Borrelia burgdorferi infection and cutaneous Lyme disease, Mexico

Clinical and laboratory features of rickettsioses in Yucatan, Mexico

Rickettsia species are obligate intracellular bacteria that can cause mild to severe human disease. Based on phylogeny, clinical symptoms, and antigenic properties, rickettsiae are classified into four groups. Infections by these agents are characterized by clinical symptoms ranging from self-limited to severe and even fatal febrile illnesses, depending on the Rickettsia spp. involved, the patient's predisposition, and timely medical care. The present study aimed to characterize rickettsial diseases in Yucatan according to clinical and laboratory features appearing in medical records corresponding to 427 samples taken between 2015 and 2018. A study was conducted over the period 2015-2018 on 427 samples. Clinical and laboratory features were documented from the patients' medical records. For molecular diagnosis, blood was collected in 3.8 % sodium citrate as anticoagulant, and DNA was extracted. Single-step and nested PCR amplification was performed using genus-specific primers for the rickettsial 17kDa and ompB genes. The amplicons obtained were purified and sequenced. A total of 22.7 % (97/427) positive cases of Rickettsia spp. were identified by PCR from 14.15 % (15/106) of the municipalities in Yucatan. 75.2 % (73/97) of the cases were from the city of Merida during the autumn (September-December). The age groups with the highest frequency of confirmed cases were pediatric (5-14 years) (57.7 %) and adults (25-49 years) (42.2 %). There were six fatal cases in children, one associated with R. typhi and five with R. rickettsii. In non-fatal cases, 32.9 % (32/97) corresponded to the spotted fever group (SFG), and 60.8 % (59/97) to the typhus group (TG). Significant differences in signs, and laboratory data, were observed between the pediatric and adult populations. For the treatment of patients, oral and intravenous doxycycline was used in severe hospitalized cases. Typhus group and spotted fever group Rickettsiae are endemic pathological agents found in urban and rural areas of our region. Molecular identification allows for greater diagnostic accuracy and timely treatment and consequently a better prognosis. It is necessary to implement or reinforce measures focused on the dissemination of knowledge regarding rickettsial diseases and their prevention.

Borrelial lymphocytoma

Borrelial lymphocytoma is a rare cutaneous manifestation of early localized European Lyme borreliosis. It manifests as a nodule or plaque with a diameter of up to a few centimeters. The lesion is, as a rule, solitary. It is more common in children than in adults and, in contrast to erythema migrans and acrodermatitis chronica atrophicans, has male predominance. A tick bite has been reported in approximately one half of patients; the tick bite is usually at the site or in the vicinity of the later borrelial lymphocytoma. The predilection site for the development of lesions is the breast in adults and the ear lobe in children. Borrelial lymphocytoma is frequently associated with erythema migrans, but rarely with other manifestations of Lyme borreliosis, and is predominantly caused by Borrelia afzelii. At presentation, approximately half of the patients with borrelial lymphocytoma have measurable serum borrelial antibodies and, in about one third, spirochetes can be cultivated from the skin lesion. A 14-day antibiotic therapy, as recommended for patients with erythema migrans, is highly successful. Posttreatment duration of a borrelial lymphocytoma is positively associated with the pretreatment duration of the lesion and with patient age, while treatment failure is associated with the clinical signs of disseminated Lyme borreliosis at presentation. Substantial improvements in knowledge on borrelial lymphocytoma and laboratory diagnostics in recent decades have contributed to earlier diagnosis and treatment. Consequently, borrelial lymphocytoma is usually a mild disease with a good prognosis.

Brown Dog Tick (Rhipicephalus sanguineus Sensu Lato) Infection with Endosymbiont and Human Pathogenic Rickettsia spp., in Northeastern México

