Latent Lyme disease.

TITLE:
Lyme disease: a neuropsychiatric illness.
AUTHORS:
Fallon BA; Nields JA
AUTHOR AFFILIATION:
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York.
SOURCE:
Am J Psychiatry 1994 Nov;151(11):1571-83
"Like syphilis, Lyme disease may have a latency period of months to years before symptoms of late infection emerge."

TITLE:
Questionnaire surveys of cases of tick bite and Lyme borreliosis in hunters in Hokkaido with reference to detection of anti-Borrelia burgdorferi antibody.
AUTHORS:
Kubo N; Arashima Y; Yoshida M; Kawabata M; Nishinarita S; Hayama T; Sawada S; Horie T; Nakao M; Miyamoto K; et al
AUTHOR AFFILIATION:
First Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
SOURCE:
Intern Med 1992 Oct;31(10):1163-8
"An epidemic of Lyme borreliosis on Hokkaido island, Japan, was surveyed by questionnaire in 587 hunters. ...These findings suggested that the many hunters exposed to Borrelia burgdorferi frequently carried latent infections, and that some had latent form of arthritis, dermatitis and other disorders."

TITLE:
Spirochetal infection of the central nervous system.
AUTHORS:
Coyle PK; Dattwyler R
AUTHOR AFFILIATION:
Health Sciences Center, State University, New York, Stony Brook.
SOURCE:
Infect Dis Clin North Am 1990 Dec;4(4):731-46
ABSTRACT:
Four spirochetal diseases frequently involve the central nervous system: syphilis, leptospirosis, relapsing fever, and Lyme borreliosis. In particular, syphilis and Lyme borreliosis are increasing problems. During the spirochetemic phase there is seeding of the nervous system. After a quiescent latent period, there may be late disease flareups producing a variety of neurologic syndromes. Cerebrospinal fluid examination is very helpful in these infections.

TITLE:
Clinical implications of delayed growth of the Lyme borreliosis spirochete, Borrelia burgdorferi.
AUTHORS:
MacDonald AB; Berger BW; Schwan TG
AUTHOR AFFILIATION:
Department of Pathology, Southampton Hospital, New York 11968.
SOURCE:
Acta Trop 1990 Dec;48(2):89-94
ABSTRACT:
Lyme borreliosis, a spirochetal infection caused by Borrelia burgdorferi, may become clinically active after a period of latency in the host. Active cases of Lyme disease may show clinical relapse following antibiotic therapy. The latency and relapse phenomena suggest that the Lyme disease spirochete is capable of survival in the host for prolonged periods of time. We studied 63 patients with erythema migrans, the pathognomonic cutaneous lesion of Lyme borreliosis, and examined in vitro cultures of biopsies from the active edge of the erythematous patch. Sixteen biopsies yielded spirochetes after prolonged incubations of up to 10.5 months, suggesting that Borrelia burgdorferi may be very slow to divide in certain situations. Some patients with Lyme borreliosis may require more than the currently recommended two to three week course of antibiotic therapy to eradicate strains of the spirochete which grow slowly.

TITLE:
Epidemiology and clinical similarities of human spirochetal diseases.
AUTHORS:
Schmid GP
AUTHOR AFFILIATION:
Division of Sexually Transmitted Diseases, Centers for Disease Control, Atlanta, Georgia 30333.
SOURCE:
Rev Infect Dis 1989 Sep-Oct;11 Suppl 6:S1460-9
"Lyme disease, first identified in 1975, is the most recently recognized of the seven human spirochetal diseases; the evolving clinical picture of Lyme disease indicates it shares many features with the other diseases. ...These similarities include the following: ...and (3) one or more subsequent stages of disease, often with intervening latent periods."

