, Romania; (S.C.C.); (R.P.); (L.P.); (C.M.M.); (M.A.C.); (L.M.)
| | - Constantin Ionescu
- Faculty of Medicine, “Ovidius” University from Constanta, 900470 Constanta, Romania; (S.C.C.); (R.P.); (L.P.); (C.M.M.); (M.A.C.); (L.M.)
| | - Roxana Penciu
- Faculty of Medicine, “Ovidius” University from Constanta, 900470 Constanta, Romania; (S.C.C.); (R.P.); (L.P.); (C.M.M.); (M.A.C.); (L.M.)
| | - Loredana Pazara
- Faculty of Medicine, “Ovidius” University from Constanta, 900470 Constanta, Romania; (S.C.C.); (R.P.); (L.P.); (C.M.M.); (M.A.C.); (L.M.)
| | - Cristina Maria Mihai
- Faculty of Medicine, “Ovidius” University from Constanta, 900470 Constanta, Romania; (S.C.C.); (R.P.); (L.P.); (C.M.M.); (M.A.C.); (L.M.)
| | - Mara Andreea Cambrea
- Faculty of Medicine, “Ovidius” University from Constanta, 900470 Constanta, Romania; (S.C.C.); (R.P.); (L.P.); (C.M.M.); (M.A.C.); (L.M.)
| | - Larisia Mihai
- Faculty of Medicine, “Ovidius” University from Constanta, 900470 Constanta, Romania; (S.C.C.); (R.P.); (L.P.); (C.M.M.); (M.A.C.); (L.M.)
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Sfeir C, Bigot W, Mouthon L, Dunogue B, Hadjadj J, Lega JC. [Asthenia and weakness in a 75-year-old man]. Rev Med Interne 2023; 44:623-625. [PMID: 37357055 DOI: 10.1016/j.revmed.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/04/2023] [Indexed: 06/27/2023]
Affiliation(s)
- C Sfeir
- Service de médecine interne, centre hospitalo-universitaire Cochin, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - W Bigot
- Service de médecine interne, centre hospitalo-universitaire Cochin, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - L Mouthon
- Service de médecine interne, centre hospitalo-universitaire Cochin, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - B Dunogue
- Service de médecine interne, centre hospitalo-universitaire Cochin, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - J Hadjadj
- Service de médecine interne, centre hospitalo-universitaire Cochin, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
| | - J-C Lega
- Service de médecine interne et pathologie vasculaire, hôpital Lyon Sud, hospices civils de Lyon, 165, chemin du Grand Revoyet, 69495 Pierre-Bénite cedex, France
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Del Giudice P, Freychet F, Kopec L, Fenollar F, Eldin C, Velin M, Hubiche T, Raoult D, Mediannikov O. Erythema Migrans Caused by Borrelia spielmanii, France. Emerg Infect Dis 2023; 29:2366-2369. [PMID: 37877610 PMCID: PMC10617338 DOI: 10.3201/eid2911.230149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
We describe a rare case of early Lyme borreliosis in France caused by Borrelia spielmanii, which manifested as a large erythema chronicum migrans rash. The patient completely recovered after a 15-day course of amoxicillin. Absence of pathognomonic signs prevented distinguishing B. spielmanii from other etiologies as cause in this case-patient.
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Finck C, Gambron T, Benchimol L, Camby S, Morsomme D. Case report: Successive ipsilateral and contralateral laryngeal nerve palsy as probable manifestation of neuroborreliosis. Heliyon 2023; 9:e20869. [PMID: 37876487 PMCID: PMC10590778 DOI: 10.1016/j.heliyon.2023.e20869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 09/30/2023] [Accepted: 10/09/2023] [Indexed: 10/26/2023] Open
Abstract
Neuroborreliosis is part of advanced stage of Lyme disease and often characterized by damage to the cranial and/or peripheral nerves. Involvement of one or both recurrent nerves is rare. Diagnosis is often difficult and based on a set of clinical manifestations, biological arguments, and cerebrospinal fluid (CSF) analysis. A 70-year-old man was referred to our Voice Clinic with a 3-month history of dysphonia caused by right vocal fold paralysis (VFP) without any cutaneous symptoms of tick bite or erythema migrans in the previous weeks and normal initial radiological examination (neck and thorax CT). Methylprednisolone had already been prescribed but without any clinical improvement. Late biological investigation 3 months after initial symptoms of VFP showed high IgG (93 U/mL; reference <10 U/mL) against Borrelia burgdorferi (BB), which was confirmed by two immunoblot markers (VIsE, p39 antigens). Therefore, a possible manifestation of Lyme disease with involvement of the right inferior laryngeal nerve was suspected, namely Lyme neuroborreliosis. However, given the spontaneous recovery of the patient after 7 months without any adapted antimicrobial regimen treatment, the diagnosis of neuroborreliosis was not confirmed by a lumbar puncture. Nineteen months later, the patient presented again for the same symptomatology but as left VFP. High IgG (68 U/mL) and IgM (>6, reference <0.90) levels against BB were confirmed by immunoblot. Subsequently, lumbar puncture was performed and revealed IgG against BB at 46.1 UA/mL (reference<5.5 UA/mL) in the CSF, with an extremely high IgG intrathecal synthesis antibody index (281.33, positive if > 1.5). Intrathecal antibody synthesis is the gold standard for Lyme neuroborreliosis demonstrating a specific immune response to BB in the central nervous system, but with the limitation of persistence for years after eradication. Our patient did not exhibit pleocytosis in the CSF. Therefore, two criteria of the European Federation of Neurological Societies (EFNS) guidelines are fulfilled for possible neuroborreliosis. Doxycycline treatment led to rapid recovery in less than 8 weeks and normal mobility of the left vocal fold. Because of this very uncommon clinical presentation with two successive episodes of VFP for no other obvious reason and serological evidence from the serum and CSF during the second episode, we consider it possible that the first episode of VFP could also have been a manifestation of neuroborreliosis. This case is the first report of possible relapse of laryngeal palsy successively on the right, and then the left side as a manifestation of Lyme neuroborreliosis.
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Affiliation(s)
- Camille Finck
- ENT Department, University Hospital of Liege, Belgium
- Faculty of Medecine, Uliege, Belgium
- Faculty of Psychology and Sciences of Education, Umons, Belgium
| | | | - Lionel Benchimol
- ENT Department, University Hospital of Liege, Belgium
- Pneumology Laboratory, I3 Group, GIGA Research Center, University of Liège, Belgium
| | | | - Dominique Morsomme
- ENT Department, University Hospital of Liege, Belgium
- Faculty of Psychology, Speech and Language Therapy and Education, University of Liege, Belgium
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11
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Shah JS, Burrascano JJ, Ramasamy R. Recombinant protein immunoblots for differential diagnosis of tick-borne relapsing fever and Lyme disease. J Vector Borne Dis 2023; 60:353-364. [PMID: 38174512 DOI: 10.4103/0972-9062.383641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
Lyme disease (LD) is caused by a group of tick-borne bacteria of the genus Borrelia termed Lyme disease Borreliae (LDB). The detection of serum antibodies to specific LDB antigens is widely used to support diagnosis of LD. Recent findings highlight a need for serological tests that can differentiate LD from tick-borne relapsing fever (TBRF) caused by a separate group of Borrelia species termed relapsing fever Borreliae. This is because LD and TBRF share some clinical symptoms and can occur in overlapping locations. The development of serological tests for TBRF is at an early stage compared with LD. This article reviews the application of line immunoblots (IBs), where recombinant proteins applied as lines on nitrocellulose membrane strips are used to detect antibodies in patient sera, for the diagnosis and differentiation of LD and TBRF.