Of the documented tick-borne diseases infecting humans in México, Rocky Mountain spotted fever (RMSF), caused by the Gram-negative bacterium Rickettsia rickettsii, is responsible for most fatalities. Given recent evidence of brown dog tick, Rhipicephalus sanguineus s.l., as an emerging vector of human RMSF, we aimed to evaluate dogs and their ticks for rickettsiae infections as an initial step in assessing the establishment of this pathosystem in a poorly studied region of northeastern México while evaluating the use of dogs as sentinels for transmission/human disease risk. We sampled owned dogs living in six disadvantaged neighborhoods of Reynosa, northeastern México to collect whole blood and ticks. Of 168 dogs assessed, tick infestation prevalence was 53%, composed of exclusively Rh. sanguineus s. l. (n = 2170 ticks). Using PCR and sequencing, we identified an overall rickettsiae infection prevalence of 4.1% (n = 12/292) in ticks, in which eight dogs harbored at least one infected tick. Rickettsiae infections included Rickettsia amblyommatis and Rickettsia parkeri, both of which are emerging human pathogens, as well as Candidatus Rickettsia andeanae. This is the first documentation of pathogenic Rickettsia species in Rh. sanguineus s.l. collected from dogs from northeastern México. Domestic dog infestation with Rickettsia-infected ticks indicates ongoing transmission; thus, humans are at risk for exposure, and this underscores the importance of public and veterinary health surveillance for these pathogens.

Assessment of the potential establishment of Lyme endemic cycles in Mexico

Although Lyme disease is currently classified as exotic in Mexico, recent studies have suggested that it might be endemic there. We assessed the potential risk for the establishment of Borrelia burgdorferi transmission in Mexico. To identify the potential routes of B. burgdorferi spread, Complex Inference Networks were used initially to identify potential vector-host interactions between hard ticks (Ixodes) and migratory birds in the U.S., and a model for predicting the most important potential bird hosts of hard ticks was then obtained. By using network metrics, keystone-vectors were identified as those species with highest connectivity within and between network communities and had the potential to keep the pathogen circulating with many birds and to be dispersed to several regions. The climatic profile where these interactions occur in the U.S. was characterized and a geographic model for each keystone-vector was built. The accuracy of these models to predict areas where hard ticks have been reported positive for B. burgdorferi allows one to identify areas of greater risk of Lyme disease emergence. These hard tick-bird interactions and their climatic profile were mapped into the winter ranges of birds in Mexico. Thus, those regions in Mexico with the highest potential for becoming endemic areas of Lyme disease through the arrival of hard ticks and birds infected by B. burgdorferi were identified. These areas are candidates for future surveillance programs.

Serological and Molecular Evidence of Patients Infected with Anaplasma phagocytophilum in Mexico

Human granulocytic Anaplasmosis (HGA), is a tick-borne infectious disease transmitted by ticks, resulting in acute feverish episodes. The etiological agent is the bacteria Anaplasma phagocytophilum; which is spread by ticks of the genus Ixodes spp. to complete its life cycle. In Mexico, there is only one case report. The primary challenge is understanding how other bacteria affect or overlap with the clinical manifestation of the disease. Sample collection occurred over the period September 2017 through October 2019. Blood samples from human subjects were obtained immediately after they signed consent forms. We analyzed for the presence for A. phagocytophilum by serological (IFA IgG two times) and PCR targeting 16SrRNA and groEL genes, followed by DNA sequencing. All patients with a history of travel abroad were dismissed for this project. In total, 1924 patients participated and of these, 1014 samples across the country were analyzed. Of these, 85 (8.38%) had IFA results that ranged from 1:384 to 1:896. Of the positive samples, 7.10% were used for PCR. Significant clinical manifestations included: dizziness, nausea, petechial, epistaxis, enlarged liver and/or spleen and thrombocytopenia. Hospitalization of at least 1.5 days was necessary for 3.2% of patients. None of the cases analyzed were lethal. This is the first clinical manifestations along with serological test results and molecular analysis confirmed the presence of A. phagocytophilum resulting in HGA in patients from Mexico. Health institutions and medical practitioners in general should include diagnostic testing for HGA among high risk populations and should recognize it as a vector-borne emerging infectious disease in Mexico.