TITLE:
Latent Lyme neuroborreliosis: presence of Borrelia burgdorferi in the cerebrospinal fluid without concurrent inflammatory signs.
AUTHORS:
Pfister HW; Preac-Mursic V; Wilske B; Einhaupl KM; Weinberger K
AUTHOR AFFILIATION:
Neurologische Klinik, Klinikum Grosshadern, University of Munich, Federal Republic of Germany.
SOURCE:
Neurology 1989 Aug;39(8):1118-20
"Borrelia burgdorferi, the etiologic agent of Lyme borreliosis, was isolated from the CSF of a patient with elevated serum IgG antibody titers against B burgdorferi and a history of multiple tick bites. The absence of concurrent inflammatory signs of CSF as well as intrathecal antibody production indicates a phase of latent Lyme neuroborreliosis in which no tissue infection or reaction has yet occurred. ..."

TITLE:
Chronic progressive neurological involvement in Borrelia burgdorferi infection.
AUTHORS:
Weder B; Wiedersheim P; Matter L; Steck A; Otto F
SOURCE:
J Neurol 1987 Jan;234(1):40-3
ABSTRACT:
Five patients with chronic meningitis were hospitalized several times for progressive neurological symptoms. The clinical manifestations included cranial neuritis, radiculoneuritis, myelitis and encephalitis. In two cases cerebral infarction occurred. The course was commonly characterized by a tendency to deteriorate. From the clinical point of view, it was repeatedly difficult to exclude multiple sclerosis or tuberculous meningitis. Finally, specific antibodies against Borrelia burgdorferi were detected by indirect immunofluorescence assay. The diagnosis of a borreliosis was not considered initially because there was no history of tick-bite or erythema chronicum migrans, and the neurological involvement of the central nervous system seemed unusual. The latency between the first symptoms and diagnosis varied from 3 months to 5 years. After a parenteral, high-dose therapy with penicillin, there was a significant improvement in all patients. In two cases, there was evidence of intrathecally produced antibodies to myelin basic protein.

TITLE:
Acrodermatitis chronica atrophicans--a spirochetosis. Clinical and histopathological picture based on 32 patients; course and relationship to erythema chronicum migrans Afzelius.
AUTHORS:
Asbrink E; Brehmer-Andersson E; Hovmark A
SOURCE:
Am J Dermatopathol 1986 Jun;8(3):209-19
"The recent discovery that spirochetes transmitted by the tick Ixodes ricinus are involved in the etiology of erythema chronicum migrans Afzelius (ECMA), Bannwarth's syndrome, and acrodermatitis chronica atrophicans (ACA) has thrown new light upon these disorders. ...In six patients spontaneous healing of ECMA was followed by ACA lesions after a latency period of 1-8 years. ...The results indicate that ACA may be a late manifestation of infection with the same spirochete that causes ECMA and Bannwarth's syndrome. If untreated, the infection may continue for many years and result in irreversible degenerative lesions."

Dormant Lyme disease.

TITLE:
Ocular manifestations of Lyme disease.
AUTHORS:
Lesser RL
AUTHOR AFFILIATION:
Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA.
SOURCE:
Am J Med 1995 Apr 24;98(4A):60S-62S
"Although ocular manifestations of Lyme disease have long been noted, they remain a rare feature of the disease. The spirochete invades the eye early and remains dormant, accounting for both early and late ocular manifestations. ..."

TITLE:
Neurologic manifestations of Lyme disease, the new "great imitator".
AUTHORS:
Pachner AR
AUTHOR AFFILIATION:
Department of Neurology, University Hospital, Georgetown University Medical School, Washington, D.C. 20007.
SOURCE:
Rev Infect Dis 1989 Sep-Oct;11 Suppl 6:S1482-6
ABSTRACT:
The causative agent of Lyme disease, Borrelia burgdorferi, is a highly neurotropic organism that not only can produce symptomatic neurologic disease but also can exist dormant within the central nervous system (CNS) for long periods. Two distinct types of neuroborreliosis occur at different stages of Lyme disease. Second-stage Lyme meningitis resembles aseptic meningitis and is often associated with facial palsies, peripheral nerve involvement, and/or radiculopathies. Lyme meningitis may be the first evidence of Lyme disease, occurring without a history of erythema chronicum migrans or flu-like illness. Third- stage parenchymal involvement causes a multitude of nonspecific CNS manifestations that can be confused with conditions such as multiple sclerosis, brain tumor, and psychiatric derangements. Manifestations of CNS parenchymal involvement in Lyme disease are generally associated, however, with a history of erythema chronicum migrans, meningitis, or carditis. Both second- and third-stage Lyme neuroborrelioses are commonly misdiagnosed because they are relatively uncommon and because they mimic many better-known disorders.