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Affiliation(s)
- Jyotsna S Shah
- IGeneX Inc. Milpitas; ID-FISH Technology Inc., California, USA
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12
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Miazga W, Wnuk K, Tatara T, Świtalski J, Matera A, Religioni U, Gujski M. The long-term efficacy of tick-borne encephalitis vaccines available in Europe - a systematic review. BMC Infect Dis 2023; 23:621. [PMID: 37735357 PMCID: PMC10515056 DOI: 10.1186/s12879-023-08562-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/24/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Despite the availability of vaccination, TBE (tick-borne encephalitis) remains a global public health problem. Therefore, the aim of our study was to assess the long-term efficacy of vaccinations against tick-borne encephalitis using vaccines available on the European market. METHODS The analysis was conducted on the results of a systematic review conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. The search was performed in three databases, namely Medline (via PubMed), EMBASE (via Ovid), and the Cochrane Library database. The authors followed the PRISMA method and the selection of the articles was performed with two independent researchers. RESULTS From a total of 199 citations, 9 studies were included in this review. According to the primary studies identified in the search, the efficacy of available anti-TBE vaccines ranges from 90.1% to 98.9%; however, in individuals above the age of 60, the protection wanes as early as one year after vaccination. Administration of a booster dose 3 years after completion of the basic vaccination schedule significantly extended the period of protection against TBE. CONCLUSIONS Anti-TBE vaccines available in Europe have a high level of efficacy. However, the level of protection against TBE is decreasing after vaccination. Therefore, in addition to the conventional schedule, booster vaccines should be administered every 5 years in individuals before the age of 60 and more frequently, e.g. every 3 years, in individuals aged 60 and beyond.
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Affiliation(s)
- Wojciech Miazga
- Department of Health Policy Programs, Department of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, 00032, Warsaw, Poland
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, Kleczewska 61/63, 01826, Warsaw, Poland
| | - Katarzyna Wnuk
- Department of Health Policy Programs, Department of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, 00032, Warsaw, Poland
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, Kleczewska 61/63, 01826, Warsaw, Poland
| | - Tomasz Tatara
- Department of Health Policy Programs, Department of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, 00032, Warsaw, Poland.
- Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, 02091, Warsaw, Poland.
| | - Jakub Świtalski
- Department of Health Policy Programs, Department of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, 00032, Warsaw, Poland
- Department of Health Economics and Medical Law, Faculty of Health Sciences, Medical University of Warsaw, 01445, Warsaw, Poland
| | - Adrian Matera
- Department of Health Policy Programs, Department of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, 00032, Warsaw, Poland
| | - Urszula Religioni
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, Kleczewska 61/63, 01826, Warsaw, Poland.
| | - Mariusz Gujski
- Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, 02091, Warsaw, Poland
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Bonnet C, Figoni J, Souty C, Septfons A, de Martino S, de Valk H, Fournier L, Hanslik T, Jaulhac B, Blanchon T. Prevalence and factors associated with a prescription of a Lyme borreliosis serology for erythema migrans diagnosis in general practice: a study from the French sentinel network, 2009-2020. BMC PRIMARY CARE 2023; 24:163. [PMID: 37620763 PMCID: PMC10464237 DOI: 10.1186/s12875-023-02108-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/18/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Serological testing of patients consulting for typical erythema migrans (EM) is not recommended in European recommendations for diagnosis of Lyme borreliosis (LB). Little is known on the level of adherence of French general practitioners to these recommendations. The objectives were to estimate the proportion of Lyme borreliosis serological test prescription in patients with erythema migrans seen in general practice consultations in France, and to study the factors associated with this prescription. METHODS LB cases with an EM reported by the French general practitioners (GPs) of the Sentinelles network between January 2009 and December 2020 were included. To assess the associations with a prescription of a serological test, multilevel logistic regression models were used. RESULTS Among the 1,831 EM cases included, a prescription for a LB serological test was requested in 24.0% of cases. This proportion decreased significantly over the study period, from 46.8% in 2009 to 15.8% in 2020. A LB serological prescription was associated with patients with no reported tick bite (Odds Ratio (OR): 1.95; 95% confidence interval [1.23-3.09]), multiple EM (OR: 3.82 [1.63-8.92]), EM of five centimeters or more (OR: 4.34 [2.33-8.08]), and GPs having diagnosed less than one EM case per year during the study period (OR: 5.28 [1.73-16.11]). CONCLUSIONS Serological testing of patients consulting for EM is not recommended in European recommendations for diagnosis of Lyme borreliosis. Therefore, the significant decrease in the rate of LB serological test for EM over the study period is encouraging. The factors identified in this study can be used to improve messaging to GPs and patients. Further efforts are needed to continue to disseminate diagnostic recommendations for LB to GPs, especially those who rarely see patients with EM.
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Affiliation(s)
- Camille Bonnet
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Paris, F75012, France.
| | - Julie Figoni
- Santé publique France, Saint-Maurice, F94410, France
| | - Cécile Souty
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Paris, F75012, France
| | | | - Sylvie de Martino
- CNR des Borrelia et Institut de Bactériologie, Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, CHRU Strasbourg, UR7290, ITI InnoVec, Strasbourg, 67000, France
| | | | - Lucie Fournier
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Paris, F75012, France
| | - Thomas Hanslik
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Paris, F75012, France
- Service de Médecine Interne, APHP, Hôpital Ambroise Paré, Assistance Publique - Hôpitaux de Paris, Boulogne-Billancourt, France
- Université Versailles Saint-Quentin-en-Yvelines, UVSQ, UFR de Médecine Simone Veil, Versailles, France
| | - Benoît Jaulhac
- CNR des Borrelia et Institut de Bactériologie, Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, CHRU Strasbourg, UR7290, ITI InnoVec, Strasbourg, 67000, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Paris, F75012, France
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Naudion P, Raffetin A, Zayet S, Klopfenstein T, Baux E, Martinot M, Piroth L, Caumes E, Chirouze C, Bouiller K. Positive intrathecal anti-Borrelia antibody synthesis: what are the implications for clinical practice? Clinical features and outcomes of 138 patients in a French multicenter cohort study. Eur J Clin Microbiol Infect Dis 2023; 42:441-452. [PMID: 36806057 DOI: 10.1007/s10096-023-04574-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/13/2023] [Indexed: 02/23/2023]
Abstract
We aimed to describe the clinical characteristics, management, and residual symptoms (RS) in patients with definite and possible Lyme neuroborreliosis (LNB). We conducted a retrospective French multicenter cohort study (2010-2020). Cases of LNB were defined as clinical manifestations attributed to LNB and a positive Borrelia-specific intrathecal antibody index (AI) ("possible" LNB) and with pleocytosis ("definite" LNB). Risk factors of RS were determined using a logistic regression model. We included 138 adult patients with a positive AI. Mean age was 59.5 years (± 14.7). The median duration of symptoms before diagnosis was 1.0 [0.5-4.0] months. The most frequent manifestation was radicular pain (n = 79, 57%). Complete cerebrospinal fluid (CSF) leukocyte analysis was available in 131 patients, of whom 72 (55%) had pleocytosis. Patients with definite LNB had a shorter duration of symptoms (median 1.0 [0.5-2.6] vs. 3.0 [0.6-7.0] months, p < 0.01) and more radicular pain (74% vs 44%, p < 0.01) than patients with possible LNB. At the last visit (median duration of follow-up: 70 [30-175] days), 74/124 patients (59.7%) reported RS, mostly radicular pain (n = 31, 25%). In multivariate analysis, definite LNB (OR = 0.21 [0.05-0.931], p = 0.039) and duration of symptoms less than 3 months (OR = 0.04 [0.01-0.37], p = 0.005) were protective factors against RS at last follow-up. Our study highlights the challenges of LNB management, especially for patients with a positive AI without pleocytosis, questioning whether LB is still ongoing or not. Early diagnosis and treatment are important to improve outcomes and to lower potential RS.
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Affiliation(s)
- Pauline Naudion
- Department of Infectious Diseases, CHU Besançon, 3 Bd Alexandre Fleming, 25030, Besançon, France
| | - Alice Raffetin
- Department of Infectious Diseases, Tick-Borne Diseases Reference Center, Paris and Northern Region, General Hospital of Villeneuve-Saint-Georges, 40 Allée de La Source, 94 190, Villeneuve-Saint-Georges, France. .,Research Unity of EpiMAI (USC Anses), Ecole Nationale Vétérinaire de Maisons-Alfort, Maisons-Alfort, France. .,European Study Group for Lyme Borreliosis (ESGBOR), Basel, Switzerland. .,EA 7380 Dynamyc, Université Paris-Est Créteil, Ecole Nationale Vétérinaire d'Alfort, USC Anses, Créteil, France.
| | - Souheil Zayet
- Department of Infectious Diseases, General Hospital of Nord Franche-Comté, Belfort, France
| | - Timothée Klopfenstein
- Department of Infectious Diseases, General Hospital of Nord Franche-Comté, Belfort, France
| | - Elisabeth Baux
- Department of Infectious Diseases, University Hospital of Nancy, Nancy, France
| | - Martin Martinot
- Department of Infectious Diseases, General Hospital of Colmar, Colmar, France
| | - Lionel Piroth
- Department of Infectious Diseases, University Hospital of Dijon, Dijon, France
| | - Eric Caumes
- Department of Infectious Diseases, University Hospital of Pitié-Salpétrière, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France.,Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie Et de Santé Publique, Paris, France
| | - Catherine Chirouze
- Department of Infectious Diseases, CHU Besançon, 3 Bd Alexandre Fleming, 25030, Besançon, France.,UMR-CNRS 6249 Chrono-Environnement, Université de Franche-Comté, 25000, Besançon, France
| | - Kevin Bouiller
- Department of Infectious Diseases, CHU Besançon, 3 Bd Alexandre Fleming, 25030, Besançon, France. .,European Study Group for Lyme Borreliosis (ESGBOR), Basel, Switzerland. .,UMR-CNRS 6249 Chrono-Environnement, Université de Franche-Comté, 25000, Besançon, France.