Lyme disease and relapsing fever in Mexico: An overview of human and wildlife infections

Lyme borreliosis and Relapsing fever are considered emerging and re-emerging diseases that cause major public health problems in endemic countries. Epidemiology and geographical distribution of these diseases are documented in the US and in Europe, yet in Mexico, studies are scarce and scattered. The aims of this study were (1) to present the first confirmatory evidence of an endemic case of Lyme disease in Mexico and (2) to analyze the epidemiological trend of these both diseases by compiling all the information published on Borrelia in Mexico. Two databases were compiled, one of human cases and another of wild and domestic animals in the country. The analysis included the evaluation of risk factors for the human population, the diversity of Borrelia species and their geographic distribution. Six Borrelia species were reported in a total of 1,347 reports, of which 398 were of humans. Women and children from rural communities were shown to be more susceptible for both Lyme borreliosis and Relapsing fever. The remaining reports were made in diverse mammalian species and ticks. A total of 17 mammalian species and 14 tick species were recorded as hosts for this bacterial genus. It is noteworthy that records of Borrelia were only made in 18 of the 32 states, mainly in northern and central Mexico. These results highlight the importance of performing further studies in areas where animal cases have been reported, yet no human studies have been done, in order to complete the epidemiological panorama for Lyme borreliosis and Relapsing fever. Finally, the search for Borrelia infections in other vertebrates, such as reptiles and amphibians is recommended to gain a more accurate view of Borrelia species and their distribution. The geographical approach presented herein justifies an intense sampling effort to improve epidemiological knowledge of these diseases to aid vector control and prevention programs.

Immuno-molecular prospecting for vector-borne diseases in central Mexico

Climatic changes have influenced the temporal and spatial distribution of diseases. In livestock-grazing areas, rodents are reservoirs of zoonotic pathogens; therefore, they play an important role in the transmission of diseases affecting domestic animals and humans. The objective of this study was to investigate the presence of the zoonotic agents: Anaplasma phagocytophilum, Borrelia burgdorferi, Ehrlichia canis and Rickettsia rickettsii, as well as the presence of viral RNA from the Bunyaviridae, Togaviridae and Flaviviridae families, in wild rodents from animal production units in central Mexico. The samples were obtained from wild rodents that had access and contact with animal production units. A total of 92 rodents were captured, and samples of blood, serum and organs, such as spleen, kidney, heart and liver, were obtained. The serum was used to detect antibodies against Anaplasma phagocytophilum, Borrelia burgdorferi, Ehrlichia canis and Rickettsia rickettsii by an immunofluorescence antibody test (IFAT); the blood was used for PCR analysis; and the organs were used to obtain RNA (cDNA) to perform RT-PCR. By IFAT, all samples were positive to A. phagocytophilum and E. canis, and negative to B. burgdorferi and R. rickettsii. The samples that were positive to IFAT were used to confirm the presence of pathogen by PCR analysis. The results from the PCR were as follows: 34 samples were positive to A. phagocytophilum, and 59 to E. canis. There was no amplification of genetic material from the Bunyaviridae, Flaviviridae and Togaviridae virus families from the organs that were sampled, which suggests that the samples obtained did not contain RNA specific to these families. This is the first immuno-molecular prospecting study on vector-borne diseases in central Mexico demonstrating the presence of A. phagocytophilum and E. canis in wild rodents living in cattle grazing areas.

Borrelia burgdorferi basic membrane protein A initiates proinflammatory chemokine storm in THP 1-derived macrophages via the receptors TLR1 and TLR2

Lyme disease, reffered to as Lyme borreliosis, is a tick-borne zoonotic disease caused by Borrelia burgdorferi spirochetes. Lyme arthritis, the most common, serious and harmful manifestation during the late stages of Lyme disease, is closely associated with the Borrelia burgdorferi basic membrane protein A (BmpA). Chemokines are also reported to have an important role in Lyme arthritis. Toll-like receptors (TLRs) recognize and bind to pathogen-associated molecules which are structurally conserved among microbes, to activate transcriptional events, including cytokine production, inflammation, and tissue damage. We speculated that BmpA could induce a storm of proinflammatory chemokines via TLRs and downstream moleculars, and that TLR1, TLR2, TLR5, TLR6 and the adaptor protein, MyD88, may be involved in this process. We explored this hypothesis using the human monocytic leukemia cell line, THP-1, and recombinant BmpA (rBmpA). Cell surface TLR1 and TLR2 were neutralized using specific antibodies before stimulation with rBmpA and analysis of chemokine secretion using a chemokine chip. Further, the expressions level of the four TLRs and MyD88 were analyzed following stimulation with rBmpA. Stimulation with rBmpA resulted in elevated levels of seven cytokines. Further, TLR1 and TLR2 antibody treated cells exhibited an overall reduction in rBmpA-induced chemokine expression. TLR1, TLR2, and MyD88 expression levels (both mRNA and protein) increased after stimulation with rBmpA. Our data confirm that TLR1, TLR2, and MyD88 are involved in BmpA-induced proinflammatory chemokines, which may be closely involved in Lyme arthritis pathogenesis.