TITLE:
Spirochetal diseases of the CNS.
AUTHORS:
Pachner AR
SOURCE:
Neurol Clin 1986 Feb;4(1):207-22
"The neurotropism of the spirochete is evident from the above discussions of syphilis, Lyme disease, leptospirosis, and relapsing fever. In all of these diseases, the organism very likely enters the CNS very early in the course of the disease. The fate of the organism then depends on the virulence of the spirochete, the host defenses, and any antibiotic treatment administered. Why Treponema pallidum lays dormant in the CNS and then somehow reactivates is a mystery; the same mystery occurs in Lyme disease. ...However, the appropriate treatment for the various stages of the disease in both syphilis and Lyme disease in order to prevent long-term sequelae is not universally accepted. At this time, it seems that high-dose intravenous penicillin is the treatment of choice for each of these infections shown to be active in the nervous system."

Subclinical Lyme disease.

TITLE:
Diagnosis of Lyme disease. Current difficulties and prospects.
AUTHORS:
Chary-Valckenaere I; Jaulhac B; Monteil H; Pourel J
AUTHOR AFFILIATION:
Department of Rheumatology, Nancy-Brabois Teaching Hospital, Vandoeuvre, France.
SOURCE:
Rev Rhum Engl Ed 1995 Apr;62(4):271-80
"Articular manifestations of Lyme disease may be less common in Europe than in the United States, perhaps because European strains of Borrelia burgdorferi are characterized by greater genetic diversity and different organotropisms as compared with American strains. The diagnosis rests on clinical symptoms. ...Serologic tests (indirect immunofluorescence, Western blotting) have not been standardized and should be used only to confirm the diagnosis in patients with suggestive clinical manifestations. The interpretation of serologic test results is made difficult by the high seroprevalence rates seen among the general population in endemic areas, where subclinical Borrelia burgdorferi infection probably occurs."

TITLE:
[The classification of Lyme borreliosis (Lyme disease)]
AUTHORS:
Lesniak OM; Belikov ES
SOURCE:
Ter Arkh 1995;67(11):49-51
ABSTRACT:
A new version of Lyme's disease classification based on the authors' experience and other classifications is proposed. It distinguishes periods of the disease (acute, subacute, chronic) and stages (I-- isolated erythema migrans, II--local disseminated infection, III-- generalized disseminated infection) as well as the signs which are significant in Lyme's disease diagnosis: erythematous and nonerythematous form, seropositivity or seronegativity against Borrelia burgdorferi. Subclinical (latent) infection, complications of Lyme's disease (fibromyalgia syndrome, chronic fatigue syndrome, etc.) and mixed-infection with tick-borne viral encephalitis are included as well.

TITLE:
First isolation of Borrelia burgdorferi from an iris biopsy.
AUTHORS:
Preac-Mursic V; Pfister HW; Spiegel H; Burk R; Wilske B; Reinhardt S; Bohmer R
AUTHOR AFFILIATION:
Max v. Pettenkofer Institut fur Hygiene u. Medizinische Mikrobiologie, LM-Universitat Munchen, Germany.
SOURCE:
J Clin Neuroophthalmol 1993 Sep;13(3):155-61; discussion 162
ABSTRACT:
The persistence of Borrelia burgdorferi in six patients is described. Borrelia burgdorferi has been cultivated from iris biopsy, skin biopsy, and cerebrospinal fluid also after antibiotic therapy for Lyme borreliosis. Lyme Serology: IgG antibodies to B. burgdorferi were positive, IgM negative in four patients; in two patients both IgM and IgG were negative. Antibiotic therapy may abrogate the antibody response to the infection as shown by our results. Patients may have subclinical or clinical disease without diagnostic antibody titers. Persistence of B. burgdorferi cannot be excluded when the serum is negative for antibodies against it.

