Detección de anticuerpos tipo igg contra borrelia burgdorferi, y factores asociados a la enfermedad de lyme en población canina, de los municipios honda-Tolima, la mesa y Chia-Cundinamarca. detección de anticuerpos tipo igg contra borrelia burgdorferi en población canina / Detection of IgG-type antibodies against Borrelia Burgdorferi, and factors associated with Lyme disease in the canine population, of the municipalities Honda-Tolima, La Mesa and Chia-Cundinamarca

Borrelia burgdorferi, is the spirochete responsible for causing Lyme disease in man and different animals. Objective. Detect specific IgG type antibodies against Borrelia burgdorferi, in canines using the immunofluorescence technique and its correlation with other factors associated with Lyme disease. Methods. Blood was taken for IgG detection against Borrelia burgdorferi sl; Peripheral blood smear of the canines and hemolymph of the ticks to search for spirochetes with Wright staining and finally classification of the ticks using morphometric keys. Results. In the serological test, on average 69.0% of the canines sampled gave positive results in the different titrations. Bacterial structures were spirally visualized both in the peripheral blood of the canines and in the hemolymph of the ticks. The vector found was classified as Rhipicephalus sanguineus, until now not reported in the scientific literature as a carrier of Borrelia, nor associated with the disease.

First serological detection of Borrelia spp. in dogs in western Cuba / Primeira detecção sorológica de Borrelia spp. em cães na região oeste de Cuba

Abstract This study aimed to verify the presence of IgG antibodies against Borrelia burgdorferi sensu lato (s.l) in domestic dogs in western Cuba. Serum samples were analyzed by indirect enzyme-linked immunosorbent assay (ELISA), using crude antigens of a B. burgdorferi strain of North American origin. To verify the presence of Borrelia spp., deoxyribonucleic acid (DNA) extracted from individual blood samples was analyzed by nested-PCR, with markers targeted for amplification of portions of the flagellin B gene (flaB) present in Borrelia spirochetes. Ticks were also collected through inspection of the animals. Sera from 93 of 176 (52.84%) dogs were reactive to the indirect ELISA. Geographic prevalence varied from 54.35% (25/46) in Boyeros, 44.44% (20/45) in Cotorro, 66.67% (22/33) in Habana del Este, and 50% (26/52) in San José de las Lajas. There was no statistical difference between these tested variables. No blood samples analyzed were positive for the Borrelia flaB gene.

Resumo Este estudo teve como objetivo confirmar a presença de anticorpos IgG contra Borrelia burgdorferi sensu lato (s.l) em cães na região oeste de Cuba. As amostras de soro foram analisadas por ensaio de imunoabsorção enzimática (ELISA) indireto, usando-se antígenos brutos de uma cepa de B. burgdorferi de origem norte-americana. Para confirmar a presença de Borrelia spp., o ácido desoxirribonucleico (DNA), extraído de amostras individuais de sangue, foi analisado por PCR, utilizando-se marcadores direcionados para a amplificação de porções do gene da flagelina B (flaB) presente nas espiroquetas de Borrelia. Os carrapatos também foram coletados através da inspeção dos animais. Os soros de 93 de 176 (52,84%) cães foram reativos ao ELISA indireto. A prevalência geográfica variou de 54,35% (25/46) em Boyeros, 44,44% (20/45) em Cotorro, 66,67% (22/33) em Habana del Este e 50% (26/52) em San José de las Lajas. Não houve diferença estatística entre essas variáveis testadas. Nenhuma amostra de sangue analisada foi positiva para o gene Borrelia flaB.

