Lyme borreliosis in Sweden – diagnostic performance of five commercial Borrelia serology kits using sera from well‐defined patient groups

Ekerfelt, Christina; Ernerudh, Jan; Forsberg, Pia; Jönsson, Anna-Lena; Vrethem, Magnus; Arlehag, L; Forsum, Urban

doi:10.1111/j.1600-0463.2004.apm1120112.x

Cited by 12 publications

(12 citation statements)

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“…A commercial ELISA kit, based on the Borrelia specific protein flagellin, was used according to the manufacturer's instructions (IDEA Borrelia burgdorferi IgG kit; DakoCytomation, Glostrup, Denmark and Oxoid, Hampshire, UK) 13. The method has a good diagnostic performance14 and is used for routine serology of LB in Sweden 15. However, antibody levels are low in early LB (ie, patients with EM) and serology is not recommended owing to low sensitivity 14 16.…”

Section: Methodsmentioning

confidence: 99%

Seroprevalence of Borrelia IgG antibodies among young Swedish children in relation to reported tick bites, symptoms and previous treatment for Lyme borreliosis: a population-based survey

Skogman

Ekerfelt²,

Ludvigsson³

et al. 2010

Archives of Disease in Childhood

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Background Lyme borreliosis (LB) is the most common tickborne infection in Sweden and the seroprevalence of Borrelia immunoglobulin G (IgG) antibodies varies between 2% and 26%. The seroprevalence in young Swedish children is unknown and the relation to clinical data has not been previously studied. Objective To determine the seroprevalence of Borrelia IgG antibodies in serum of young Swedish children and to relate it to gender, geographical location, reported tick bites, symptoms and previous treatment for LB. Methods 2000 healthy 5-year-old children (n=2000) were randomly selected from among participants of a larger prospective population-based study, the ABIS (All Babies in Southeast Sweden) study. Serum samples were collected and a Borrelia specific ELISA test (Dako) were performed for IgG antibody detection. Clinical data were collected from questionnaires completed by the parents. Results The seroprevalence of Borrelia IgG antibodies was 3.2% (64/2000). Previous tick bite had been noted in 66% of these seropositive children but the majority (94%) had not previously been treated for LB. In addition, another 55 children reported a history of LB but were negative to Borrelia IgG antibodies in serum. Many of these seronegative children had received treatment for erythema migrans (n=24), which is a clinical diagnosis. Whether children were correctly treated or overtreated for LB is however unknown. No differences in gender, geographical location or reported tick bites were found when comparing Borrelia-seropositive children (n=64) and seronegative children with previous LB (n=55). Conclusion This population-based study demonstrates a Borrelia IgG antibody seroprevalence of 3.2% in young Swedish children. Very few of these seropositive children report previous symptoms or treatment for LB. Thus the findings suggest that exposure to the Borrelia spirochaete (with subsequent antibody response in serum) does occur in young children, mostly without giving rise to clinical LB. Future studies on cell-mediated immune responses are needed to investigate explanatory immunological mechanisms.Original Publication: Barbro H Skogman, Christina Ekerfelt, Johnny Ludvigsson and Pia Forsberg, Seroprevalence of Borrelia IgG antibodies among young Swedish children in relation to reported tick bites, symptoms and previous treatment for Lyme borreliosis: a population-based survey, 2010, ARCHIVES OF DISEASE IN CHILDHOOD, (95), 12, 1013-1016. http://dx.doi.org/10.1136/adc.2010.183624 Copyright: BMJ Publishing Group http://group.bmj.com

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Section: Methodsmentioning

confidence: 99%

Seroprevalence of Borrelia IgG antibodies among young Swedish children in relation to reported tick bites, symptoms and previous treatment for Lyme borreliosis: a population-based survey

Skogman

Ekerfelt²,

Ludvigsson³

et al. 2010

Archives of Disease in Childhood

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“…A major problem is that current commercial Lyme serologic tests are not sensitive enough for diagnosis, especially during the later stages of disease [52][53][54][55][56][57][58][59][60][61][62][63][64]. The Centers for Disease Control and Prevention (CDC) advocates a "2-tier" testing system using an ELISA or immunofluorescence assay as a screening test, followed by a Western blot for confirmation if the result of the ELISA or immunofluorescence assay is positive.…”

Section: Laboratory Testingmentioning

confidence: 99%

“…Thus, the diagnosis of Lyme disease remains problematic, with as many as one-half of patients experiencing failure with the current 2-tier testing approach [52][53][54][55][56][57][58][59][60][61][62][63][64].…”

Section: Laboratory Testingmentioning

confidence: 99%

Counterpoint: Long-Term Antibiotic Therapy Improves Persistent Symptoms Associated with Lyme Disease

Stricker

2007

Clinical Infectious Diseases

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“…One shortcoming of ELISA is that it may cross-react with antigens from other bacteria (e.g other spirochetes such as Treponema and Leptospira) than B. burgdorferi sensu lato (Magnarelli et al, 2012). Another important limitation of ELISA is the lack of standardization: commercially available ELISA tests use different antigenic composition and detect different immunoglobulin classes (Aguero-Rosenfeld et al, 2005;Ekerfelt et al, 2004).…”

Section: Enzyme-linked Immunosorbent Assaymentioning

confidence: 99%

A STING from a Tick : Epidemiology, Ecology and Clinical Aspects of Lyme Borreliosis

Wilhelmsson¹

2014

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Lyme borreliosis in Sweden – diagnostic performance of five commercial Borrelia serology kits using sera from well‐defined patient groups

Cited by 12 publications

References 4 publications

Seroprevalence of Borrelia IgG antibodies among young Swedish children in relation to reported tick bites, symptoms and previous treatment for Lyme borreliosis: a population-based survey

Seroprevalence of Borrelia IgG antibodies among young Swedish children in relation to reported tick bites, symptoms and previous treatment for Lyme borreliosis: a population-based survey

Counterpoint: Long-Term Antibiotic Therapy Improves Persistent Symptoms Associated with Lyme Disease

A STING from a Tick : Epidemiology, Ecology and Clinical Aspects of Lyme Borreliosis

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