Lyme borreliosis in south-eastern Poland: relationships with environmental factors and medical attention standards.
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Chair and Department of Biology and Parasitology, Medical University of Lublin, Lublin, Poland
Department of Internal Medicine, Medical University of Lublin, Lublin, Poland
Chair and Department of Paedodontics, Medical University of Lublin, Lublin, Poland
Katarzyna Bartosik   

Chair and Department of Biology and Parasitology, Medical University of Lublin, Radziwillowska 11, 20-080 Lublin, Poland
Ann Agric Environ Med. 2011;18(1):131–137
Yhe aim of the study was the investigation of the dynamics of LB prevalence in central Europe over a 12-year period and estimation of its dependence on the environmental factors and on the level of medical services. Epidemiological studies of LB were conducted in the years 1996-2007 in 9 regions of the Swietokrzyskie province in south-eastern Poland (Central Europe). On the basis of patient registry, the incidence, prevalence in various months of the year, the mean number of cases in various seasons and the seasonality factors (SF) of LB were calculated. Between 2000-2007, an increased borreliosis incidence was observed in the study area. During the entire study period, the highest incidence (25.93 and 30.66) was observed in the regions with the highest density of Ixodes ricinus ticks - vectors of Borrelia burgdorferi spirochetes, and where the inhabitants are offered the best available LB diagnosis and treatment due to a sufficient number of doctors (r=0.74) and all medical personnel (doctors, nurses and diagnosticians) (r=0.89). The highest LB incidence was present in the summer and autumn seasons (SF=113.25 and 155.18%) in the areas with the highest density of nymphs and adult I. ricinus ticks (≥19/1 h of sampling). Improved standards of public medical care as well as environmental monitoring of tick threat may contribute to a decrease in prevalence of LB and to its better detection.
Aguero-Rosenfeld ME, Wang G, Schwartz I, Wormser GP: Diagnosis of Lyme borreliosis. Clin Microbiol Rev 2005, 18, 484–509.
Barral M, García-Pérez AL, Juste RA, Hurtado A, Escudero R, Sellek RE, Anda P: Distribution of Borrelia burgdorferi sensu lato in Ixodes ricinus (Acari: Ixodidae) ticks from the Basque Country, Spain. J Med Entomol 2002, 39, 177–184.
Bartosik K, Kubrak T, Olszewski T, Jung M, Buczek A: Prevention of tick bites and protection against tick-borne diseases in South-Eastern Poland. Ann Agric Environ Med 2008, 15, 181–185.
Bazovska S, Machacova E, Spalekova M, Kontrosova S: Reported incidence of Lyme disease in Slovakia and antibodies to B. burgdorferi antigens detected in healthy population. Bratisl Lek Listy 2005, 106, 270–273.
Biletska H, Podavalenko L, Semenyshyn O, Lozynskyja I, Tarasyuk O: Study of Lyme borreliosis in Ukraine. Int J Med Microbiol 2008, 298, 154–160.
Bormane A, Lucenko I, Duks A, Mavtchoutko V, Ranka R, Salmina K, Baumanis V: Vectors of tick-borne diseases and epidemiological situation in Latvia in 1993–2002. Int Med Microbiol 2004, 293, 36–47.
Buczek A, Pabis B, Bartosik K, Stanislawek IM, Salata M, Pabis A: Epidemiological study of scabies in different environmental conditions in central Poland. Ann Epidemiol 2006, 16, 423–428.
Buczek A, Rudek A, Bartosik K, Szymańska J, Wojcik-Fatla A: Seroepidemiological study of Lyme borreliosis among forestry workers in southern Poland. Ann Agric Environ Med 2009, 16, 257–261.
Burgdorfer W, Anderson JF, Gern L, Lane RS, Piesman J, Spielman A: Relationship of Borrelia burgdorferi to its arthropod vectors. Scand J Infect Dis 1991, 77, 35–40.
Burgdorfer W, Barbour AG, Hayes SF, Benach JL, Grunwald E, Davis JP: Lyme disease – a tick-borne spirochetosis? Science 1982, 216, 1317–1319.