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15
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Adepoju OA, Afinowi OA, Tauheed AM, Danazumi AU, Dibba LBS, Balogun JB, Flore G, Saidu U, Ibrahim B, Balogun OO, Balogun EO. Multisectoral Perspectives on Global Warming and Vector-borne Diseases: a Focus on Southern Europe. CURRENT TROPICAL MEDICINE REPORTS 2023; 10:47-70. [PMID: 36742193 PMCID: PMC9883833 DOI: 10.1007/s40475-023-00283-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2023] [Indexed: 01/30/2023]
Abstract
Purpose of Review The climate change (CC) or global warming (GW) modifies environment that favors vectors' abundance, growth, and reproduction, and consequently, the rate of development of pathogens within the vectors. This review highlights the threats of GW-induced vector-borne diseases (VBDs) in Southern Europe (SE) and the need for mitigation efforts to prevent potential global health catastrophe. Recent Findings Reports showed astronomical surges in the incidences of CC-induced VBDs in the SE. The recently (2022) reported first cases of African swine fever in Northern Italy and West Nile fever in SE are linked to the CC-modified environmental conditions that support vectors and pathogens' growth and development, and disease transmission. Summary VBDs endemic to the tropics are increasingly becoming a major health challenge in the SE, a temperate region, due to the favorable environmental conditions caused by CC/GW that support vectors and pathogens' biology in the previously non-endemic temperate regions.
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Affiliation(s)
- Oluwafemi A. Adepoju
- Department of Biochemistry, Ahmadu Bello University, Zaria, 2222 Kaduna State Nigeria
| | | | - Abdullah M. Tauheed
- Department of Veterinary Pharmacology and Toxicology, Faculty of Veterinary Medicine, Ahmadu Bello University, Zaria, 2222 Kaduna State Nigeria
| | - Ammar U. Danazumi
- Faculty of Chemistry, Warsaw University of Technology, Warsaw, Poland
| | - Lamin B. S. Dibba
- Department of Physical and Natural Sciences, School of Arts and Sciences, University of the Gambia, Serrekunda, The Gambia
| | - Joshua B. Balogun
- Department of Biological Sciences, Federal University Dutse, Jigawa State Dutse, Nigeria
| | - Gouegni Flore
- Department of Biochemistry, Ahmadu Bello University, Zaria, 2222 Kaduna State Nigeria
- Africa Centre of Excellence for Neglected Tropical Diseases and Forensic Biotechnology (ACENTDFB), Ahmadu Bello University, Zaria, 2222 Kaduna State Nigeria
| | - Umar Saidu
- Department of Biochemistry, Ahmadu Bello University, Zaria, 2222 Kaduna State Nigeria
- Africa Centre of Excellence for Neglected Tropical Diseases and Forensic Biotechnology (ACENTDFB), Ahmadu Bello University, Zaria, 2222 Kaduna State Nigeria
| | - Bashiru Ibrahim
- Department of Biochemistry, Ahmadu Bello University, Zaria, 2222 Kaduna State Nigeria
| | - Olukunmi O. Balogun
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - Emmanuel O. Balogun
- Department of Biochemistry, Ahmadu Bello University, Zaria, 2222 Kaduna State Nigeria
- Africa Centre of Excellence for Neglected Tropical Diseases and Forensic Biotechnology (ACENTDFB), Ahmadu Bello University, Zaria, 2222 Kaduna State Nigeria
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16
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Oteo JA, Corominas H, Escudero R, Fariñas-Guerrero F, García-Moncó JC, Goenaga MA, Guillén S, Mascaró JM, Portillo A. Executive summary of the consensus statement of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), Spanish Society of Neurology (SEN), Spanish Society of Immunology (SEI), Spanish Society of Pediatric Infectology (SEIP), Spanish Society of Rheumatology (SER), and Spanish Academy of Dermatology and Venereology (AEDV), on the diagnosis, treatment and prevention of Lyme borreliosis. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:40-45. [PMID: 36621247 DOI: 10.1016/j.eimce.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/01/2022] [Indexed: 01/09/2023]
Abstract
The diagnosis of Lyme borreliosis (LB) is based on the epidemiological history, clinical manifestations and microbiological findings in the early disseminated and late phases of the disease. Related to this fact, microbiological diagnostic techniques have recently appeared. Far from facilitating the diagnosis and the clinical-therapeutic management of LB patients, they are generating confusion. Herein, experts and representatives of Spanish Scientific Societies [Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), Spanish Society of Neurology (SEN), Spanish Society of Immunology (SEI), Spanish Society of Pediatric Infectology (SEIP), Spanish Society of Rheumatology (SER), and Spanish Academy of Dermatology and Venereology (AEDV)] exposed the executive summary after reviewing the epidemiology, clinical spectrum, available diagnostic techniques for the diagnosis of Borrelia burgdorferi infection, therapeutic and prevention options of LB. By consensus, recommendations for microbiological diagnosis are offered together with those supporting the therapeutic management and prophylaxis of infection.
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Affiliation(s)
- José A Oteo
- Centre of Rickettsiosis and Arthropod-Borne Diseases (CRETAV), Department of Infectious Diseases, San Pedro University Hospital - Centre for Biomedical Research from La Rioja (CIBIR), Logroño, Spain.
| | - Héctor Corominas
- Spanish Society of Rheumatology, Rheumatology and Systemic Autoimmune Diseases Department, Hospital de la Santa Creu i Sant Pau/Hospital Dos de Maig, Barcelona, Spain
| | - Raquel Escudero
- Special Pathogens Reference and Research Laboratory, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain
| | - Fernando Fariñas-Guerrero
- Spanish Society of Immunology. Institute of Clinical Immunology and Infectious Diseases, YNMUN Biomedicine Group, Málaga, Spain
| | - Juan Carlos García-Moncó
- Spanish Society of Neurology. Department of Neurology, Hospital Universitario Basurto, Bilbao, Spain
| | - Miguel A Goenaga
- Infectious Diseases Service, Hospital Donostia, OSI Donostialdea. Instituto BioDonostia, San Sebastián, Spain
| | - Sara Guillén
- Spanish Society of Pediatric Infectology (SEIP), Department of Pediatrics, Hospital Universitario de Getafe, Madrid, Spain
| | - José M Mascaró
- Spanish Academy of Dermatology and Venereology, Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Aránzazu Portillo
- Centre of Rickettsiosis and Arthropod-Borne Diseases (CRETAV), Department of Infectious Diseases, San Pedro University Hospital - Centre for Biomedical Research from La Rioja (CIBIR), Logroño, Spain
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Myszkowska-Torz A, Tomaszewski M, Kotowski M, Witczak C, Figlerowicz M, Mazur-Melewska K. Cutaneous Manifestations of Lyme Borreliosis in Children-A Case Series and Review. LIFE (BASEL, SWITZERLAND) 2022; 13:life13010072. [PMID: 36676022 PMCID: PMC9864164 DOI: 10.3390/life13010072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/15/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
The occurrence of skin lesions is the earliest symptom of Lyme disease, and the diagnosis of these lesions and appropriate treatment may prevent complications of the disease, which are mainly neurological. The cutaneous presentation in borreliosis is heterogeneous. There are typical lesions that constitute the basis for the diagnosis of Lyme disease, and atypical ones, which cause significant diagnostic difficulties especially when the patient does not remember the tick bite. This study aims to describe the heterogeneous skin symptoms of Lyme borreliosis, as well as offer a practical approach for the recognition of the disease. Based on pediatric cases from clinical practice, rare cutaneous presentations of Lyme disease at various stages of illness and therapy are presented. Diagnostic recommendations for recognizing individual forms are discussed.
