Differences in Genotype, Clinical Features, and Inflammatory Potential<i>of Borrelia burgdorferi</i>sensu stricto Strains from Europe and the United States

Cerar, Tjaša; Strle, Franc; Stupica, Daša; Ružić‐Sabljić, Eva; McHugh, Gail; Steere, Allen C.; Strle, Klemen

doi:10.3201/eid2205.151806

Cited by 80 publications

(72 citation statements)

References 31 publications

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“…genospecies expands slower than that evident in cases in the United States and is not usually accompanied by other symptoms. Interestingly, the clinical features of B. burgdorferi infection in Europe more closely resemble that of infection with B. afzelii or B. garinii , which share the same ecological niche, than the clinical features of B. burgdorferi infection in the United States 88 . Although B. garinii infection also begins in most cases as a solitary skin lesion, itching and burning symptoms within the lesion are more common and local spreading is faster than with B. afzelii or B. burgdorferi infection in Europe 89,90 .…”

Section: Diagnosis Screening and Preventionmentioning

confidence: 97%

Lyme borreliosis

Steere

Strle

Wormser

et al. 2016

Nat Rev Dis Primers

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606

697

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Lyme borreliosis is a tick-borne disease that predominantly occurs in temperate regions of the northern hemisphere and is primarily caused by the bacterium Borrelia burgdorferi in North America and Borrelia afzelii or Borrelia garinii in Europe and Asia. Infection usually begins with an expanding skin lesion, known as erythema migrans (referred to as stage 1), which, if untreated, can be followed by early disseminated infection, particularly neurological abnormalities (stage 2), and by late infection, especially arthritis in North America or acrodermatitis chronica atrophicans in Europe (stage 3). However, the disease can present with any of these manifestations. During infection, the bacteria migrate through the host tissues, adhere to certain cells and can evade immune clearance. Yet, these organisms are eventually killed by both innate and adaptive immune responses and most inflammatory manifestations of the infection resolve. Except for patients with erythema migrans, Lyme borreliosis is diagnosed based on a characteristic clinical constellation of signs and symptoms with serological confirmation of infection. All manifestations of the infection can usually be treated with appropriate antibiotic regimens, but the disease can be followed by post-infectious sequelae in some patients. Prevention of Lyme borreliosis primarily involves the avoidance of tick bites by personal protective measures.

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Section: Diagnosis Screening and Preventionmentioning

confidence: 97%

Lyme borreliosis

Steere

Strle

Wormser

et al. 2016

Nat Rev Dis Primers

Self Cite

606

697

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“…The motile spirochete Borrelia burgdorferi sensu lato complex is believed to be the predominant cause of Lyme disease . The primary North American genospecies is B. burgdorferi sensu stricto, with Ixodid ticks being the vector for transmission . The disease is common in humans and occurs sporadically in dogs but in both species some aspects of the disease remain controversial .…”

Section: Grade Of Recommendation or Level Of Evidence Criteriamentioning

confidence: 99%

Borrelia burgdorferiInfection and Lyme Disease in North American Horses: A Consensus Statement

Divers

Gardner²,

Madigan

et al. 2018

Veterinary Internal Medicne

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Borrelia burgdorferi infection is common in horses living in Lyme endemic areas and the geographic range for exposure is increasing. Morbidity after B. burgdorferi infection in horses is unknown. Documented, naturally occurring syndromes attributed to B. burgdorferi infection in horses include neuroborreliosis, uveitis, and cutaneous pseudolymphoma. Although other clinical signs such as lameness and stiffness are reported in horses, these are often not well documented. Diagnosis of Lyme disease is based on exposure to B. burgdorferi, cytology or histopathology of infected fluid or tissue and antigen detection. Treatment of Lyme disease in horses is similar to treatment of humans or small animals but treatment success might not be the same because of species differences in antimicrobial bioavailability and duration of infection before initiation of treatment. There are no approved equine label Lyme vaccines but there is strong evidence that proper vaccination could prevent infection in horses.

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“…Therefore, it can be manifested in every month of the year, not only within time of increased outdoor activity [33]. In accordance with aforementioned diversity of genospecies, LA observed in Europe (caused mainly by B. garinii and B. afzelii) tends to occur in shorter period after initial tick bite comparing to B. burgdorferi sensu stricto infections [9]. …”

Section: Introductionmentioning

confidence: 97%

When a patient suspected with juvenile idiopathic arthritis turns out to be diagnosed with an infectious disease – a review of Lyme arthritis in children

2017

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The Lyme arthritis is a common manifestation of infection with Borrelia burgdorferi spirochete. Despite its infectious background, the inflammation clinically and histopatologically resembles juvenile idiopathic arthritis. As it affects a considerable number of Lyme disease patients, it should be routinely considered in differential diagnosis. Development of arthritis is partially dependent on spirochetal factors, including the ribosomal spacer type and the sequence of outer surface protein C. Immunological background involves Th1-related response, but IL-17 provides an additional route of developing arthritis. Autoimmune mechanisms may lead to antibiotic-refractory arthritis. The current diagnostic standard is based on a 2-step testing: ELISA screening and immunoblot confirmation. Other suggested methods contain modified two-tier test with C6 ELISA instead of immunoblot. An initial 28-day course of oral antibiotics (doxycycline, cefuroxime axetil or amoxicillin) is a recommended treatment. Severe cases require further anti-inflammatory management. Precise investigation of new diagnostic and therapeutic approaches is advisable.

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Differences in Genotype, Clinical Features, and Inflammatory Potentialof Borrelia burgdorferisensu stricto Strains from Europe and the United States

Abstract: Strains from the United States are more virulent and have greater inflammatory potential.

Cited by 80 publications

References 31 publications

Lyme borreliosis

Lyme borreliosis

Borrelia burgdorferiInfection and Lyme Disease in North American Horses: A Consensus Statement

When a patient suspected with juvenile idiopathic arthritis turns out to be diagnosed with an infectious disease – a review of Lyme arthritis in children

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