Burri C, Morán Cadenas F, Douet V, Moret J, Gern L: Ixodesd ricinus and infection prevalence of Borrelia burgdorferi sensu lato along a north-facing altitudinal gradient in the Rhône Valley (Switzerland). Vector Borne Zoonotic Dis 2007, 7, 50–58.
Casati S, Bernasconi MV, Gern L, Pifferetti JC: Diversity within Borrelia burgdorferi sensu lato genospecies in Switzerland by recA gene sequence. FEMS Microbiol Lett 2004, 234, 115–123.
Centers for Disease Control and Prevention: Lyme disease – United States, 2001–2002. MMWR Morb Mortal Wkly Rep 2004, 53, 365–369.
Cisak E, Chmielewska-Badora J, Zwoliński J, Wojcik-Fatla A, Zajac V, Skórska C, Dutkiewicz J: Study on Lyme borreliosis focus in the Lublin region (eastern Poland). Ann Agric Environ Med 2008, 15, 327–332.
Cisak E, Wójcik-Fatla A, Stojek N, Chmielewska-Badora J, Zwoliński J, Buczek A, Dutkiewicz J: Prevalence of Borrelia burgdorferi genospecies in Ixodes ricinus ticks from Lublin region (eastern Poland). Ann Agric Environ Med 2006, 13, 301–306.
Daniel M, Kolár J, Zeman P, Pavelka K, Sádlo J: Tick-borne encephalitis and Lyme borreliosis: comparison of habitat risk assessments using satellite data (an experience from the Central Bohemian region of the Czech Republic). Cent Eur J Public Health 1999, 7, 35–39.
Dautel H, Dippel C, Kämmer D, Werkhausen A, Kahl O: Winter activity of Ixodes ricinus in a Berlin forest. Int J Med Microbiol 2008, 298, 50–54.
Dennis DT, Hayes EB: Epidemiology of Lyme Borreliosis. In: Gray JS, Kahl O, Lane RS, Stanek G (Eds): Lyme Borreliosis: Biology, Epidemiology and Control, 251–280. CABI Publishing, Oxford 2002.
Dennis DT, Nekomoto TS, Victor JC, Paul WS, Piesman J: Reported distribution of Ixodes scapularis and Ixodes pacifi cus (Acari:Ixodidae) in the United States. J Med Entomol 1998, 35, 629–638.
Dobracki W, Dobracka B, Paczosa W, Zieba J, Bereś P: Epidemiology of borreliosis in workers of the district forestry offi ces in Lower Silesia. Przegl Epidemiol 2007, 61, 385–391.
Dumler JS, Dotevall L, Gustafson R, Granström M: A populationbased seroepidemiologic study of human granulocytic ehrlichiosis and Lyme borreliosis on the west coast of Sweden. J Infect Dis 1997, 175, 720–722.
Falco RC, McKenna DF, Daniels TJ, Nadelman RB, Nowakowski J, Fish D, Wormser GP: Temporal relation between Ixodes scapularis abundance and risk for Lyme disease associated with erythema migrans. Am J Epidemiol 1999, 149, 771–776.
Flisiak R, Prokopowicz D: Zagrożenia endemiczne boreliozą z Lyme w regionie Puszczy Białowieskiej. Przegl Epidemiol 1994, 48, 210–217.
Fritz CL, Kjemtrup AM, Conrad PA, Flores GR, Campbell GL, Schriefer ME, Gallo D, Vugia DJ: Seroepidemiology of emerging tickborne infectious diseases in a Northern California community. J Infect Dis 1997, 175, 1432–1439.
Gern L, Morán Cadenas F, Burri C: Infl uence of some climatic factors on Ixodes ricinus ticks studied along altitudinal gradients in two geographic regions in Switzerland. Int J Med Microbiol 2008, 298, 55–59.
Gern L, Pierre-Francois H: Ecology of Borrelia burgdorferi sensu lato in Europe. In: Gray JS, Kahl O, Lane RS, Stanek D (Eds): Lyme Borreliosis: Biology, Epidemiology and Control, 149–174. CABI Publishing, Oxford 2002.
Gray JS, Kahl O, Janetzki C, Stein J: Studies on the ecology of Lyme disease in a deer forest in County Galway, Ireland. J Med Entomol 1992, 29, 915–920.