TITLE:
The prevalence of Borrelia burgdorferi seropositivity in an area endemic for Lyme disease.
AUTHORS:
Jochimsen E; Sikkink J; Marx JJ
AUTHOR AFFILIATION:
Eau Claire Family Medicine Clinic, WI 54701.
SOURCE:
Wis Med J 1990 Dec;89(12):677-81
"We conducted a seroprevalence survey of antibodies to Borrelia burgdorferi in West Central Wisconsin, an area endemic for Lyme disease. One hundred and thirty-seven of 153 patients having blood drawn at the Eau Claire Family Medicine Clinic and the associated rural Augusta practice participated in the study... We conclude that the prevalence of positive Lyme serologies in this area is similar to that of other endemic areas and that subclinical or asymptomatic infection probably accounts for many of these positive results.

TITLE:
Serologic testing for Lyme disease.
AUTHORS:
Magnarelli LA
AUTHOR AFFILIATION:
Connecticut Agricultural Experiment Station, New Haven 06504.
SOURCE:
Postgrad Med 1990 May 1;87(6):149-50, 153, 156
"Serologic testing for antibodies is, at present, the only practical means of diagnosing Borrelia burgdorferi infection. ...In patients who have had subclinical Lyme disease and contract another illness that causes similar symptoms, interpretation of serologic test results may be confused by residual antibodies. Therefore, assay results should always be interpreted in conjunction with clinical and epidemiologic findings."

TITLE:
[Lyme borreliosis in neurology and psychiatry]
AUTHORS:
Kohler J
AUTHOR AFFILIATION:
Neurologische Klinik mit Poliklinik, Universitat Freiburg.
SOURCE:
Fortschr Med 1990 Apr 10;108(10):191-3, 197
"Neurological manifestations of Lyme disease are as multifarious as the entire spectrum of this common infection. ...Connatal and subclinical latent infections of the nervous system with Borrelia represent special forms."

TITLE:
[Epidemiology of Borrelia burgdorferi infection. Relation of the prevalence rate on determination by serologic procedures]
AUTHORS:
Mautner VF; Gittermann M; Freitag V; Schneider E
AUTHOR AFFILIATION:
Neurologische und Bakteriologisch-Serologische Abteilung, Allgemeinen Krankenhauses Hamburg-Harburg.
SOURCE:
Nervenarzt 1990 Feb;61(2):94-7
ABSTRACT:
Investigation of subclinical infections with Borrelia burgdorferi in risk groups in Switzerland, Austria and southern Germany showed an infection rate of 16%-27%. Random samples of patients admitted to the neurological department of a hospital on the outskirts of Hamburg gave the following results: in 100 sera there was in 27% a positive Elisa- test, in 77 sera the IFT-test was positive in 13%, and in 210 sera 6% showed a positive IFT-test after absorption; the IFT- and IFT-Abs. were compared in 15 sera. The investigation confirms that subclinical infection with Borrelia burgdorferi in northern Germany is not uncommon. The fact that increased levels of IgG and IgM antibodies do not necessarily mean the presence of an acute or chronic disease should be remembered in making decisions about treatment.

TITLE:
Survival of Borrelia burgdorferi in antibiotically treated patients with Lyme borreliosis.
AUTHORS:
Preac-Mursic V; Weber K; Pfister HW; Wilske B; Gross B; Baumann A; Prokop J
AUTHOR AFFILIATION:
Neurologische Klinik Grosshadern, Munchen, FR Germany.
SOURCE:
Infection 1989 Nov-Dec;17(6):355-9
ABSTRACT:
The persistence of Borrelia burgdorferi in patients treated with antibiotics is described. The diagnosis of Lyme disease is based on clinical symptoms, epidemiology and specific IgG and IgM antibody titers to B. burgdorferi in serum. Antibiotic therapy may abrogate the antibody response to the infection as shown in our patients. B. burgdorferi may persist as shown by positive culture in MKP-medium; patients may have subclinical or clinical disease without diagnostic antibody titers to B. burgdorferi. We conclude that early stage of the disease as well as chronic Lyme disease with persistence of B. burgdorferi after antibiotic therapy cannot be excluded when the serum is negative for antibodies against B. burgdorferi.