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Affiliation(s)
- Agnieszka Myszkowska-Torz
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences, 61-701 Poznań, Poland
| | - Mateusz Tomaszewski
- Department of Orthodontics and Temporomanidbular Disorders, Karol Marcinkowski University of Medical Sciences, 61-701 Poznań, Poland
| | - Michał Kotowski
- Department of Pediatric Otolaryngology, Karol Marcinkowski University of Medical Sciences, 61-701 Poznań, Poland
| | - Cezary Witczak
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences, 61-701 Poznań, Poland
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences, 61-701 Poznań, Poland
| | - Katarzyna Mazur-Melewska
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences, 61-701 Poznań, Poland
- Correspondence:
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Lutaud R, Verger P, Peretti-Watel P, Eldin C. When the patient is making the (wrong?) diagnosis: a biographical approach to patients consulting for presumed Lyme disease. Fam Pract 2022:cmac116. [PMID: 36267023 PMCID: PMC9619758 DOI: 10.1093/fampra/cmac116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Media coverage of Lyme disease (LD) has led to an increase in consultations for presumed LD in Europe. However, LD is confirmed in only 10%-20% of patients, with a significant number remaining in a diagnostic dead-end. OBJECTIVES To reach a deeper understanding of how patients themselves contribute to the diagnostic process. To describe the genesis of the LD hypothesis in care pathways. METHODS In 2019, 30 patients from a prospective cohort consulting in the infectious diseases department at University Hospital in Marseille for presumed LD were recruited for semistructured interviews. The inclusion criteria were: suffering from subjective symptoms for 6 months, no clinical or paraclinical argument suggesting current LD. The patients' medical trajectories were collected using a biographical approach. RESULTS The diagnosis of LD was primarily triggered by identification with personal testimonies found on the Internet. Most of patients were leading their own diagnostic investigation. The majority of participants were convinced they had LD despite the lack of medical evidence and the scepticism of their referring GP. CONCLUSION GPs should first systematically explore patients' aetiologic representations in order to improve adherence to the diagnosis especially in the management of medically unexplained symptoms. Long COVID-19 syndrome challenge offers an opportunity to promote active patient involvement in diagnosis.
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Affiliation(s)
- Romain Lutaud
- Department of General Practice, Aix Marseille University, Marseille, France
- UMR UMR 7268 ADES, EFS, CNRS, Aix-Marseille University, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Pierre Verger
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
| | | | - Carole Eldin
- UMR UVE, Aix Marseille University, IRD, Inserm, Marseille, France
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Oteo JA, Corominas H, Escudero R, Fariñas-Guerrero F, García-Moncó JC, Goenaga MA, Guillén S, Mascaró JM, Portillo A. Executive summary of the consensus statement of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), Spanish Society of Neurology (SEN), Spanish Society of Immunology (SEI), Spanish Society of Pediatric Infectology (SEIP), Spanish Society of Rheumatology (SER), and Spanish Academy of Dermatology and Venereology (AEDV), on the diagnosis, treatment and prevention of Lyme borreliosis. Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bord S, Dernat S, Ouillon L, René-Martellet M, Vourc'h G, Lesens O, Forestier C, Lebert I. Tick ecology and Lyme borreliosis prevention: A regional survey of pharmacists’ knowledge in Auvergne-Rhône-Alpes, France. Ticks Tick Borne Dis 2022; 13:101932. [DOI: 10.1016/j.ttbdis.2022.101932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 12/14/2022]
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Duffau P, Korbi S, Guillotin V, Talagrand-Reboul E, Ménard A, Peuchant O. An unexpected case of Borrelia garinii liver infection. Ann Clin Microbiol Antimicrob 2022; 21:15. [PMID: 35346214 PMCID: PMC8958789 DOI: 10.1186/s12941-022-00506-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/17/2022] [Indexed: 11/24/2022] Open
Abstract
Background Lyme borreliosis is the most prevalent arthropod-borne infection in the Northern Hemisphere. In Europe, Borrelia afzelii is predominantly involved in cutaneous manifestations, Borrelia garinii and Borrelia bavariensis in neurological manifestations, and Borrelia burgdorferi sensu stricto in articular ones. Liver impairement is not classical in Lyme borreliosis. Diagnosis is currently mainly based on serological testing, and is challenging in immunocompromised patients. Case presentation We report the first case of B. garinii infection revealed by liver involvement in an immunocompromised man. A 73-year-old man with marginal zone lymphoma, treated with bendamustine and rituximab, developed intermittent fever and inflammatory syndrome. Microbial investigations were all negative and FDG-PET showed complete remission of the lymphoma. Three months later, liver biopsy was performed and histology revealed spirochetes-like bacteria. Microbial diagnosis was performed by 16S rDNA sequencing, flagellin (flaB) gene sequencing and multi-locus sequence typing and identified B. garinii. The patient recovered successfully after a three weeks course of antibiotics. Diagnosis was challenging because Borrelia hepatic involvement is unusual and no erythema migrans nor tick bite were notified. Conclusion This case highlights that unexplained fever and inflammatory syndrome in immunocompromised patients warrants specific investigations to identify bacteria such as spirochetes.
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Sevestre J, Benichou A, Rio V, Delaunay P, Gonfrier G, Martaresche C, Carlo V, Nakam S, Mondain V, Carles M, Jeandel PY, Durant J. Emergence of Lyme Disease on the French Riviera, a Retrospective Survey. Front Med (Lausanne) 2022; 9:737854. [PMID: 35391881 PMCID: PMC8981725 DOI: 10.3389/fmed.2022.737854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 02/23/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe French Riviera has been declared free of Lyme Borreliosis (LB) for years. Many patients are referred for presumed LB, sometimes with atypical clinical signs and/or doubtful serology, calling the diagnosis into question.MethodsPatients were assessed for LB diagnosis, depending on clinical presentation, laboratory findings, and further examination by other medical professionals.ResultsAmong 255 patients, 45 (18%) were classified as confirmed LB cases [including 28 ongoing LB (10%) and 17 past LB (8%)], and for 210 (82%) a Lyme borreliosis diagnosis was ruled out. Among ongoing LB, 56% had been exposed to or bitten by ticks, exclusively in rural locations of the Alpes-Maritimes. As a result of the diagnostic procedure, 132 (52%) patients had been treated. An alternative diagnosis was established for 134 (52%) patients, covering a wide range of conditions, including mainly psychological (28%) and neurological conditions (25%) or inflammatory and systemic diseases (22%).ConclusionsOur results strongly suggest the endemicity of LB in the Alpes-Maritimes region. Confirmed LB accounted for 18% of patients while 52% were diagnosed with other conditions.
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Affiliation(s)
- Jacques Sevestre
- Laboratory of Parasitology, Nice University Hospital, Nice, France
- IHU Méditerranée Infection, Marseille, France
| | - Antoine Benichou
- Department of Internal Medicine, Nice University Hospital, Nice, France
| | - Vanessa Rio
- Department of Infectious Diseases, Nice University Hospital, Nice, France
| | - Pascal Delaunay
- Laboratory of Parasitology, Nice University Hospital, Nice, France
| | | | | | - Virginie Carlo
- Department of Infectious Diseases, Nice University Hospital, Nice, France
| | - Sarah Nakam
- Department of Infectious Diseases, Nice University Hospital, Nice, France
| | - Véronique Mondain
- Department of Infectious Diseases, Nice University Hospital, Nice, France
| | - Michel Carles
- Department of Infectious Diseases, Nice University Hospital, Nice, France
| | | | - Jacques Durant
- Department of Infectious Diseases, Nice University Hospital, Nice, France
- *Correspondence: Jacques Durant
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Multidisciplinary Management of Suspected Lyme Borreliosis: Clinical Features of 569 Patients, and Factors Associated with Recovery at 3 and 12 Months, a Prospective Cohort Study. Microorganisms 2022; 10:microorganisms10030607. [PMID: 35336182 PMCID: PMC8955660 DOI: 10.3390/microorganisms10030607] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction. Because patients with a suspicion of Lyme borreliosis (LB) may have experienced difficult care paths, the Tick-Borne Diseases Reference Center (TBD-RC) was started in 2017. The aim of our study was to compare the clinical features of patients according to their final diagnoses, and to determine the factors associated with recovery in the context of multidisciplinary management for suspected LB. Methods. We included all adult patients who were seen at the TBD-RC (2017–2020). Four groups were defined: (i) confirmed LB, (ii) possible LB, (iii) Post-Treatment Lyme Disease Syndrome (PTLDS) or sequelae, and (iv) other diagnoses. Their clinical evolution at 3, 6, and 9–12 months after care was compared. Factors associated with recovery at 3 and at 9–12 months were identified using logistic regression models. Results. Among the 569 patients who consulted, 72 (12.6%) had confirmed LB, 43 (7.6%) possible LB, 58 (10.2%) PTLDS/sequelae, and 396 (69.2%) another diagnosis. A favorable evolution was observed in 389/569 (68.4%) at three months and in 459/569 (80.7%) at 12 months, independent of the final diagnosis. A longer delay between the first symptoms and the first consultation at the TBD-RC (p = 0.001), the multiplicity of the diagnoses (p = 0.004), and the inappropriate prescription of long-term antibiotic therapy (p = 0.023) were negatively associated with recovery, reflecting serial misdiagnoses. Conclusions. A multidisciplinary team dedicated to suspicion of LB may achieve a more precise diagnosis and better patient-centered medical support in the adapted clinical sector with a shorter delay, enabling clinical improvement and avoiding inappropriate antimicrobial prescription.
