ABSTRACT
BACKGROUND: Facial palsy is the most frequent manifestation of neuroborreliosis in the United States, Europe, and Asia, whereas in Mexico, its frequency is unknown. OBJECTIVE: We aimed to determine the frequency of Borrelia spp. infection in patients with acute facial palsy in Mexico. MATERIALS AND METHODS: In this cross-sectional, referral hospital-based survey, 191 patients with facial palsy were selected and clinical and epidemiologic data recorded. IgM and IgG serum antibodies to Borrelia burgdorferi were tested by enzyme-linked immunosorbent assay (ELISA) and confirmed by Western-Blot (WB). IgM and IgG antibodies against the herpes viruses HSV-1, HSV-2, cytomegalovirus, and Epstein-Barr virus were tested by ELISA. RESULTS: 71 patients (37%) tested positive by ELISA to either Borrelia spp. or the herpes viruses. Of 25 patients (13%) who tested positive for B. burgdorferi by ELISA, 23 (12%) were confirmed by WB; 14 had IgM and 9 had IgG antibodies. Among the 14 IgM-WB positive patients, two cases recognized antigens of B. burgdorferi sensu stricto (s.s.), 10 of Borrelia garinii and 2 of B. afzelii, whereas all 9 IgG-WB positive were reactive against B. burgdorferi s.s. 14 patients had facial palsy in addition to other clinical data compatible with Lyme borreliosis. Patients infected with B. burgdorferi s.s. had a longer recovery time and a significantly higher risk (odds ratio 4.4, 95% confidence interval 1.5-12.9) of recurrent facial palsy than patients infected with other Borrelia genospecies. CONCLUSIONS: Borrelia infection is frequent in facial palsy patients in Mexico, with B. burgdorferi s.s. and B. garinii being the most frequent causative species.
Subject(s)
Facial Paralysis/epidemiology , Lyme Disease/epidemiology , Lyme Neuroborreliosis/epidemiology , Acute Disease , Adult , Antibodies, Bacterial/blood , Blotting, Western , Borrelia burgdorferi/isolation & purification , Borrelia burgdorferi Group/isolation & purification , Cross-Sectional Studies , Enzyme-Linked Immunosorbent Assay , Facial Paralysis/diagnosis , Facial Paralysis/microbiology , Female , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Lyme Disease/diagnosis , Lyme Disease/microbiology , Lyme Neuroborreliosis/diagnosis , Lyme Neuroborreliosis/microbiology , Male , Mexico/epidemiology , Middle AgedABSTRACT
INTRODUCTION: Twenty years ago, prevalence of Hepatitis A in Mexican children was 90%. OBJECTIVE: To describe a shift in the prevalence of Hepatitis A virus (HAV) infection and to demonstrate an increment in the age at the first contact with HAV, in a sample of Mexican children. MATERIAL AND METHODS: Reports of antiviral serologic studies collected from 1991 to 2005 from patients attending a pediatric hospital, were reviewed, and those with IgM anti-HAV positive in serum were selected. Age at the moment of acute infection was analyzed. Additionally, a serological survey searching IgG anti-HAV was made in a group of HAV unvaccinated children. RESULTS: From 1708 determinations of IgM, 221 were positive (13%). According to the year of report, five groups were constituted. Mean age by group was: 1991-1993 of 6.4 years, 1994-1996 of 8.0, 1997-1999 of 8.4, 2000-2002 of 8.0 and from 2003-2005 of 10.1 years. In a cohort of 259 unvaccinated children (mean of age 8.59 years), IgG antibodies were detected in 51%. CONCLUSION: In the infantile population studied a Hepatitis A epidemiology shift is suggested.