Manifestations of Lyme carditis

The first data of Lyme carditis, a relatively rare manifestation of Lyme disease, were published in eighties of the last century. Clinical manifestations include syncope, light-headedness, fainting, shortness of breath, palpitations, and/or chest pain. Atrioventricular (AV) electrical block of varying severity presents the most common conduction disorder in Lyme carditis. Although is usually mild, AV block can fluctuates rapidly and progress from a prolonged P-R interval to a His-Purkinje block within minutes to hours and days. Rarely, Lyme disease may be the cause of endocarditis, while some studies and reports, based on serological and/or molecular investigations, have suggested possible influence of Borrelia burgdorferi on degenerative cardiac valvular disease. Myocarditis, pericarditis, pancarditis, dilated cardiomyopathy, and heart failure have also been described as possible manifestations of Lyme carditis. The clinical course of Lyme carditis is generally mild, short term, and in most cases, completely reversible after adequate antibiotic treatment.

Antibody profile to Borrelia burgdorferi in veterinarians from Nuevo León, Mexico, a non-endemic area of this zoonosis

Objectives

Lyme disease is a tick-borne disease caused by infections with Borrelia. Persons infected with Borrelia can be asymptomatic or can develop disseminated disease. Diagnosis and recognition of groups at risk of infection with Borrelia burgdorferi is of great interest to contemporary rheumatology. There are a few reports about Borrelia infection in Mexico, including lymphocytoma cases positive to B. burgdorferi sensu stricto by PCR and a patient with acrodermatitis chronica atrophicans. Veterinarians have an occupational risk due to high rates of tick contact.

The aim of this work was to investigate antibodies to Borrelia in students at the Faculty of Veterinary Medicine and Zootechnics, at Nuevo León, Mexico, and determine the antibody profile to B. burgdorferi antigens.

Material and methods

Sera were screened using a C6 ELISA, IgG and IgM ELISA using recombinant proteins from B. burgdorferi, B. garinii and B. afzelii. Sera with positive or grey-zone values were tested by IgG Western blot to B. burgdorferi sensu stricto.

Results

All volunteers reported tick exposures and 72.5% remembered tick bites. Only nine persons described mild Lyme disease related symptoms, including headaches, paresthesias, myalgias and arthralgias. None of the volunteers reported erythema migrans. Nine samples were confirmed by IgG Western blot. The profile showed 89% reactivity to OspA, 67% to p83, and 45% to BmpA.

Conclusions

Positive sera samples shared antibody reactivity to the markers of late immune response p83 and BmpA, even if individuals did not present symptoms of Lyme arthritis or post-Lyme disease. The best criterion to diagnose Lyme disease in our country remains to be established, because it is probable that different strains coexist in Mexico. This is the first report of antibodies to B. burgdorferi in Latin American veterinarians. Veterinarians and high-risk people should be alert to take precautionary measures to prevent tick-borne diseases.

Prevalencia de Borrelia burgdorferi sensu lato en roedores sinantrópicos de dos comunidades rurales de Yucatán, México

