Lyme serology in healthy Jamaicans and with tropical spastic paraparesis patients - abstract

ABSTRACT

Lyme disease, caused by the spirochaete Borrelia burgdorfer, occurs worldwide, but has not been reported in Jamaica. Nevertheless, antibodies to B. burgdorferi have been found in sera from Jamaican patients with tropical spastic parapareisis (TSP). Lyme disease may asymptomatic. The late stages may be confused with other diseases having neurologic or arthritic features. This study was therefore undertaken to investigate the prevalence of B. burgdorferi antibodies in health Jamaicans and their significance in patients with TSP. Commercially available indirect immunofluorescence antibody (IFA), enzyme immunoassay (EIA) and Western immunoblot kits for Lyme disease were used to examine serum samples from healthy Jamaican (n=200) and TSP patients (n=128). Sera were also examined for a serological test for syphilis (STS) and for antibodies to leptospira. The prevalence of positive IFA tests and EIA for antibodies to B. burgdorferi did not differ significantly between sera from TSP patients (12.5 percent) and healthy controls (10 percent). Western immunoblot analysis showed that all sera occurred in 26.6 percent of sera from TSP patients and 15.5 percent from healthy controls. Of 16 sera from TSP patients which were positive in Lyme IFA and/or EIA, 81.2 percent had treponemal antibodies, while 80 percent of those from healthy controls were negative in STS. Leptospiral antibodies were not found in any serum tested. These data indicate that serological tests for Lyme disease are of limited value is settings such as Jamaica where there is a high prevalence of treponemal antibodies. In these circumstances, diagnostic or epidemiological studies should include Western immunoblot assays (AU)