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Jia W, Chen S, Chi S, He Y, Ren L, Wang X. Recent Progress on Tick-Borne Animal Diseases of Veterinary and Public Health Significance in China. Viruses 2022; 14:v14020355. [PMID: 35215952 PMCID: PMC8875255 DOI: 10.3390/v14020355] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 02/04/2023] Open
Abstract
Ticks and tick-borne diseases pose a growing threat to human and animal health, which has brought great losses to livestock production. With the continuous expansion of human activities and the development of natural resources, there are more and more opportunities for humans to contract ticks and tick-borne pathogens. Therefore, research on ticks and tick-borne diseases is of great significance. This paper reviews recent progress on tick-borne bacterial diseases, viral diseases, and parasitic diseases in China, which provides a theoretical foundation for the research of tick-borne diseases.
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Affiliation(s)
- Weijuan Jia
- College of Animal Science and Technology, Inner Mongolia Minzu University, Tongliao 028000, China; (W.J.); (S.C.); (Y.H.)
| | - Si Chen
- College of Animal Sciences, Key Lab for Zoonoses Research, Ministry of Education, Jilin University, Changchun 130062, China;
| | - Shanshan Chi
- College of Animal Science and Technology, Inner Mongolia Minzu University, Tongliao 028000, China; (W.J.); (S.C.); (Y.H.)
| | - Yunjiang He
- College of Animal Science and Technology, Inner Mongolia Minzu University, Tongliao 028000, China; (W.J.); (S.C.); (Y.H.)
| | - Linzhu Ren
- College of Animal Sciences, Key Lab for Zoonoses Research, Ministry of Education, Jilin University, Changchun 130062, China;
- Correspondence: (L.R.); (X.W.); Tel.: +86-15924529577 (X.W.)
| | - Xueli Wang
- College of Animal Science and Technology, Inner Mongolia Minzu University, Tongliao 028000, China; (W.J.); (S.C.); (Y.H.)
- Correspondence: (L.R.); (X.W.); Tel.: +86-15924529577 (X.W.)
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Marques A, Okpali G, Liepshutz K, Ortega‐Villa AM. Characteristics and outcome of facial nerve palsy from Lyme neuroborreliosis in the United States. Ann Clin Transl Neurol 2022; 9:41-49. [PMID: 35064770 PMCID: PMC8791801 DOI: 10.1002/acn3.51488] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/04/2021] [Accepted: 11/23/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Facial palsy is the most common manifestation of Lyme neuroborreliosis (LNB) in the United States. This study aimed to describe features of patients with early LNB presenting with facial palsy and to determine if corticosteroids in addition to antibiotic therapy was associated with unfavorable outcome. METHODS Retrospective analysis of participants enrolled in clinical studies investigating Lyme disease (N = 486) identified 44 patients who had facial palsy from LNB. The House-Brackmann scale was used to quantify the facial nerve dysfunction. RESULTS Most patients presented in the summer months. Erythema migrans, frequently associated with systemic symptoms, occurred in 29 patients. Thirteen patients presented with bilateral facial palsy, usually with sequential involvement. Fourteen patients had painful radiculopathy. Of the 38 patients treated with antibiotics before the resolution of the palsy who had complete follow-up, 24 received both antibiotics and corticosteroids. Of these 38 patients, 34 recovered completely, 3 had nearly complete recovery, and 1 had moderate dysfunction. There were no differences between the treatment groups in achieving complete resolution of the palsy at 12 months or in time to complete recovery. INTERPRETATION A history of rash compatible with erythema migrans or febrile illness in the weeks preceding the palsy are helpful clues pointing toward LNB and should be actively sought when evaluating patients with acute-onset peripheral facial palsy, particularly bilateral facial palsy. Treatment with antibiotic therapy is highly effective and most patients will fully recover facial nerve function. Adjunctive corticosteroid therapy appears to not affect the speed of recovery or overall outcome in this retrospective observational study.
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Affiliation(s)
- Adriana Marques
- Laboratory of Clinical Microbiology and ImmunologyNational Institute of Allergy and Infectious Diseases, National Institutes of HealthBethesdaMarylandUSA
| | - Grace Okpali
- Laboratory of Clinical Microbiology and ImmunologyNational Institute of Allergy and Infectious Diseases, National Institutes of HealthBethesdaMarylandUSA
| | - Kelly Liepshutz
- Clinical Monitoring Research Program DirectorateFrederick National Laboratory for Cancer ResearchFrederickMarylandUSA
| | - Ana Maria Ortega‐Villa
- Biostatistics Research Branch, Division of Clinical ResearchNational Institute of Allergy and Infectious DiseasesBethesdaMarylandUSA
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Zhou G, Xu X, Zhang Y, Yue P, Luo S, Fan Y, Chen J, Liu M, Dong Y, Li B, Kong J, Wen S, Liu A, Bao F. Antibiotic prophylaxis for prevention against Lyme disease following tick bite: an updated systematic review and meta-analysis. BMC Infect Dis 2021; 21:1141. [PMID: 34749665 PMCID: PMC8573889 DOI: 10.1186/s12879-021-06837-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/22/2021] [Indexed: 12/22/2022] Open
Abstract
Background In areas where Lyme disease is endemic, bites from ticks are common, but no vaccine is currently available against Lyme disease for humans. Therefore, the feasibility of using antibiotic prophylaxis to prevent Lyme disease after a tick bite is worth further exploration. Previous meta-analyses lack sufficient power to demonstrate the efficacy of about antibiotic prophylaxis for the prevention of Lyme disease following a tick bite. In this study, we explored more precise evidence and attempted to identify and update optimum treatment strategies. Methods We searched PubMed, Embase, and the Cochrane Library for studies until March 23, 2021. We included studies if the enrolled patients were randomly allocated to a treatment or control group within 72 h following a tick bite and had no clinical evidence of Lyme disease at enrolment. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines were followed for data abstraction. Two authors (GZZ and XX) independently reviewed the abstracts and identified articles for detailed assessment. We used a random-effects model to calculate the pooled results and reported the 95% confidence interval (CI). Study quality was assessed using a modified Jadad scale, and publication bias was assessed using Egger’s test. We calculated the risk ratio (RR) for the rates of unfavorable events in patients who received intervention versus the control group. This study is registered with PROSPERO, number CRD42021245002. Results Six studies (3,766 individuals) were included. The pooled rate of unfavorable events in persons receiving treatment and the control group were 0.4% (95%CI: 0.1–1.1%) and 2.2% (95%CI: 1.6–3.0%), respectively. The pooled RR was 0.38 (95%CI: 0.22–0.66). Subgroup analysis revealed that the pooled RR was 0.29 (95%CI: 0.14–0.60) in the single-use 200-mg doxycycline group; 0.28 (95%CI: 0.05–1.67) in a 10-day course group (Amoxicillin, Penicillin or tetracycline); and 0.73 (95%CI: 0.25–2.08) in a topical antibiotic treatment group (Azithromycin). Conclusions The available evidence supports the use of antibiotics for the prevention of Lyme disease, and reveals advantages of using single-dose; however, further confirmation is needed.