<p><strong>Introducción.</strong> La enfermedad de Lyme es una zoonosis multisistémica causada por Borrelia burgdorferi sensu lato. Esta espiroqueta circula en un ciclo enzoótico entre un reservorio vertebrado primario y las garrapatas. Diferentes especies de roedores están identificadas por ser eficientes reservorios naturales para B. burgdorferi s.l.</p><p><strong>Objetivo.</strong> Estimar la prevalencia de B. burgdorferi s.l. en roedores sinantrópicos empleando dos comunidades rurales de Yucatán, México.</p><p><strong>Materiales y métodos.</strong> Se capturaron 123 roedores (94 Mus musculus y 29 Rattus rattus) para obtener muestras de tejidos de oreja y vejiga. Para detectar la presencia de B. burgdorferi s.l. en la muestras, se amplificaron los genes de la flagelina B (fla B) y las lipoproteínas de membrana externa, ospC y p66, empleado la reacción en cadena de la polimerasa. Los amplicones obtenidos fueron secuenciados.</p><p><strong>Resultados.</strong> La frecuencia de infección de B. burgdorferi s.l. en roedores fue de 36,5% para flaB (45/123), 10,5% (13/123) para p66 y 3,2% (4/123) para ospC. R. rattus tuvo una frecuencia de infección de 17,2% y M. musculus de 42,5%. La frecuencia de infección de B. burgdorferi s.l. en los tejidos estudiados fue de 11,3% (14/123) en vejigas y 17,0% (21/123) en orejas. No se encontraron diferencias estadísticas (p &gt; 0,05) en la frecuencia de infección entre las dos muestras de tejido utilizadas para el diagnóstico. El gen ospC presentó un 98% de homología con la especie  Borrelia garinii, una de las especies heterogéneas del complejo B. burgdorferi s.l.</p><p> </p><p><strong>Conclusiones.</strong> Se concluye que los roedores presentan alta prevalencia de infección con B. burgdorferi s.l., y ambas especies, M. musculus y R. rattus, podrían estar jugando un papel importante en el mantenimiento de esta bacteria en comunidades rurales de Yucatán, México.</p><pre style="line-height: 200%; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;"><strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Arial',sans-serif; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: ES-MX;" lang="ES">Introducción.</span></strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Arial',sans-serif; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: ES-MX;" lang="ES"> La enfermedad de Lyme es una zoonosis multisistémica causada por <em>Borrelia burgdorferi</em> sensu lato. Esta espiroqueta circula en un ciclo enzoótico entre un reservorio vertebrado primario y las garrapatas. Diferentes especies de roedores están identificadas por ser eficientes reservorios naturales para <em>B. burgdorferi</em> s.l.</span></pre><pre style="line-height: 200%; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;"><strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Arial',sans-serif; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: ES-MX;" lang="ES">Objetivo.</span></strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Arial',sans-serif; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: ES-MX;" lang="ES"> Estimar la prevalencia de <em>B. burgdorferi</em> s.l. en roedores sinantrópicos empleando dos comunidades rurales de Yucatán, México.</span></pre><pre style="line-height: 200%; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;"><strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Arial',sans-serif; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: ES-MX;" lang="ES">Materiales y métodos.</span></strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Arial',sans-serif; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: ES-MX;" lang="ES"> Se capturaron 123 roedores (94 <em>Mus musculus</em> y 29 <em>Rattus rattus</em>) para obtener muestras de tejidos de oreja y vejiga. Para detectar la presencia de<em> B. burgdorferi</em> s.l. en la muestras, se amplificaron los genes de la flagelina B (<em>fla B</em>) y las lipoproteínas de membrana externa, <em>ospC</em> y <em>p66</em>, empleado la reacción en cadena de la polimerasa. Los amplicones obtenidos fueron secuenciados.</span></pre><pre style="line-height: 200%; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;"><strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Arial',sans-serif; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: ES-MX;" lang="ES">Resultados.</span></strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Arial',sans-serif; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: ES-MX;" lang="ES"> La frecuencia de infección de <em>B. burgdorferi</em> s.l. en roedores fue de 36,5% para <em>flaB</em> (45/123), 10,5% (13/123) para <em>p66 </em>y 3,2% (4/123) para <em>ospC</em>. <em>R. rattus</em> tuvo una frecuencia de infección de 17,2% y <em>M. musculus</em> de 42,5%. La frecuencia de infección de <em>B. burgdorferi</em> s.l. en los tejidos estudiados fue de 11,3% (14/123) en vejigas y 17,0% (21/123) en orejas. No se encontraron diferencias estadísticas (p &gt; 0,05) en la frecuencia de infección entre las dos muestras de tejido utilizadas para el diagnóstico. El gen <em>ospC</em> presentó un 98% de homología con la especie  <em>Borrelia garinii, </em>una de las especies heterogéneas del complejo<em> B. burgdorferi s.l</em>.</span></pre><pre style="line-height: 200%; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;"><strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Arial',sans-serif; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: ES-MX;" lang="ES">Conclusiones.</span></strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Arial',sans-serif; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: ES-MX;" lang="ES"> Se concluye que los roedores presentan alta prevalencia de infección con <em>B. burgdorferi</em> s.l., y ambas especies, <em>M. musculus</em> y <em>R. rattus, </em>podrían estar jugando un papel importante en el mantenimiento de esta bacteria en comunidades rurales de Yucatán, México.<strong></strong></span></pre>