TITLE:
Infections following tickbites. Tick-borne encephalitis and Lyme borreliosis--a prospective epidemiological study from Tyrol.
AUTHORS:
Schmutzhard E; Stanek G; Pletschette M; Hirschl AM; Pallua A; Schmitzberger R; Schlogl R
AUTHOR AFFILIATION:
Department of Neurology, University of Innsbruck.
SOURCE:
Infection 1988 Sep-Oct;16(5):269-72
"We present here a prospective study on infections following tickbites in military recruits in the province of Tyrol (Austria). ...Our results support the predominance of a subclinical course of a tick-transmitted borrelia infection in the population under observation, and shed some light on the epidemiological situation of tick-transmitted diseases in Tyrol."

TITLE:
Incidence and cumulative frequency of endemic Lyme disease in a community.
AUTHORS:
Hanrahan JP; Benach JL; Coleman JL; Bosler EM; Morse DL; Cameron DJ; Edelman R; Kaslow RA
SOURCE:
J Infect Dis 1984 Oct;150(4):489-96
"We conducted an epidemiological study of the cumulative frequency and incidence of Lyme disease in a summer community on Fire Island, New York, an area endemic for the disease. ...We conclude that the incidence of Lyme disease can be appreciably higher in endemic areas than previously recognized and that subclinical or inapparent seroconversion may occur after infection."

Asymptomatic Lyme disease.

TITLE:
Longitudinal study of Lyme borreliosis in a high risk population in Switzerland.
AUTHORS:
Zhioua E; Gern L; Aeschlimann A; Sauvain MJ; Van der Linden S; Fahrer H
AUTHOR AFFILIATION:
Department of Parasitology, University of Neuchatel, Switzerland.
SOURCE:
Parasite 1998 Dec;5(4):383-6
"Orienteers from all parts of Switzerland (n = 416) were included in a longitudinal study for Lyme borreliosis. ...Among orienteers who seroconverted during the study (n = 16), only two developed clinical symptoms. Hence, Borrelia burgdorferi infection is often asymptomatic."

TITLE:
Prevalence of antibodies to Borrelia burgdorferi in forestry workers of Ile de France, France.
AUTHORS:
Zhioua E; Rodhain F; Binet P; Perez-Eid C
AUTHOR AFFILIATION:
Unite d'Ecologie des Systemes Vectoriels, Institut Pasteur, Paris, France. [email protected]
SOURCE:
Eur J Epidemiol 1997 Dec;13(8):959-62
ABSTRACT:
A cross-sectional sero-epidemiological study was conducted on forestry workers, a high risk population for Lyme borreliosis. The prevalence of seropositive forestry workers (indirect immuno fluorescence assay) is 15.2% (n = 211). Almost 70% of participants reported a history of tick bite. Among districts, high seroprevalences were observed in Fontainebleau and Rambouillet; two sites of high risk for Lyme borreliosis. However, clinical prevalence of the disease is very low. During the investigation no active Lyme borreliosis was observed. Thus, asymptomatic infection predominates.

TITLE:
Prospective assessment of Lyme disease in a school-aged population in Connecticut.
AUTHORS:
Feder HM Jr; Gerber MA; Cartter ML; Sikand V; Krause PJ
AUTHOR AFFILIATION:
Department of Pediatrics, University of Connecticut Health Center, Farmington 06030-3960, USA.
SOURCE:
J Infect Dis 1995 May;171(5):1371-4
"To determine the incidence and cumulative frequency of Lyme disease in a school-aged population in an area in which Lyme disease is endemic, serum specimens were obtained before and after the 1990-1992 tick seasons from 410 middle and high school students in southeastern Connecticut. ...The incidences of clinical Lyme disease and asymptomatic B. burgdorferi infection were 10.1 and 3.8 cases/1000 person-years, respectively. Lyme disease is an important health problem in school-aged children living in southeastern Connecticut."