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Affiliation(s)
- Guozhong Zhou
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Xin Xu
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Yu Zhang
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Peng Yue
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Shiqi Luo
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Yuxin Fan
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Jingjing Chen
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Meixiao Liu
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Yan Dong
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Bingxue Li
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Jing Kong
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Shiyuan Wen
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Aihua Liu
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China. .,Yunnan Province Key Laboratory for Tropical Infectious Diseases in Universities, Kunming Medical University, Kunming, 650500, China.
| | - Fukai Bao
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China. .,Yunnan Province Key Laboratory for Tropical Infectious Diseases in Universities, Kunming Medical University, Kunming, 650500, China.
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Septfons A, Figoni J, Gautier A, Soullier N, de Valk H, Desenclos JC. Increased awareness and knowledge of Lyme Borreliosis and tick bite prevention among the general population in France: 2016 and 2019 health barometer survey. BMC Public Health 2021; 21:1808. [PMID: 34620144 PMCID: PMC8499535 DOI: 10.1186/s12889-021-11850-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 09/22/2021] [Indexed: 11/28/2022] Open
Abstract
Background Lyme borreliosis (LB) is the most frequent tick-borne disease in France. In the absence of a vaccine, LB prevention mainly relies on reducing tick bites. In 2016, the French Ministry of Health launched a national plan against tick-borne infections, including a prevention component. To evaluate the impact of this prevention strategy, we assessed knowledge and practices of tick bite prevention using the 2016 and 2019 national surveys on health attitudes and beliefs known as the French Health Barometer. Methods The Health Barometer is a repeated nationwide phone survey conducted annually on a random sample aged 18 to 75 years living in mainland France. In 2016 and 2019, participants were asked, among others, about their exposure to ticks, their behavior and practices regarding tick bites, and their knowledge about LB and its prevention. Results In 2019, 30% of the population reported a lifetime tick bite and 6% in the last year, an increase from 25% and 4%, respectively, in 2016 (p < 0.001). In 2019, 25% of the population felt exposed to tick bites compared to 23% in 2016 (p < 0.001). The proportion of participants who had heard about LB and who considered themselves well informed respectively increased from 66% and 29% in 2016 to 79% and 41% in 2019, (p < 0.001). In 2019 compared to 2016, a greater part of the French population applied protective measures against tick bites, particularly wearing protective clothing (74% vs 66%, p < 0.001) and regular tick checks and prompt tick removal after exposure (54% vs 47%, p < 0.001). Conclusions A substantial proportion of French residents are exposed to tick bites and apply protective measures. Our findings indicate a trend toward an increased knowledge and awareness of tick bites and LB between 2016 and 2019 in France. Our results can be used to target future information campaigns to specific age groups or at-risk areas in addition to the general population. However, we need to further study the barriers to the use of preventive measures.
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Borreliosi di Lyme e neuroborreliosi. Neurologia 2021. [DOI: 10.1016/s1634-7072(21)45319-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Methodological Quality Assessment with the AGREE II Scale and a Comparison of European and American Guidelines for the Treatment of Lyme Borreliosis: A Systematic Review. Pathogens 2021; 10:pathogens10080972. [PMID: 34451436 PMCID: PMC8399315 DOI: 10.3390/pathogens10080972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Most European and American countries recently updated their guidelines on Lyme borreliosis (LB). The aim of this study was to provide a comparative overview of existing guidelines on the treatment of LB in Europe and America and to assess the methodological quality of their elaboration. METHODS A systematic search was carried out in MEDLINE, Google Scholar, and the national databases of scientific societies from 2014 to 2020. Quality was assessed by two independent reviewers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. RESULTS Twelve guidelines were included. The scores for the AGREE II domains (median ± IQR) were: overall assessment 100 ± 22, scope and purpose 85 ± 46, stakeholder involvement 88 ± 48, rigour of development 67 ± 35, clarity of presentation 81 ± 36, applicability 73 ± 52 and editorial independence 79% ± 54%. Cohen's weighted kappa showed a high agreement (K = 0.90, 95%CI 0.84-0.96). Guidelines were quite homogeneous regarding the recommended molecules (mostly doxycycline in the first intention and ceftriaxone in the second intention), their duration (10 to 28 days), and their dosage. The differences were due to the lack of well-conducted comparative trials. The International Lyme and Associated Diseases Society (ILADS) guidelines were the only ones to suggest longer antibiotics based on an expert consensus. CONCLUSION European and American guidelines for the treatment of LB were quite homogeneous but based on moderate- to low-evidence studies. Well-conducted comparative trials are needed to assess the best molecules, the optimal duration and the most effective doses.
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Sevestre J, Diarra AZ, Oumarou HA, Durant J, Delaunay P, Parola P. Detection of emerging tick-borne disease agents in the Alpes-Maritimes region, southeastern France. Ticks Tick Borne Dis 2021; 12:101800. [PMID: 34352531 DOI: 10.1016/j.ttbdis.2021.101800] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/13/2021] [Accepted: 07/17/2021] [Indexed: 11/19/2022]
Abstract
Lyme borreliosis is a zoonotic tick-borne infection representing the most frequent vector-borne disease in the northern hemisphere. The Mediterranean rim is generally described as unsuitable for the European vector, Ixodes ricinus. We conducted an epidemiological study to assess whether I. ricinus was present and study its infection status for tick-borne bacteria. Ticks originating from southeastern France were obtained from flagging sampling and removed from animals and tick-bitten patients. Species level identification used morphological keys and MALDI-TOF MS. Quantitative PCR and sequencing assays were used to detect and identify tick-associated bacteria (Borrelia, Rickettsia, Anaplasmataceae, Bartonella, Coxiella burnetii) in each specimen. A total of 1232 ticks were collected in several localities. Among these, 863 were identified as I. ricinus (70%). Bacterial screening allowed identification of Lyme group Borrelia among I. ricinus ticks originating from various regional areas. Other emerging tick-borne pathogens like Borrelia miyamotoi and Rickettsia species were also detected. The Alpes-Maritimes region, part of the French Riviera, harbours I. ricinus ticks infected with Lyme group Borrelia and several other tick-borne bacterial agents. Clinicians and outdoor activity participants should be aware of the local Lyme borreliosis transmission risk.
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Affiliation(s)
- Jacques Sevestre
- Service de Parasitologie, Centre Hospitalier Universitaire de Nice, Nice, France; Institut Hospitalo-Universitaire Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille 13385 Cedex 05, France; Aix-Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Adama Zan Diarra
- Institut Hospitalo-Universitaire Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille 13385 Cedex 05, France; Aix-Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | | | - Jacques Durant
- Service d'Infectiologie, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Pascal Delaunay
- Service de Parasitologie, Centre Hospitalier Universitaire de Nice, Nice, France; MIVEGEC, Université de Montpellier, Montpellier, France
| | - Philippe Parola
- Institut Hospitalo-Universitaire Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille 13385 Cedex 05, France; Aix-Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.
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Raffetin A, Barquin A, Nguala S, Paoletti G, Rabaud C, Chassany O, Caraux-Paz P, Covasso S, Partouche H. Perceptions, Representations, and Experiences of Patients Presenting Nonspecific Symptoms in the Context of Suspected Lyme Borreliosis. Microorganisms 2021; 9:microorganisms9071515. [PMID: 34361950 PMCID: PMC8304161 DOI: 10.3390/microorganisms9071515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Some subjective symptoms may be reported at all stages of Lyme borreliosis (LB) and may persist for several months after treatment. Nonspecific symptoms without any objective manifestation of LB are sometimes attributed by patients to a possible tick bite. The aim of our study was to explore the perceptions, representations, and experiences that these patients had of their disease and care paths. METHODS We performed a qualitative study through individual interviews (October 2017-May 2018), based on grounded theory, following the COREQ checklist. A balanced sample of patients with diverse profiles was recruited at consultations with general practitioners and infectious disease physicians. RESULTS Twelve patients were interviewed. Data saturation was reached at the twelfth interview. For codes, 293 were identified, and classified into 5 themes: (1) the experience of disabling nonspecific symptoms, especially pain, causing confusion and fear, (2) long and difficult care paths for the majority of the patients, experienced as an obstacle course, (3) a break with the previous state of health, causing a negative impact on every sphere of the patient's life, (4) empowerment of the patients and the self-management of their disease, and (5) the strong expression of a desire for change, with better listening, greater recognition of the symptoms, and simpler care paths. CONCLUSIONS This study allows for the understanding of a patient's behaviours and the obstacles encountered, the way they are perceived, and the necessary solutions. The patients' expectations identified here could help physicians better understand the doctor-patient relationship in these complex management situations, which would reduce the burden of the disease. The current development of specialised reference centres could help meet the patients' demands and those of family physicians.