Epidemiology of Lyme disease

Lyme disease is the most common vector-borne illness in North America and Europe. The etiologic agent, Borrelia burgdorferi sensu lato, is transmitted to humans by certain species of Ixodes ticks, which are found widely in temperate regions of the Northern hemisphere. Clinical features are diverse, but death is rare. The risk of human infection is determined by the geographic distribution of vector tick species, ecologic factors that influence tick infection rates, and human behaviors that promote tick bite. Rates of infection are highest among children 5 to 15 years old and adults older than 50 years.

The cutaneous manifistation of Lyme Borreliosis: primary borrelial lymphocytoma and surrounding secondary erythema chronicum migrans

The authors describe a rare clinical observation of the cutaneous manifistation of Lyme Borreliosis: primary borrelial lymphocytoma and surrounding secondary erythema chronicum migrans. The review of clinical features, histology, is also present.

Pathogenic Landscape of Transboundary Zoonotic Diseases in the Mexico-US Border Along the Rio Grande

Transboundary zoonotic diseases, several of which are vector borne, can maintain a dynamic focus and have pathogens circulating in geographic regions encircling multiple geopolitical boundaries. Global change is intensifying transboundary problems, including the spatial variation of the risk and incidence of zoonotic diseases. The complexity of these challenges can be greater in areas where rivers delineate international boundaries and encompass transitions between ecozones. The Rio Grande serves as a natural border between the US State of Texas and the Mexican States of Chihuahua, Coahuila, Nuevo León, and Tamaulipas. Not only do millions of people live in this transboundary region, but also a substantial amount of goods and people pass through it everyday. Moreover, it occurs over a region that functions as a corridor for animal migrations, and thus links the Neotropic and Nearctic biogeographic zones, with the latter being a known foci of zoonotic diseases. However, the pathogenic landscape of important zoonotic diseases in the south Texas-Mexico transboundary region remains to be fully understood. An international perspective on the interplay between disease systems, ecosystem processes, land use, and human behaviors is applied here to analyze landscape and spatial features of Venezuelan equine encephalitis, Hantavirus disease, Lyme Borreliosis, Leptospirosis, Bartonellosis, Chagas disease, human Babesiosis, and Leishmaniasis. Surveillance systems following the One Health approach with a regional perspective will help identifying opportunities to mitigate the health burden of those diseases on human and animal populations. It is proposed that the Mexico-US border along the Rio Grande region be viewed as a continuum landscape where zoonotic pathogens circulate regardless of national borders.

Implications of climate change on the distribution of the tick vector Ixodes scapularis and risk for Lyme disease in the Texas-Mexico transboundary region

BACKGROUND

Disease risk maps are important tools that help ascertain the likelihood of exposure to specific infectious agents. Understanding how climate change may affect the suitability of habitats for ticks will improve the accuracy of risk maps of tick-borne pathogen transmission in humans and domestic animal populations. Lyme disease (LD) is the most prevalent arthropod borne disease in the US and Europe. The bacterium Borrelia burgdorferi causes LD and it is transmitted to humans and other mammalian hosts through the bite of infected Ixodes ticks. LD risk maps in the transboundary region between the U.S. and Mexico are lacking. Moreover, none of the published studies that evaluated the effect of climate change in the spatial and temporal distribution of I. scapularis have focused on this region.

METHODS

The area of study included Texas and a portion of northeast Mexico. This area is referred herein as the Texas-Mexico transboundary region. Tick samples were obtained from various vertebrate hosts in the region under study. Ticks identified as I. scapularis were processed to obtain DNA and to determine if they were infected with B. burgdorferi using PCR. A maximum entropy approach (MAXENT) was used to forecast the present and future (2050) distribution of B. burgdorferi-infected I. scapularis in the Texas-Mexico transboundary region by correlating geographic data with climatic variables.

RESULTS

Of the 1235 tick samples collected, 109 were identified as I. scapularis. Infection with B. burgdorferi was detected in 45% of the I. scapularis ticks collected. The model presented here indicates a wide distribution for I. scapularis, with higher probability of occurrence along the Gulf of Mexico coast. Results of the modeling approach applied predict that habitat suitable for the distribution of I. scapularis in the Texas-Mexico transboundary region will remain relatively stable until 2050.