Hubálek Z, Halouzka J, Juricová Z, Sikutová S, Rudolf I: Effect of forest clearing on the abundance of Ixodes ricinus ticks and the prevalence of Borrelia burgdorferi s.l. Med Vet Entomol 2006, 20, 166–172.
Hubálek Z, Halouzka J: Distribution of Borrelia burgdorferi sensu lato genomics groups in Europe, a review. Eur J Epidemiol 1997, 13, 951–957.
Jenkins A, Kristiansen BE, Allum AG, Aakre RK, Strand L, Kleveland EJ, van de Pol I, Schouls L: Borrelia burgdorferi sensu lato and Ehrlichia spp. in Ixodes ticks from southern Norway. J Clin Microbiol 2001, 39, 3666–3671.
Jouda F, Perret JL, Gern L: Ixodes ricinus density, and distribution and prevalence of Borrelia burgdorferi sensu lato infection along an altitudinal gradient. J Med Entomol 2004, 41, 162–169.
Lencáková D, Hizo-Teufel C, Petko B, Schulte-Spechtel U, Stanko M, Wilske B, Fingerle V: Prevalence of Borrelia burgdorferi s.l. OspA types in Ixodes ricinus ticks from selected localities in Slovakia and Poland. Int J Med Microbiol 2006, 296, 108–118.
Lin T, Oliver JH Jr, Gao L, Kollars TM Jr, Clark KL: Genetic heterogeneity of Borrelia burgdorferi sensu lato in the southern United States based on restriction fragment length polymorphism and sequence analysis. J Clin Microbiol 2001, 39, 2500–2507.
Lindgren E, Tälleklint L, Polfeldt T: Impact of climatic change on the northern latitude limit and population density of the disease-transmitting European tick Ixodes ricinus. Environ Health Perspect 2000, 108, 119–123.
Lingren M, Rowley WA, Thompson C, Gilchrist M: Geographic distribution of ticks (Acari: Ixodidae) in Iowa with emphasis on Ixodes scapularis and their infection with Borrelia burgdorferi. Vector Borne Zoonotic Dis 2005, 5, 219–226.
Mathiesen DA, Oliver JH Jr, Kolbert CP, Tullson ED, Johnson BJ, Campbell GI, Mitchell PD, Reed KD, Telford III SR, Anderson JF, Lane RS, Persing DH: Genetic heterogeneity of Borrelia burgdorferi in the United States. J Infect Dis 1997, 175, 98–107.
Michalik J, Hofman T, Buczek A, Skoracki M, Sikora B: Borrelia burgdorferi s.l. in Ixodes ricinus (Acari: Ixodidae) ticks collected from vegetation and small rodents in recreational areas of the city of Poznań. J Med Entomol 2003, 40, 690–697.
Morán Cadenas F, Rais O, Jouda F, Douet V, Humair P, Moret J, Gern L: Phenology of Ixodes ricinus and infection with Borrelia burgdorferi sensu lato along a north- and south-facing altitudinal gradient on Chaumont mountain, Switzerland. J Med Entomol 2007, 44, 683–693.
Morshed MG, Scott JD, Fernando K, Geddes G, McNabb A, Mak S, Durden LA: Distribution and characterization of Borrelia burgdorferi isolates from Ixodes scapularis and presence in mammalian hosts in Ontario, Canada. J Med Entomol 2006, 43, 762–773.
Nakao M, Miyamoto K, Fukunaga M: Lyme disease spirochetes in Japan: enzootic transmission cycles in birds, rodents, and Ixodes persulcatus ticks. J Infect Dis 1994, 170, 878–882.
O’Connell S: Lyme disease in the UK: epidemiology, clinical presentations and diagnosis. J Med Microbiol 1994, 40, 77–78.
Oliver J, Means RG, Kogut S, Prusinski M, Howard JJ, Layne LJ, Chu FK, Reddy A, Lee L, White DJ: Prevalence of Borrelia burgdorferi in small mammals in New York state. J Med Entomol 2006, 43, 924–935.
Orloski KA, Hayes EB, Campbell GL, Dennis DT: Surveillance for Lyme disease: United States, 1992–1998. MMWR CDC Surveill Summ 2000, 49, 1–11.