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Affiliation(s)
- Alice Raffetin
- Department of Infectious Diseases, Tick-Borne Diseases Reference Centre, North Region, CH Villeneuve Saint Georges, 40 Allée de la Source, 94190 Villeneuve-Saint-Georges, France; (S.N.); (P.C.-P.); (S.C.)
- European Study Group for Lyme Borreliosis ESGBOR, ESCMID, Gerbergasse 14 3rd Floor, 4001 Basel, Switzerland
- Correspondence: ; Tel.: +33-143862068
| | - Aude Barquin
- Département de Médecine Générale, Paris University, Site Cochin 27, Rue du Fbg Saint-Jacques, CEDEX 14, 75679 Paris, France; (A.B.); (H.P.)
| | - Steve Nguala
- Department of Infectious Diseases, Tick-Borne Diseases Reference Centre, North Region, CH Villeneuve Saint Georges, 40 Allée de la Source, 94190 Villeneuve-Saint-Georges, France; (S.N.); (P.C.-P.); (S.C.)
| | - Giulia Paoletti
- Department of Psychiatry, Tick-Borne Diseases Reference Centre, Île-de-France/Hauts-de-France, CH Villeneuve Saint Georges, 40 Allée de la Source, 94190 Villeneuve-Saint-Georges, France;
| | - Christian Rabaud
- Department of Infectious Diseases, Tick-Borne Diseases Reference Centre, East Region, CHRU Nancy, Bâtiment Philippe Canton, Hôpitaux de Brabois, Allée du Morvan, 54500 Vandoeuvre les Nancy, France;
| | - Olivier Chassany
- Health Economics Clinical Trial Unit (URC-ECO), Hôpital Hotel-Dieu, AP-HP, 1 Place du Parvis Notre Dame, 75004 Paris, France;
| | - Pauline Caraux-Paz
- Department of Infectious Diseases, Tick-Borne Diseases Reference Centre, North Region, CH Villeneuve Saint Georges, 40 Allée de la Source, 94190 Villeneuve-Saint-Georges, France; (S.N.); (P.C.-P.); (S.C.)
| | - Sarah Covasso
- Department of Infectious Diseases, Tick-Borne Diseases Reference Centre, North Region, CH Villeneuve Saint Georges, 40 Allée de la Source, 94190 Villeneuve-Saint-Georges, France; (S.N.); (P.C.-P.); (S.C.)
- Department of Anthropology, University Lyon II, UFR Anthropologie, Sociologie et Science Politique, Université Lumière Lyon 2, 5 Avenue Pierre Mendès France, 69676 Bron, France
| | - Henri Partouche
- Département de Médecine Générale, Paris University, Site Cochin 27, Rue du Fbg Saint-Jacques, CEDEX 14, 75679 Paris, France; (A.B.); (H.P.)
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Garcia-Vozmediano A, Giglio G, Ramassa E, Nobili F, Rossi L, Tomassone L. Low Risk Perception about Ticks and Tick-Borne Diseases in an Area Recently Invaded by Ticks in Northwestern Italy. Vet Sci 2021; 8:vetsci8070131. [PMID: 34357923 PMCID: PMC8310202 DOI: 10.3390/vetsci8070131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/09/2021] [Accepted: 07/10/2021] [Indexed: 12/30/2022] Open
Abstract
Risk perception, together with the adoption of measures to prevent tick bites, may strongly influence human exposure to ticks and transmitted pathogens. We created a questionnaire to evaluate how people perceive the health risk posed by ticks in an area recently invaded by these arthropods, in the western Italian Alps. Moreover, through a collaborative effort with park rangers and physicians, we investigated which tick species bite humans and their infection with pathogens (Borrelia burgdorferi s.l., Anaplasma phagocytophilum, and spotted-fever group Rickettsiae). Apart from two Dermacentor marginatus bites, we identified Ixodes ricinus (n = 124) as the main species responsible for tick bites. The investigated pathogens infected 25.4% of tested I. ricinus. The evaluation of the engorgement rate of biting I. ricinus revealed that they had been likely feeding on humans for 24 h or more, suggesting a high probability of pathogen transmission. Indeed, the questionnaires revealed that people infrequently adopt preventive measures, such as inspecting the body for ticks, although most respondents claimed that ticks are a threat to human health. Having suffered from previous tick bites was positively associated with the adoption of personal protection measures. Given the increasing incidence of tick-borne diseases in the region, the public should be better informed about the possibility of being bitten by infected ticks in order to mitigate the risk.
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Affiliation(s)
- Aitor Garcia-Vozmediano
- Department of Veterinary Sciences, University of Turin, L.go Braccini, 2, 10095 Grugliasco, Italy; (A.G.-V.); (G.G.); (L.R.)
| | - Giorgia Giglio
- Department of Veterinary Sciences, University of Turin, L.go Braccini, 2, 10095 Grugliasco, Italy; (A.G.-V.); (G.G.); (L.R.)
| | - Elisa Ramassa
- Ente di Gestione delle Aree Protette delle Alpi Cozie, Via Fransuà Fontan, 1, 10050 Salbertrand, Italy;
| | - Fabrizio Nobili
- Ente di Gestione delle Aree Protette del Po Torinese, Corso Trieste 98, 10024 Moncalieri, Italy;
| | - Luca Rossi
- Department of Veterinary Sciences, University of Turin, L.go Braccini, 2, 10095 Grugliasco, Italy; (A.G.-V.); (G.G.); (L.R.)
| | - Laura Tomassone
- Department of Veterinary Sciences, University of Turin, L.go Braccini, 2, 10095 Grugliasco, Italy; (A.G.-V.); (G.G.); (L.R.)
- Correspondence: ; Tel.: +39-011-670-9195
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Abstract
Lyme borreliosis is a tick-borne disease that is widespread throughout the northern hemisphere. Ixodes ricinus is present throughout metropolitan France, except for the Mediterranean region. The debate revolves around whether or not a chronic form of Lyme disease exists. This controversy is not limited to France but has been reported worldwide. In France, in 2019, 24 scientific societies representing the medical disciplines most involved in Lyme disease, including the Société Française de Rhumatologie (French Rheumatology Society [SFR]) and the Société de Pathologie Infectieuse de la Langue Française (French Infectious Disease Society-SPILF), published recommendations on the management of Lyme borreliosis following a submission to the Director General of Health. These recommendations conflict with those of the Haute Autorité de Santé (HAS), a multi-specialties independent group of physician, on a key point: whether to add a new nosological entity labeled as "persistent polymorphous signs and symptoms (or syndrome) possibly due to tick bite." The creation of this new syndrome risks should increase anchoring bias, leading to the attribution of all symptoms to a possible tick bite, without considering differential diagnoses. Lyme disease has been extensively studied. Erythema migrans is the primary clinical manifestation. In the presence of nonmetabolic, nonseptic monoarthritis involving the knee or radiculitis of a lower limb during the summer, Lyme disease should be suspected. Serologic testing for Lyme disease is reliable in the case of late forms such as chronic arthritis, while the detection of Borrelia DNA in synovial fluid by PCR is inconsistent. Sometimes, the serology can be misleading in early forms such as radiculitis. Treatment is based on doxycycline for 14 days in early forms (radiculitis), or 28 days in late forms (arthritis). Arthritis can persist or recur after antibiotic therapy. The prevalence of a diffuse polyalgia syndrome (fibromyalgia) following Lyme disease does not seem to differ much from that in the general population. It is not improved by prolonged antibiotic therapy, which is therefore not recommended.
