Determination of Seroprevalence of Borrelia burgdorferi IgG in Adult Population Living in Trabzon

Abstract

Background: Lyme borreliosis is a tick-borne, multi-systemic infectious disease that is thought to be wide spread in Turkey even though studies on its seroprevalence are limited. Aims: To determine the seroprevalence of Lyme borreliosis in part of north-eastern Tur-key (in the city of Trabzon), and to identify possible relationships between seropositivity and various factors such as location, gender, age group, occupation, income, and educational level. Study Design: Retrospective cross-sectional study. Methods: A total of 884 blood samples collected from provincial and district health centers serving a population of about 800,000 were included in this study. ELISA was used to determine the anti-Borrelia IgG antibody levels in the samples. Samples that yielded positive results by ELISA were further subjected to western blot (WB). Results: IgG antibodies were found in 128 samples (14.5%). Statistical analysis revealed significant differences between age groups and educational levels in terms of the incidence of seropositivity, whereas location, gender, occupational group and income level had no effect (p<0.001, p<0.001, p=0.948, p=0.645, p=0.131, p=0.080 respectively). Conclusions: The risk of contracting Lyme borreliosis in Trabzon is high, and necessary measures need to be taken to avoid the spread of disease.

Keywords

• Lyme borreliosis, seroprevalence, tick, ELISA, western blot

References

1. 1. Stanek G, Wormser GP, Gray J, Strle F. Lyme borreliosis. Lancet 2012;379:461-73.
2. 2. Cook MJ. Lyme borreliosis: a review of data on transmission time after tick attachment. Int J Gen Med 2014;8:1-8.
3. 3. Potok OV, Brassard A. Lyme Borreliosis: An Update for Canadian Dermatologists. J Cutan Med Surg 2013;17:13-21.
4. 4. Bacon RM, Kugeler KJ, Mead PS. Surveillance for Lyme disease-United States, 1992-2006. Centers for Disease Control and Prevention.http://www. cdc.gov/mmwr/preview/mmwrhtml/ ss5710a1.htm. (Access 08.07.2014)
5. 5. Bhate C, Schwartz RA. Lyme disease: Part I. Advances and perspectives. J Am Acad Dermatol 2011;64:619-36.
6. 6. United States Centers for Disease Control and Prevention (CDC). Two-step aboratory testing process. (cited 13.04.2015) Available from: http://www. cdc.gov/lyme/diagnosistesting/ labtest/twostep/index.html
7. 7. Bhate C, Schwartz RA. Lyme disease: Part II. Management and prevention. J Am Acad Dermatol 2011;64:639-53.
8. 8. Aguero-Rosenfeld ME, Wang G, Schwartz I, Wormser GP. Diagnosis of Lyme borreliosis. Clin Microbiol Rev 2005;18:484-509.

9. 9. Özkurt Z. Türkiye’de Borrelia burgdorferi enfeksiyonları ve tanı ilkeleri. XII. Türk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Kongresi Özet Kitabı. KLİMİK Derg. 2007;20 (Ek-Özel Sayı):109-20.
10. 10. Güneş T, Kaya S, Poyraz Ö, Engin A. The Prevalence of Borrelia burgdorferi sensu lato in Ixodes ricinus Ticks in the Sinop Region of Turkey. Turk J Vet Anim Sci 2007;31:153-8.
11. 11. Aydın K, Köksal İ, Çaylan R, Karagüzel A, Volkan S, Kaygusuz S et al. Trabzon yöresinde Lyme seropozitifliği. İnfek Derg 2001;15:141-4.
12. 12. Yavuzyılmaz A. Trabzon ilinde 40 yaş ve üzeri erişkinlerin tetanoz antitoksin düzeyleri ve etkileyen faktörler [Dissertation]. Trabzon: Karadeniz Technical University School of Medicine;2010.
13. 13. Köksal İ, Saltoğlu N, Bingül T, Öztürk H. Bir Lyme hastalığı olgusu. Ankem Derg 1990;4:284.
14. 14. Kaya AD, Parlak AH, Ozturk CE, Behcet M. Seroprevalence of Borrelia burgdorferi infection among forestry workers and farmers in Duzce, Northwestern Turkey. New Microbiol 2008;31:203-9.
15. 15. Uyanık MH, Yazgı H, Ayyıldız A. Erzurum yöresinde Lyme seropozitifliğinin araştırılması. İnfek Derg 2009;23:69-72.
16. 16. Altındiş M, Yılmaz S, Bilici D. Kuzey Kıbrıs bölgesinde Borrelia burgdorferi antikor sıklığının araşltırılması. İnfek Derg 2002;16:163-6.
17. 17. Mutlu G, Gültekin M, Ergin Ç, Sayın F, Kurşun AE. Antalya yöresinde Borrelia burgdorferi antikorlarının ve vektörlerinin araştırılması. Mikrobiyol Bul 1995;29:1-6.
18. 18. Aslan Başbulut E, Gözalan A, Sönmez C, Çöplü N, Körhasan B, Esen B et al. Seroprevalence of Borrelia burgdorferi and tickborne encephalitis virus in a rural area of Samsun, Turkey. Mikrobiyol Bul 2012;46:247-56.
19. 19. Cetin E, Sotoudeh M, Auer H, Stanek G. Paradigm Burgland: Risk of Borrelia burgdorferi sensu lato infection indicated by variable seroprevalence rates in hunters. Wien Klin Wochenschr 2006;118:677-81.
20. 20. Calderaro A, Montecchini S, Gorrini C, Piccolo G, Chezzi C, Dettori G. Presence of anti-Borrelia burgdorferi antibodies and Borrelia burgdorferi sensu lato DNA in samples of subjects in an area of the Northern Italy in the period 2002-2008. Diagn Microbiol Infect Dis 2011;70:455-60.
21. 21. Buczek A, Rudek A, Bartosik K, Szymańska J, Wójcik-Fatla A. Seroepidemiological study of Lyme borreliosis among forestry workers in southern Poland. Ann Agric Environ Med 2009;16:257-61.
22. 22. Wilking H, Fingerle V, Klier C, Thamm M, Stark K. Antibodies against Borrelia burgdorferi sensu lato among Adults, Germany, 2008-2011. Emerg Infect Dis 2015;21:107-10.
23. 23. Hjetland R, Nilsen R M, Grude N, Ulvestad E. Seroprevaence of antibodies to Borrelia burgdorferi sensu lato in healthy adults from western Norway: risk factors and methodological aspects. APMIS 2014;122:1114-24.
24. 24. Lledó L, Gegúndez M I, Giménez-Pardo C, Álamo R, Fernández-Soto P, Nuncio MS et al. A seventeen-year epidemiological surveillance study of Borrelia burgdorferi infections in two provinces of Northern Spain. Int J Environ Res Public Health 2014;11:1661-72.
25. 25. Hao Q, Geng Z, Hou X X, Tian Z, Yang ZJ, Jiang WJ et al. Seroepiedmiological investigation of lyme disease and human granulocytic anaplasmosis among people living in forest areas of eight provinces in China. Biomed Environ Sci 2013;26:185-9.
26. 26. Berglund J, Eitrem R, Ornstein K, Lindberg A, Ringér A, Elmrud H, et al. An epidemiologic study of Lyme disease in southern Sweden. N Engl J Med 1995;333:1319-27.
27. 27. Skogman BH, Ekerfelt C, Ludvigsson J, Forsberg P. Seroprevalence of Borrelia IgG antibodies among young Swedish children in relation to reported tick bites, symptoms and previous treatment for Lyme borreliosis: a population-based survey. Arch Dis Child 2010;95:1013-6.