TITLE:
Demonstration of Borrelia burgdorferi DNA in urine samples from healthy humans whose sera contain B. burgdorferi-specific antibodies.
AUTHORS:
Karch H; Huppertz HI; Bohme M; Schmidt H; Wiebecke D; Schwarzkopf A
AUTHOR AFFILIATION:
Institut fur Hygiene und Nikrobiologie, Universitat Wurzburg, Germany.
SOURCE:
J Clin Microbiol 1994 Sep;32(9):2312-4
ABSTRACT:
Since the possibility of asymptomatic infection with Borrelia burgdorferi has been suggested by a positive serology found in healthy subjects, we hypothesized that these subjects might excrete borrelial DNA sequences in urine as happens in patients with Lyme borreliosis. We found borrelial sequences by nested PCR in the urine samples from 3 of 13 healthy B. burgdorferi antibody-positive adults but not in urine samples from 79 antibody-negative healthy controls. After therapy with doxycycline, the urine samples were repeatedly negative for B. burgdorferi DNA. We conclude that urinary excretion of borrelial DNA sequences may occur in seropositive healthy subjects during asymptomatic infection. Demonstration of such sequences in urine must be interpreted cautiously and may not necessarily prove a borrelial cause of disease.

TITLE:
Lyme disease: a review.
AUTHORS:
O'Connell S
AUTHOR AFFILIATION:
Southampton Public Health Laboratory.
SOURCE:
Commun Dis Rep CDR Rev 1993 Jul 16;3(8):R111-5
"Lyme disease is an uncommon multisystem spirochaetal infection that has attracted public and media attention in the United Kingdom during the last few years. ...The illness can present with skin, nervous system, joint or other manifestations although infection may be asymptomatic."

TITLE:
One year follow-up study to assess the prevalence and incidence of Lyme borreliosis among Dutch forestry workers.
AUTHORS:
Kuiper H; van Dam AP; Moll van Charante AW; Nauta NP; Dankert J
AUTHOR AFFILIATION:
Department of Medical Microbiology, Academisch Medisch Centrum, University of Amsterdam, The Netherlands.
SOURCE:
Eur J Clin Microbiol Infect Dis 1993 Jun;12(6):413-8
"A one-year serological and clinical follow-up study was conducted to assess the prevalence and incidence of asymptomatic and symptomatic infection with Borrelia burgdorferi among 151 Dutch forestry workers. ...None of 32 asymptomatic seropositive forestry workers had developed Lyme borreliosis one year later."

TITLE:
Management of asymptomatic Borrelia burgdorferi infection [see comments]
AUTHORS:
Christian CL
AUTHOR AFFILIATION:
Hospital for Special Surgery, New York, NY.
SOURCE:
Arthritis Rheum 1992 Nov;35(11):1395
COMMENT:
Comment in: Arthritis Rheum 1993 Nov;36(11):1637-8
No abstract available.

TITLE:
[Prevalence of Lyme borreliosis in The Netherlands]
AUTHORS:
Nohlmans MK; van den Bogaard AE; Blaauw AA; van Boven CP
AUTHOR AFFILIATION:
Rijksuniversiteit Limburg, vakgroep Medische Microbiologie, Maastricht.
SOURCE:
Ned Tijdschr Geneeskd 1991 Nov 30;135(48):2288-92
"In the autumn of 1989 a seroepidemiological study was carried out among 440 owners of hunting dogs and 1052 blood donors from different regions in the Netherlands. ...Of the 68 seropositive hunters 64 (94%) were asymptomatic. The results of this study indicate that in the Netherlands asymptomatic infections with B. burgdorferi are common in individuals highly exposed to ticks and that there is considerable variation in the prevalence of seropositivity in the general population. Hence caution is called for in the clinical interpretation of IgG test results."

TITLE:
A Lyme borreliosis human serosurvey of asymptomatic adults in Ireland.
AUTHORS:
Smith HV; Gray JS; Mckenzie G
AUTHOR AFFILIATION:
Department of Bacteriology, Stobhill Hospital, Glasgow, U.K.
SOURCE:
Zentralbl Bakteriol 1991 Aug;275(3):382-9
"Blood samples were obtained through the Blood Transfusion Service in Ireland in order to obtain information on the prevalence of asymptomatic B. burgdorferi infections and in an attempt to identify the type of habitat that presents the most risk of infection. ...Prevalence figures of 15, 11, 8 and 5% were obtained for high, high/medium, medium/low and low risk areas respectively. No positive samples were detected in blood from an Icelandic population which is not exposed to I. ricinus bites. The overall subclinical prevalence (9.75%) is surprisingly high in view of the apparent rarity of clinical cases in Ireland, though under- diagnosis probably occurs."

