engleski

Prevalence of tick-borne encephalitis, Lyme- borreliosis and human granulocytic anaplasmosis in patients with a history of a tick bite, Croatia (2017-2018)

The Ixodes ricinus ticks are vectors of a large variety of pathogens, of which tick-borne encephalitis virus (TBEV), Borrelia burgdorferi sensu lato complex and Anaplasma phagocytophilum are the most important human pathogens. In Croatia, TBE and Lyme-borreliosis are continuously detected, while human granulocytic anaplasmosis is reported sporadically. The aim of this study was to analyze the prevalence of tick-borne zoonoses in patients with a history of a tick bite. During a two-year period (January 2017-December 2018), serum and cerebrospinal fluid (CSF) samples were collected from 45 patients with neuroinvasive disease and tested for the presence of IgM and IgG antibodies to TBEV, B. burgdorferi and A. phagocytophilum. Patients were from continental Croatian counties. Serological tests were performed using a commercial enzyme-linked immunosorbent assay ; ELISA (TBEV and B. burgdorferi) or indirect immunofluorescence assay ; IFA (A. phagocytophilum). TBEV IgM/IgG positive samples were further tested for IgG avidity (ELISA). B. burgdorferi IgM/IgG positive samples were confirmed using an immunoblot test. TBE was confirmed in 29 patients and neuroborreliosis in three patients by detection of IgM and IgG antibodies in both serum and CSF samples. In two patients, TBEV and B. burgdorferi co-infection was found. Human granulocytic anaplasmosis was not detected during the tested period ; however IgG antibodies to A. phagocytophilum were detected in 12 patients with antibody titers ranged from 64 to 512. Cases occurred from April to November. Majority of patients were from Koprivnica- Križevci, Međimurje, Osijek-Baranja and Varaždin County. Our results showed that continental Croatian regions are still endemic for TBEV and Lyme-borreliosis. Further studies on larger number of patients are needed to confirm the prevalence and clinical significance of human granulocytic anaplasmosis.

Tick-borne encephalitis ; Lyme-borreliosis ; Anaplasmosis ; Prevalence ; Croatia

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