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Affiliation(s)
- Guillaume Coiffier
- Service de Rhumatologie, GHT Rance-Émeraude, CH Dinan, 74 boulevard Chateaubriand, 22100 Dinan, France; Centre de Référence des Maladies Vectorielles à Tiques (MVT), Pontchaillou, CHU Rennes, 33 boulevard Louis Guilloux, 35000 Rennes, France; Groupe de travail sur les Infections Ostéo-articulaires, Société Française de Rhumatologie (SFR), Paris, France.
| | - Pierre Tattevin
- Service de Maladies Infectieuses & Réanimation Médicale, Pontchaillou, CHU Rennes, 33 boulevard Louis Guilloux, 35000 Rennes, France; Centre de Référence des Maladies Vectorielles à Tiques (MVT), Pontchaillou, CHU Rennes, 33 boulevard Louis Guilloux, 35000 Rennes, France
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Yang X, Gao Z, Wang L, Xiao L, Dong N, Wu H, Li S. Projecting the potential distribution of ticks in China under climate and land use change. Int J Parasitol 2021; 51:749-759. [PMID: 33798559 DOI: 10.1016/j.ijpara.2021.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 12/18/2022]
Abstract
Ticks are known as vectors of several pathogens causing various human and animal diseases including Lyme borreliosis, tick-borne encephalitis, and Crimean-Congo hemorrhagic fever. While China is known to have more than 100 tick species well distributed over the country, our knowledge on the likely distribution of ticks in the future remains very limited, which hinders the prevention and control of the risk of tick-borne diseases. In this study, we selected four representative tick species which have different regional distribution foci in mainland China. i.e., Dermacentor marginatus, Dermacentor silvarum, Haemaphysalis longicornis and Ixodes granulatus. We used the MaxEnt model to identify the key environmental factors of tick occurrence and map their potential distributions in 2050 under four combined climate and socioeconomic scenarios (i.e., SSP1-RCP2.6, SSP2-RCP4.5, SSP3-RCP7.0 and SSP5-RCP8.5). We found that the extent of the urban fabric, cropland and forest, temperature annual range and precipitation of the driest month were the main determinants of the potential distributions of the four tick species. Under the combined scenarios, with climate warming, the potential distributions of ticks shifted to further north in China. Due to a decrease in the extent of forest, the distribution probability of ticks declined in central and southern China. In contrast with previous findings on an estimated amplification of tick distribution probability under the extreme emission scenario (RCP8.5), our studies projected an overall reduction in the distribution probability under RCP8.5, owing to an expected effect of land use. Our results could provide new data to help identify the emerging risk areas, with amplifying suitability for tick occurrence, for the prevention and control of tick-borne zoonoses in mainland China. Future directions are suggested towards improved quantity and quality of the tick occurrence database, comprehensiveness of factors and integration of different modelling approaches, and capability to model pathogen spillover at the human-tick interface.
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Affiliation(s)
- Xin Yang
- College of Environment Science and Engineering, Huazhong University of Science and Technology, Wuhan 430070, China
| | - Zheng Gao
- College of Environment Science and Engineering, Huazhong University of Science and Technology, Wuhan 430070, China
| | - Luqi Wang
- College of Environment Science and Engineering, Huazhong University of Science and Technology, Wuhan 430070, China
| | - Lingjun Xiao
- College of Environment Science and Engineering, Huazhong University of Science and Technology, Wuhan 430070, China
| | - Na Dong
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Hongjuan Wu
- College of Environment Science and Engineering, Huazhong University of Science and Technology, Wuhan 430070, China
| | - Sen Li
- College of Environment Science and Engineering, Huazhong University of Science and Technology, Wuhan 430070, China; UK Centre for Ecology & Hydrology, Wallingford OX10 8BB, UK; Environmental Change Institute, University of Oxford, Oxford OX1 3QY, UK.
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[Mediastinal lymphadenopathy: Do not forget tularemia!]. Rev Mal Respir 2021; 38:204-209. [PMID: 33581986 DOI: 10.1016/j.rmr.2020.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/27/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Mediastinal lymphadenopathy is a common cause of referral to the pulmonologist. In addition to more frequent aetiologies such as malignancy, sarcoidosis, tuberculosis and lymphoma, unusual causes must be considered, especially in specific contexts. CASE SERIES We report the cases of three young patients referred to our pulmonology department for the assessment of hypermetabolic mediastinal lymphadenopathy. The context of the onset of symptoms (tick bite, contact with an infected animal) as well as paraclinical investigations (Francisella tularensis serology) made it possible to make a diagnosis of tularemia. The clinical and radiological evolution was favourable in all three cases. Tularemia is a rare but currently re-emerging infection caused by a Gram negative coccobacillus, Francisella tularensis. Human contamination occurs mainly through contact with infected animals or by tick bites. The diagnosis can be difficult because the symptoms (fever, diffuse myalgia) are non-specific, and is based on serology and an appropriate clinical context. Treatment is based on ciprofloxacin or doxycycline. CONCLUSION The diagnosis of tularemia must be considered in the presence of lymphadenopathy occurring after a tick bite or contact with an infected animal.
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A Novel Case of Life-Threatening Thrombocytopenia Secondary to Anaplasmosis. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2020. [DOI: 10.1097/ipc.0000000000000888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lampros A, Caumes E, Psimaras D, Galanaud D, Clarençon F, Peyre M, Deltour S, Bielle F, Lhote R, Haroche J, Amoura Z, Cohen Aubart F. [Infection associated cerebral vasculitis]. Rev Med Interne 2020; 42:258-268. [PMID: 32868117 DOI: 10.1016/j.revmed.2020.05.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 04/26/2020] [Accepted: 05/07/2020] [Indexed: 12/11/2022]
Abstract
Infections are a frequent cause of cerebral vasculitis, important to diagnose because a specific treatment may be required. Infection-associated vasculitis can be caused by angiotropic pathogens (varicella zoster virus, syphilis, aspergillus). They can be associated with subarachnoidal meningitis (tuberculosis, pyogenic meningitis, cysticercosis). They can appear contiguously to sinuses or orbital infection (aspergillosis, mucormycosis). Finally, they also may be due to an immune mechanism in the context of chronic infections (hepatitis B virus, hepatitis C virus, human immunodeficiency virus). Cerebral vasculitis are severe conditions and their prognosis is directly linked to early recognition and diagnosis. Infectious causes must therefore be systematically considered ahead of cerebral vasculitis, and the appropriate investigations must be determined according to the patient's clinical context. We propose here an update on the infectious causes of cerebral vasculitis, their diagnosis modalities, and therapeutic options.
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Affiliation(s)
- A Lampros
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Médecine Interne 2, Centre de Référence Maladies systémiques rares et Histiocytoses, 75013 Paris, France
| | - E Caumes
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service des maladies infectieuses et tropicales, 75013 Paris, France
| | - D Psimaras
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Neurologie 2, 75013 Paris, France
| | - D Galanaud
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Neuroradiologie, 75013 Paris, France
| | - F Clarençon
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Neuroradiologie, 75013 Paris, France
| | - M Peyre
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Neurochirurgie, 75013 Paris, France
| | - S Deltour
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service des Urgences cérébro-vasculaires, 75013 Paris, France
| | - F Bielle
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Neuropathologie, 75013 Paris, France
| | - R Lhote
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Médecine Interne 2, Centre de Référence Maladies systémiques rares et Histiocytoses, 75013 Paris, France
| | - J Haroche
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Médecine Interne 2, Centre de Référence Maladies systémiques rares et Histiocytoses, 75013 Paris, France
| | - Z Amoura
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Médecine Interne 2, Centre de Référence Maladies systémiques rares et Histiocytoses, 75013 Paris, France
| | - F Cohen Aubart
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, Service de Médecine Interne 2, Centre de Référence Maladies systémiques rares et Histiocytoses, 75013 Paris, France.
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Lumbar Radiculitis as a Complication of Vaccination against Tick-Borne Encephalitis: A Differential Diagnosis of Low Back Pain and Nerve Root Compression. Case Rep Med 2020; 2020:6130364. [PMID: 32280350 PMCID: PMC7142386 DOI: 10.1155/2020/6130364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 02/17/2020] [Indexed: 12/30/2022] Open
Abstract
Serious adverse reactions following immunisation with adult tick-borne encephalitis (TBE) vaccines are rare, but when they occur, they most frequently involve the nervous system. We present a case of a female patient who developed a sensory and motor L4 monoradiculopathy following self-injection of an inactivated vaccine against TBE in the ipsilateral quadriceps muscle. The motor and sensory L4 dysfunction vanished after 12 months. TBE vaccine-induced radiculopathy should be considered as a mimic of spinal root compression.
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Courtioux B, Hamidović A. Se protéger des tiques. ACTUALITES PHARMACEUTIQUES 2020. [DOI: 10.1016/j.actpha.2019.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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