Pancewicz SA, Januszkiewicz A, Hermanowska-Szpakowicz T: Detection of antibodies of Borrelia burgdorferi among inhabitants of north-eastern Poland. Przegl Epidemiol 1996, 50, 375–381.
Phillips CB, Matthew HL, Sangha O, Wright EA, Fossel AH, Lew RA, Fossel KK, Shadick NA: Lyme disease and preventive behaviours in residents of Nantucket Island, Massachusetts. Am J Prev Med 2001, 20, 219–224.
Pichon B, Kahl O, Hammer B, Gray JS: Pathogens and host DNA in Ixodes ricinus nymphal ticks from a German forest. Vector Borne Zoonotic Dis 2006, 6, 382–387.
Rahn DW: Lyme disease: clinical manifestations, diagnosis, and treatment. Semin Arthritis Rheum 1991, 20, 201–218.
Randolph SE: Dynamics of tick-borne disease systems: minor role of recent climate change. Rev Sci Tech 2008, 27, 367–381.
Rath PM, Ibershoff B, Mohnhaupt A, Albig J, Eljaschewitsch B, Jürgens D, Horbach I, Fehrenbach FJ: Seroprevalence of Lyme borreliosis in forestry workers from Brandemburg, Germany. Eur J Clin Microbiol Infect Dis 1996, 15, 372–377.
Rizzoli A, Rosà R, Mantelli B, Pecchioli E, Hauffe H, Tagliapietra V, Beninati T, Neteler M, Genchi C: Ixodes ricinus, transmitted diseases and reservoirs. Parassitologia 2004, 46, 119–122.
Rojko T, Ruzić-Sabljić E, Strle F, Lotric-Furlan S: Prevalence and incidence of Lyme borreliosis among Slovene forestry workers during the period of tick activity. Wien Klin Wochenschr 2005, 117, 219–225.
Santino I, Cammarata E, Franco S, Galdiero F, Oliva B, Sessa R, Cipriani P, Tempera G, Del Piano M: Multicentric study of seroprevalence of Borrelia burgdorferi and Anaplasma phagocytophila in high-risk groups in regions of central and southern Italy. Int J Immunopathol Pharmacol 2004, 17, 219–223.
Siński E, Karbowiak G, Siuda K, Buczek A, Jongejan F: Borrelia burgdorferi infection of ticks in some regions of Poland. Przegl Epidemiol 1994, 48, 461–465.
Smetanová K, Schwarzová K, Kocianová E: Detection of Anaplasma phagocytophilum, Coxiella burnetii, Rickettsia spp., and Borrelia burgdorferi s.l. in ticks, and wild-living animals in western and middle Slovakia. Ann N Y Acad Sci 2006, 1078, 312–315.
Stańczak J, Gabre RM, Kruminis-Łozowska W, Racewicz M, Kubica-Biernat B: Ixodes ricinus as a vector of Borrelia burgdorferi sensu lato, Anaplasma phagocytophilum and Babesia microti in urban and suburban forests. Ann Agric Environ Med 2004, 11, 109–114.
Steere A: Lyme borreliosis in 2005, 30 years after initial observations in Lyme Connecticut. Wien Klin Wochenschr 2006, 118, 625–633.
Tälleklint L, Jaenson T: Increasing geographical distribution and density of Ixodes ricinus (Acari: Ixodidae) in central and northern Sweden. J Med Entomol 1998, 35, 521–526.
van Dam AP, Kuiper H, Vos K, Widjojokusumo A, de Jongh BM, Spanjaard L, Ramselaar AC, Kramer MD, Dankert J: Different genospecies of Borrelia burgdorferi are associated with distinct clinical manifestations of Lyme borreliosis. Clin Infect Dis 1993, 17, 708–717.
Wang G, Van Dam AP, Schwartz I, Dankert J: Molecular typing of Borrelia burgdorferi sensu lato: taxonomic, epidemiological, and clinical implications. Clin Microbiol Rev 1999, 12, 633–653.
Zwoliński J, Chmielewska-Badora J, Cisak E, Buczek A, Dutkiewicz J: Prevalence of antibodies to Anaplasma phagocytophilum and Borrelia burgdorferi in forestry workers from the Lublin region. Wiad Parazytol 2004, 50, 221–227.