Panuveítis asociada a la enfermedad de Lyme en un paciente colombiano. Reporte de caso / Panuveitis due to Lyme disease in a Colombian patient: Case report

RESUMEN La enfermedad de Lyme es una zoonosis transmitida por la picadura de garrapatas del género Ixodes sp. Ha sido descrita con más frecuencia en zonas endémicas de países meridionales. Sus manifestaciones clínicas son muy variables y se presentan de acuerdo con el estadio clínico de la enfermedad, teniendo así el compromiso ocular un espectro clínico muy variado que incluye manifestaciones desde la superficie ocular hasta la inflamación del segmento posterior. Se presenta el caso de un paciente de 72 años con un viaje reciente a los Estados Unidos (EE. UU.), atendido en la consulta particular por un oftalmólogo supraespecialista en uveítis de la ciudad de Medellín. El paciente hacía un mes refería una disminución de la agudeza visual (AV) en su ojo izquierdo y al examen oftalmológico presentó signos clínicos de panuveítis no granulomatosa asociada a un edema macular y vasculitis retinal. Se confirmó la enfermedad de Lyme en fase tardía por la presencia de anticuerpos en sangre por Western blot. Se realizó tratamiento exitoso con antibióticos (doxiciclina), con recuperación de la AV y la mejoría completa de los signos inflamatorios intraoculares.

SUMMARY Lyme Disease is a zoonosis transmitted by arthropods that has been described with more frequency in endemic zones of meridional countries. Its clinical manifestations vary according to the clinical stage of the disease. The eye can be affected in many forms including the involvement of the ocular surface and the posterior segment, with more severe inflammation of the retina and the choroid. We present a case of a 72-year male with a recent trip to EEUU who complained of decreasing vision in his left eye had clinical signs of non-granulomatous panuveitis with macular edema and retinal vasculitis. Lyme disease was confirmed with positive antibodies in blood and Western blot test, and the patient was successfully treated using oral Doxycycline. His visual acuity improved and had a resolution of the intraocular inflammation after the specific treatment.

Manifestações neuroftalmológicas associadas a doença de Lyme / Neuro-ophthalmological manifestations associated with Lyme disease

Resumo A doença de Lyme é uma infecção sistêmica causada pela espiroqueta Borrelia burgdorferi e transmitida pelo carrapato do gênero Ixodes sp. e espécie Amblyomma cajennense. A doença costuma se manifestar em três estágios clínicos distintos, que podem variar de acordo com as características de cada hospedeiro. O objetivo deste trabalho é relatar o caso de uma paciente de 33 anos com doença de Lyme que apresentou como manifestações neuroftalmológicas diplopia, lagoftalmo paralítico e ceratite punctata, com exames laboratoriais negativos. Embora a espiroqueta Borrelia burgdorferi tenha maior tropismo pelos tecidos da pele, sistema nervoso e articulações, o acometimento ocular não deve ter sua importância diminuída, sendo descrito neste relato de caso, que abordou os aspectos mais pertinentes à doença para auxiliar seu diagnóstico e tratamento.

Abstract Lyme disease is a systemic infection caused by the spirochete Borrelia burgdorferi and transmitted by the tick of the genus Ixodes sp. and species Amblyomma cajennense. The disease usually manifests itself in three distinct clinical stages, which may vary according to the characteristics of each host. The objective of this paper is to report the case of a 33-year-old patient with Lyme disease who presented as neuro-ophthalmological manifestations diplopia, paralytic lagophthalmos and punctate keratitis, with negative laboratory tests. Although the spirochete Borrelia burgdorferi has a greater tropism in the tissues of the skin, nervous system and joints, the ocular involvement should not be diminished, being described in this case report, which approached the most pertinent aspects to the disease to aid its diagnosis and treatment.

Enfermedad de Lyme en el Perú. Una revisión clínica y epidemiológica / Lyme disease in Perú. A clinical and epidemiological review

RESUMEN Esta es una revisión crítica y organizada de la información disponible y actualizada acerca de la enfermedad de Lyme y la infección por Borrelia en el Perú. Varios estudios de serología contra Borrelia burgdorferi, y de casos de enfermedad de Lyme han sido reportados en el Perú en las pasadas dos décadas. Nueva información sugiere la existencia de nuevas especies de Borrelia burgdorferi sensu lato en Sudamérica, y posiblemente en el Perú. Futuros estudios genéticos y microbiológicos en esta parte del continente, no sólo en casos con Western blot indeterminado, sino también en vectores y posibles reservorios, son necesarios para medir la extensión de estas nuevas especies de Borrelia y su implicancia clínica.