TITLE:
The prevalence and incidence of clinical and asymptomatic Lyme borreliosis in a population at risk.
AUTHORS:
Fahrer H; van der Linden SM; Sauvain MJ; Gern L; Zhioua E; Aeschlimann A
AUTHOR AFFILIATION:
Department of Rheumatology, University of Berne, Switzerland.
SOURCE:
J Infect Dis 1991 Feb;163(2):305-10
"A past history of clinical Lyme borreliosis and the 6-month incidence of clinical and asymptomatic Lyme borreliosis was studied prospectively in a high-risk population. ...Among all participants, the 6-month incidence of clinical Lyme borreliosis was 0.8% (6/755) but was much higher (8.1%) for asymptomatic seroconversion (45/558)."

TITLE:
[Lyme disease: biological diagnosis and treatment]
AUTHORS:
Dournon E
SOURCE:
Rev Prat 1989 May 18;39(15):1300-3
"In daily practice the diagnosis of Lyme disease is confirmed in the laboratory by serological tests the specificity and sensitivity of which are not fully satisfactory. There are false-positive results due to antibodies directed against antigens others than Borrelia burgdorferi, but the main problem is that most people living in endemic areas have specific antibodies while being, and remaining, asymptomatic. In addition, the sensitivity of the current tests is mediocre at the onset of the disease. A negative serology therefore should not exclude definitively a diagnosis of Lyme disease, just as a positive serology should not compulsorily lead to this diagnosis in patients with atypical clinical signs."

TITLE:
[Prevalence of Lyme borreliosis in a Swiss population at risk]
AUTHORS:
Fahrer H; Sauvain MJ; v.d. Linden S; Zhioua E; Gern L; Aeschlimann A
AUTHOR AFFILIATION:
Rheumatologische Universitatsklinik, Bern.
SOURCE:
Schweiz Med Wochenschr 1988 Jan 16;118(2):65-9
ABSTRACT:
The epidemiology of "Lyme borreliosis" in Europe and the significance of positive antibody titers against Borrelia burgdorferi is not well known. Since "orienteering", a competitive cross country sport with a map and a compass, usually in forests, elevates the risk of being bitten by ticks and infected by B. burgdorferi, nearly 1000 orienteerers were included in a prospective study. - In this population the prevalence of positive IgG-antibodies (immunofluorescence technique) was almost 20% and of IgM-antibodies 4%. However, the frequency of associated symptoms in the clinical history of the probands was very low, even in individuals with highly positive titers. - We conclude that the rate of asymptomatic Borrelia infections is high in this special group, and probably also in the general population, and that one has therefore to be cautious in interpreting an isolated positive "Lyme titer". Further investigations are needed, and, in particular, follow-up of the many "positive" subjects without clinical symptoms may be helpful in understanding this fascinating disease better.

TITLE:
Longitudinal assessment of the clinical and epidemiological features of Lyme disease in a defined population.
AUTHORS:
Steere AC; Taylor E; Wilson ML; Levine JF; Spielman A
SOURCE:
J Infect Dis 1986 Aug;154(2):295-300
"From 1979 to 1983, Lyme disease was studied longitudinally in the 162 long-term residents of Great Island, Massachusetts. ...Of 121 asymptomatic residents who gave blood samples, 10 adults (8%) had high titers of IgG antibodies to the Lyme disease spirochete; these titers sometimes persisted for years. From 1981 to 1983, the estimated ratio of apparent-to-inapparent infection was 1:1. The high frequency of Lyme disease on Great Island underscores the need for surveillance and control programs."

For more information about Lyme disease, see: Lots Of Links On Lyme Disease

Last updated on 2 November 1999 by
Art Doherty
Lompoc, California
[email protected]

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