Clinical-epidemiologic and serologic characteristics of Lyme disease in the Zaporizhzhia region (a retrospective analysis for 2015–2019 according to the Municipal Institution “Regional Infectious Hospital” of Zaporizhzhia Regional Council)

Abstract

The aim of the work is to clarify the clinical and laboratory features of Lyme disease in the Zaporizhzhia region on the basis of a retrospective clinical, epidemiological and serological analysis of this disease cases in the period from 2015 to 2019. Materials and methods. A retrospective analysis of 62 medical cards of stationary patients with Lyme disease for the period from 2015 to 2019 was carried out. The age of the patients ranged from 18 to 79 years. There were 38 men and 24 women. All the patients were given a traditional complex clinical-laboratory examination; ELISA was used to defined serum IgM and IgG to Borrelia burgdorferi. Results. According to the study results it was found that Lyme disease in the Zaporizhzhia region had a clear seasonal prevalence in summer (56.5 %) and spring (25.8 %). The vast majority of patients (80.6 %) clearly indicated the tick bite. The disease was mostly acute (90.3 %) with a predominance of erythema (94.6 %). In the acute course of the disease, patients were seropositive in 75.0 % of cases with simultaneous detection of both IgM and IgG to Borrelia burgdorferi, and positive IgM in the absence of IgG. Seronegative 25.0 % of patients required clear clinical and epidemiological data to confirm the diagnosis. Under prolonged and chronic conditions, patients had positive IgG to Borrelia burgdorferi (100 %) and IgM (50.0 %). Certain clinical and laboratory features at different course of Lyme disease were revealed. So, the acute course was characterized by the predominance of erythema (94.6 %), mild or no manifestations of general intoxication syndrome, lack of pathological changes in the hemogram in most patients (80.4 %). In the prolonged and chronic course, there was no history of erythema, clinical symptoms were polymorphic, half of the patients had increased erythrocyte sedimentation rate in the absence of changes in blood count, mild cytolytic syndrome and hyperbilirubinemia. Conclusions. As a result of the retrospective analysis of Lyme disease cases in the period from 2015 to 2019, certain patterns of epidemiological, clinical and serological changes in different courses of this infection in the Zaporizhzhia region were revealed, namely the clear seasonality of the disease, in the acute course – the predominance of erythema and different variants of serological profile in patients, and in prolonged and chronic course – polymorphism of all clinical symptoms and no history of erythema.