ABSTRACT This is a critical and organized review of all the available and updated information on Lyme disease and Borrelia infection in Peru. Several studies of positive serology to Borrelia burgdorferi and several cases of Lyme disease have been reported in Peru in the last two decades. New information suggests that new species of Borrelia burgdorferi sensu lato do exist in South America, and possibly in Peru. Future genetic and microbiology studies in this part of the continent, not only in cases with an indeterminate Western blot but in vectors and possible reservoirs as well, are necessary to measure the extent and clinical implications of these new Borrelia species

Síndrome de Lyme crónico con manifestaciones neurológicas: a propósito de un caso / Chronic Lyme syndrome with neurological manifestations: A case report

RESUMEN El síndrome de Lyme crónico representa un término controversial que agrupa un conjunto de síntomas persistentes e inespecíficos, en su mayoría reumatológicos o neurológicos, dentro de los cuales se encuentra la enfermedad postLyme, cuya incidencia epidemiológica es baja, el conocimiento fisiopatológico es controversial y el abordaje diagnóstico se basa especialmente en la interpretación clínica, dirigiendo su enfoque terapéutico hacia la resolución sintomática. Se presenta un caso de una mujer de 17 años, con enfermedad de Lyme de reciente diagnóstico, de aparente evolución de 3 años, con diagnóstico previo de enfermedad desmielinizante, que consultó por deterioro neurológico. Se revisan consideraciones científicas sobre su aproximación clínica y principios terapéuticos, los cuales se contrastan con los aplicados.

SUMMARY Chronic Lyme syndrome represents a controversial term that groups together a set of persistent and nonspecific symptoms, mostly rheumatological and / or neurological, among which is the Post Lyme Disease, whose epidemiological incidence is low, pathophysiology is controversial and the diagnostic approach is based especially on clinical interpretation, directing its therapeutic approach towards symptomatic resolution. We present a case of a female patient of 17 years of age with Lyme disease of recent diagnosis of apparent evolution of 3 years, with previous diagnosis of demyelinating disease, who consulted for neurological deterioration. Scientific considerations on its clinical approach and therapeutic principles are reviewed, contrasting them with those applied.

Acerca de la enfermedad de Lyme en Cuba y su conocimiento en personal médico / About Lyme disease in Cuba and its knowledge by medical personnel

Introducción: La borreliosis de Lyme no ha sido notificada oficialmente en Cuba pero existen sospechas clínico-epidemiológicas y evidencias serológicas sugestivas de la infección por Borrelia burgdorferi sensu lato, su agente causal. Objetivo: Describir aspectos clínicos y epidemiológicos de pacientes que padecieron la enfermedad y explorar el nivel de conocimientos en personal médico. Métodos: Se realizó revisión documental de los Registros de Diagnóstico de la infección por B. burgdorferi sensu lato, entre 2007-2016, conservados en el Laboratorio Nacional de Referencia del Instituto de Medicina Tropical Pedro Kourí y se combinó con un estudio exploratorio del nivel de conocimientos sobre la enfermedad en personal médico. Resultados: Hubo incremento discreto en el número de muestras recepcionadas. El suero y el líquido cefalorraquídeo, fueron las muestras de elección para el diagnóstico, realizado por ensayos inmunoenzimáticos. Se confirmó la infección en 10,9 por ciento de las muestras de sueros recibidas. Las lesiones en piel, adenopatías regionales, parálisis faciales, dificultad para la marcha y otras, motivaron la sospecha clínica de esta enfermedad. Predominó el antecedente de picaduras por insectos o garrapatas. El 70 por ciento de los médicos encuestados plantearon conocer sobre la enfermedad de Lyme, pero de ellos solo el 46 por ciento reconoció al menos una de sus manifestaciones clínicas. Conclusiones: Los aspectos clínicos y epidemiológicos descritos, deben ser tomados en cuenta en pacientes con sintomatologías compatibles con la infección por B. burgdorferi sensu lato. Se requieren intervenciones educativas en el personal médico para un mejor reconocimiento clínico de esta entidad infecciosa y propiciar un mejor diagnóstico(AU)