CONCLUSIONS

The Texas-Mexico transboundary region appears to be part of a continuum in the pathogenic landscape of LD. Forecasting based on climate trends provides a tool to adapt strategies in the near future to mitigate the impact of LD related to its distribution and risk for transmission to human populations in the Mexico-US transboundary region.

Species distribution models and ecological suitability analysis for potential tick vectors of lyme disease in Mexico

Species distribution models were constructed for ten Ixodes species and Amblyomma cajennense for a region including Mexico and Texas. The model was based on a maximum entropy algorithm that used environmental layers to predict the relative probability of presence for each taxon. For Mexico, species geographic ranges were predicted by restricting the models to cells which have a higher probability than the lowest probability of the cells in which a presence record was located. There was spatial nonconcordance between the distributions of Amblyomma cajennense and the Ixodes group with the former restricted to lowlands and mainly the eastern coast of Mexico and the latter to montane regions with lower temperature. The risk of Lyme disease is, therefore, mainly present in the highlands where some Ixodes species are known vectors; if Amblyomma cajennense turns out to be a competent vector, the area of risk also extends to the lowlands and the east coast.

Lyme borreliosis

Borreliosis is an infectious disease caused by spirochetes of the genus Borrelia. Lyme borreliosis, also known as Lyme disease, is a non-contagious infectious disease caused by spirochetes belonging to the complex Borrelia burgdorferi sensu lato and more often transmitted by the bite of infected ticks of the genus Ixodes.The disease is characterized by a varied clinical profile, which can trigger cutaneous, articular, neurological and cardiac manifestations.

Antibody reactivity to Borrelia burgdorferi sensu stricto antigens in patients from the Brazilian Amazon region with skin diseases not related to Lyme disease

In the present study, we report the occurrence of borreliosis in patients from the Brazilian Amazonic region. Nineteen (7.2%) out of 270 dermatological patients with different skin diseases (no one with clinical Lyme disease), tested positive by ELISA for Borrelia burgdorferi. Serum samples from 15 out of the 19 ELISA-positive patients were further evaluated by Western blot. Presence of Borrelia burgdorferi specific IgG was confirmed in eight (53.3%) out of the 15 patients. All eight patients with ELISA and Western blot positive reactions were treated with doxycycline, according to the Centers for Disease Control and Prevention guidelines. One of them had clinical manifestations of colagenosis and was sent to the Department of Internal Medicine for further investigation. Data presented here suggested that borreliosis "lato sensu" is in the Brazilian Amazon region.

Borrelia Burgdorferi "sensu lato" in Brazil: Occurrence confirmed by immunohistochemistry and focus floating microscopy

In the present study, we report the occurrence of Lyme's borreliosis in patients from the Brazilian Amazon Region. Borreliosis was investigated by immunohistochemistry and focus floating microscopy for Borrelia burgdorferi in skin biopsy samples from 22 patients with both clinical and histopathology evidences compatible with Erythema Migrans. Spirochetes were detected by specific immunohistochemistry and focus floating microscopy for B. burgdorferi in samples from five patients. Clinical cure of the cutaneous lesions was observed in all the patients after treatment with doxycycline regimen as proposed by the Center Disease Control guidelines. A limitation of our study was the fact that we were not able to isolate and culture these organisms. These are the first known Brazilian cases of borreliosis to have Focus Floating Microscopy confirmation.

Demonstration of Borrelia burgdorferi sensu stricto infection in ticks from the northeast of Mexico

Borrelia burgdorferisensu lato infection has been confirmed in clinical cases in the northeast of Mexico; however, the bacterium has not been identified as infecting the tick vector Ixodes, Amblyomma and Dermacentor ticks were collected from mammals and plants in northeastern Mexico and examined for Borrelia. Eighteen of 214 ticks were PCR-positive for the fla and 16S rRNA genes and 15 for the ospA gene. Southern blotting with a fla probe and sequencing of ospA genes confirmed infection with B. burgdorferi sensu stricto. These findings, together with reports of indigenous cases, fulfil the criteria that allow northeastern Mexico to be considered as a zone endemic for Lyme disease.