Introduction: Lyme borreliosis has not been officially reported in Cuba but there are clinical-epidemiological suspicions and serological evidence that are suggestive of its causal agent: the infection by Borrelia burgdorferi sensu lato. Objective: To describe clinical and epidemiological aspects of patients who suffered from the disease and to explore the level of knowledge about it in medical personnel. Methods: A documentary review of the Diagnostic Records of B. burgdorferi sensu lato infection that are preserved in the National Reference Laboratory of Pedro Kourí Institute of Tropical Medicine was carried out from 2007 to 2016, and it was combined with an exploratory study of the knowledge´s level about the disease in medical personnel. Results: There was a slight increase in the number of samples received. Serum and cerebrospinal fluid were the samples chosen for a diagnosis that was performed by enzyme immunoassay. Infection was confirmed in 10.9 percent of the serum samples received. Skin lesions, regional lymphadenopathy, facial paralysis, difficulty for walking and others led to the clinical suspicion of this disease. It was predominant the antecedent of insect or tick bites. Seventy percent of the doctors surveyed said they knew about Lyme disease, but only 46 percent of them acknowledged at least one of its clinical manifestations. Conclusions: B. burgdorferi sensu lato infection should be taken into account in patients with symptoms compatible with Lyme disease. Educational interventions are required in the medical personnel for a better clinical recognition of this infectious entity and to promote a better diagnosis(AU)

Passage of Borrelia burgdorferi through diverse Ixodid hard ticks causes distinct diseases: Lyme borreliosis and Baggio-Yoshinari syndrome

Baggio-Yoshinari syndrome is an emerging, tick-borne, infectious disease recently discovered in Brazil. This syndrome is similar to Lyme disease, which is common in the United States of America, Europe and Asia; however, Brazilian borreliosis diverges from the disease observed in the Northern Hemisphere in its epidemiological, microbiological, laboratory and clinical characteristics. Polymerase chain reaction procedures showed that Baggio-Yoshinari syndrome is caused by the Borrelia burgdorferi sensu stricto spirochete. This bacterium has not yet been isolated or cultured in adequate culture media. In Brazil, this zoonosis is transmitted to humans through the bite of Amblyomma and Rhipicephalus genera ticks; these vectors do not belong to the usual Lyme disease transmitters, which are members of the Ixodes ricinus complex. The adaptation of Borrelia burgdorferi to Brazilian vectors and reservoirs probably originated from spirochetes with atypical morphologies (cysts or cell-wall-deficient bacteria) exhibiting genetic adjustments, such as gene suppression. These particularities could explain the protracted survival of these bacteria in hosts, beyond the induction of a weak immune response and the emergence of serious reactive symptoms. The aim of the present report is to note differences between Baggio-Yoshinari syndrome and Lyme disease, to help health professionals recognize this exotic and neglected zoonosis.

Enfermedad de Lyme: a propósito de un caso clínico importado / Lyme disease: about an imported case report

Resumen Presentamos el caso clínico de una mujer norteamericana que consultó en nuestro país por un eritema migrans múltiple, diagnosticándose una enfermedad de Lyme. Este cuadro infeccioso es causado por espiroquetas del complejo Borrelia burgdorferi sensu lato (Bbsl) y es transmitido por la mordedura de garrapatas. Tradicionalmente Bbsl había sido detectada en garrapatas sólo en el hemisferio norte. Sin embargo, desde el 2013 ha habido reportes en Sudamérica. En Chile, recientemente se describió Borrelia chilensis, la cual no tiene una enfermedad asociada en humanos. Se discuten aspectos del agente infeccioso, su epidemiología, sus vectores y nuevos hallazgos en Sudamérica. Además, se plantean los criterios diagnósticos clínicos, de laboratorio y tratamiento, de acuerdo a la etapa en su historia natural.

This is a case report of an american woman who consulted in our country for multiple erythema migrans, from which a Lyme disease was diagnosed. This infectious disease is caused by spirochetes from the Borrelia burgdorferi sensu lato complex (Bbsl) and is transmitted by the bite of ticks. Traditionally Bbsl had been detected in ticks only in the Northern Hemisphere. However, since 2013 there have been reports in South America. In Chile, Borrelia chilensis was recently described, which does not have an associated disease in humans. Aspects of the infectious agent, its epidemiology, its vectors and new findings in South America are discussed. Likewise, the clinical diagnostic criteria, laboratory and appropriate treatment are proposed, according to the stage in their natural history.

Optic neuritis and chorioretinitis as ocular manifestations of borreliosis in Brazil: three cases reported / Neurite óptica e coriorretinite como manifestações oculares da borreliose no Brasil: três casos relatados

Abstract Lyme disease is a systemic infection caused by a tick bite and transmission of the Borrelia burgdorferi spirochete. Species of tick vectors of the disease infest mainly wild or rural animals and rodents that may be asymptomatic reservoirs of the bacteria. Characteristic of the northern hemisphere, Lyme disease in Brazil takes on different characteristics, complicating diagnosis. This paper aims to describe three cases of Lyme-like disease in a city in the state of Bahia, Brazil, with ophthalmologic findings.

Resumo A doença de Lyme é uma infecção sistêmica causada pela picada do carrapato e transmissão da espiroqueta Borrelia burgdorferi. As espécies de carrapatos vetores da doença infestam, principalmente, animais silvestres, rurais e roedores que podem ser reservatórios assintomáticos da bactéria. Característica do hemisfério norte, a doença de Lyme no Brasil assume características distintas, dificultando seu diagnóstico. Esse trabalho tem por objetivo, descrever três casos da doença Lyme símile do Brasil, com achados oftalmológicos, em município do Estado da Bahia.

Brazilian borreliosis with special emphasis on humans and horses

Abstract Borreliosis caused by Borrelia burgdorferi sensu lato is a cosmopolitan zoonosis studied worldwide; it is called Lyme disease in many countries of the Northern Hemisphere and Lyme-like or Baggio-Yoshinari Syndrome in Brazil. However, despite the increasing number of suspect cases, this disease is still neglected in Brazil by the medical and veterinary communities. Brazilian Lyme-like borreliosis likely involves capybaras as reservoirs and Amblyomma and Rhipicephalus ticks as vectors. Thus, domestic animals can serve as key carriers in pathogen dissemination. This zoonosis has been little studied in horses in Brazil. The first survey was performed in the state of Rio de Janeiro, and this Brazilian Borreliosis exhibits many differences from the disease widely described in the Northern Hemisphere. The etiological agent shows different morphological and genetic characteristics, the disease has a higher recurrence rate after treatment with antibiotics, and the pathogen stimulates intense symptoms such as a broader immune response in humans. Additionally, the Brazilian zoonosis is not transmitted by the Ixodes ricinus complex. With respect to clinical manifestations, Baggio-Yoshinari Syndrome has been reported to cause neurological, cardiac, ophthalmic, muscle, and joint alterations in humans. These symptoms can possibly occur in horses. Here, we present a current panel of studies involving the disease in humans and equines, particularly in Brazil.

Prevalencia de Borrelia burgdorferi sensu lato en roedores sinantrópicos de dos comunidades rurales de Yucatán, México / Prevalence of Borrelia burgdorferi sensu lato in synanthropic rodents in two rural communities of Yucatán, México

Introducción. 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. Se ha encontrado que varias especies de roedores son eficientes reservorios naturales de B. burgdorferi s.l. Objetivo. Estimar la prevalencia de B. burgdorferi s.l. en roedores sinantrópicos en dos comunidades rurales de Yucatán, México. Materiales y métodos. Se capturaron 123 roedores (94 Mus musculus y 29 Rattus rattus ) para obtener muestras de tejidos de oreja y vejiga. Para la detección de B. burgdorferi s.l. en las muestras, se amplificaron los genes de la flagelina B ( fla B ) y las lipoproteínas de membrana externa, ospC y p66 , mediante reacción en cadena de la polimerasa, y se secuenciaron los amplicones obtenidos. Resultados. La frecuencia de infección por B. burgdorferi s.l. en roedores fue de 36,5 % para flaB (45/123), de 10,5 % (13/123) para p66 y de 3,2 % (4/123) para ospC . En R. rattus la frecuencia de infección fue de 17,2 % y en M. musculus fue de 42,5 %. La frecuencia de infección de B. burgdorferi s.l. en los tejidos estudiados fue de 11,3 % (14/123) en muestras de tejido de vejiga y de 17,0 % (21/123) en las de oreja. No se encontraron diferencias estadísticas (p>0,05) en la frecuencia de infección entre los dos tipos de muestras de tejido utilizadas para el diagnóstico. El gen ospC presentó 98 % de homología con la especie Borrelia garinii , una de las especies heterogéneas del complejo B. burgdorferi s.l. Conclusiones. Los roedores presentaron una alta prevalencia de infección con B. burgdorferi s.l.; las especies M. musculus y R. rattus podrían jugar un papel importante en la continuidad de la presencia de esta bacteria en comunidades rurales de Yucatán, México.

Introduction: Lyme disease is a multisystemic zoonotic disease caused by Borrelia burgdorferi sensu lato. This spirochete circulates in an enzootic cycle between the primary vertebrate reservoir and its tick vectors. Different species of rodents are known to be efficient natural reservoirs for B. burgdorferi s.l. Objective: To estimate the prevalence of B. burgdorferi s.l. in synanthropic rodents from two rural communities of Yucatán, México. Materials and methods: A total of 123 rodents (94 Mus musculus and 29 Rattus rattus ) were trapped, and ear and bladder samples were collected. Flagelin B ( flaB ) genes and outer membrane lipoproteins ospC y p66 were amplified in order to detect B. burgdorferi s.l. presence in the samples. The obtained amplicons were sequenced. Results: The overall infection rates in rodents were 36.5% for flaB (45/123), 10.5% (13/123) for p66, and 3.2% (4/123) for ospC . Rattus rattus had 17.2% of infection and M. musculus , 42.5%. From all examined tissue, 11.3% (14/123) of bladders, and 17.0% (21/123) of ears were infected with the spirochete Borrelia burgdorferi s.l. No statistical differences (p>0.05) were found between the two tissue samples used for diagnosis. The ospC gen was 98% homologous to Borrelia garinii , one species of the B. burgdorferi s.l. complex. Conclusions: We concluded that rodents have a high prevalence of B. burgdorferi s.l. infection, and both species of rodents, M. musculus and R. rattus, might be playing an important role in the maintenance of this bacterium in rural communities of Yucatán, México.

Seroprevalence of Borrelia burgdorferi in occupationally exposed persons in the Belgrade area, Serbia

Lyme disease (LD) is a natural focal zoonotic disease caused by Borrelia burgdorferi, which is mainly transmitted through infected Ixodes ricinus tick bites. The presence and abundance of ticks in various habitats, the infectivity rate, as well as prolonged human exposure to ticks are factors that may affect the infection risk as well as the incidence of LD. In recent years, 20% to 25% of ticks infected with different borrelial species, as well as about 5,300 citizens with LD, have been registered in the Belgrade area. Many of the patients reported tick bites in city’s grassy areas. The aim of this study was to assess the seroprevalence of B. burgdorferi in high-risk groups (forestry workers and soldiers) in the Belgrade area, and to compare the results with healthy blood donors. A two-step algorithm consisting of ELISA and Western blot tests was used in the study. Immunoreactivity profiles were also compared between the groups. The results obtained showed the seroprevalence to be 11.76% in the group of forestry workers, 17.14% in the group of soldiers infected by tick bites and 8.57% in the population of healthy blood donors. The highest IgM reactivity was detected against the OspC protein, while IgG antibodies showed high reactivity against VlsE, p19, p41, OspC, OspA and p17. Further investigations in this field are necessary in humans and animals in order to improve protective and preventive measures against LD.

Borrelia burgdorferi sensu lato in humans in a rural area of Paraná State, Brazil

This study describes the detection of Borrelia garinii and Borrelia burgdorferi sensu stricto (s.s.) in Brazilian individuals using PCR and DNA sequencing. Our results suggest that these species are emerging pathogens in this country, and additional studies are necessary to determine the epidemiological characteristics of this disease in Brazil.