Online first

Prevalence of Borrelia burgdorferi in ticks removed from skin of people and circumstances of being bitten – research from the area of Poland, 2012–2014

Nella Najda 2,  
Marcin Rząca 1,  
Chair of Oncology and Environmental Health, Faculty of Health Sciences, Medical University in Lublin, Lublin, Poland
Chair and Department of Biology and Genetics, Faculty of Pharmacy with medical Analytics Division, Medical University in Lublin, Lublin, Poland
Chair of Surgery and Surgical Nursing, Faculty of Health Sciences, Medical University in Lublin, Lublin, Poland
State Higher Vocational School, Memorial of Prof. Stanislaw Tarnowski in Tarnobrzeg, Tarnobrzeg, Poland
Institute of Health, State Higher Vocational School of Technology and Economic in Jaroslaw, Jaroslaw, Poland
During feeding, the tick sucks blood from the host along with the pathogens that are in the blood, simultaneously exchanging its own pathogens with the host. Humans can also be a host. It is important to understand the most typical circumstances in which people might become infected with Borrelia burgdorferi. This knowledge will help to prepare health education programmes aimed at the prevention of Lyme disease and other tick-borne diseases.

The aim of the study was to determine the percentage of ticks infected with Borrelia burgdorferi sensu lato, depending on the circumstances of getting bitten.

Material and Methods:
The research material consisted of ticks acquired from people who had been bitten, and questionnaires completed by these people. 510 ticks were acquired from 257 females and 253 males. Following delivery of a tick for testing, the stage of its development was determined and a molecular assay of Borrelia burgdorferi DNA performed.

A positive result of the nested-PCR test was obtained in 78 ticks, which represents 15.30% of all ticks. The infected ticks were collected from male (41 ticks – 52.56%) and female subjects (37 ticks – 47.44%). The biggest number of infected ticks were collected in autumn (54 ticks – 69.23%) and from people who had been into forests (44 ticks – 56.41%). Among the people from whom the infected ticks were acquired, the dominating group included persons over 16 years of age (53 persons – 67.95%) and children aged 0–5 years (16 persons – 20.51%). One in four infected ticks were acquired from the southwestern (20 ticks – 25.64%) and eastern regions of Poland (21 ticks – 26.92%).

Infestation of ticks infected with Lyme disease spirochete in this study proved to be variable and depend on the season, the area of tick attack and the region in Poland. The results of the study clearly show that ticks infected with Borrelia burgdorferi inhabit all regions of Poland. The results are consistent with National Institute of Hygiene data which indicates that Lyme disease cases are recorded in all regions of Poland.

1. Stańczak J, Racewicz M, Kubica-Biernat B, Kruminis-Łozowska W, Dąbrowski J, Adamczyk A, Markowska M. Prevalence od Borrelia Burgdorferi sensu lato in Ixodes ricinus ticks (Acari, Ixodidae) in different polish woodlands. Ann Agric Environ Med. 1999; 6: 127–132.
2. Wodecka B. Detection of Borrelia burgdorferi sensu lato in Ixodes ricinus ticks in north-western Poland. Ann Agric Environ Med. 2003; 10: 171–178.
3. 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.
4. Stefanoff P, Rosińska M, Zieliński A. Epidemiologia chorób prze -noszonych przez kleszcze w polsce. Przegl Epidemiol. 2006; 60: 151–159.
5. Lindgren E, Jaenson TGT. Lyme borreliosis in Europe: influences of climate and climate change, epidemiology, ecology and adaptation measures. 2006;35.
6. Vinh VH, Lionel A, Cristina S, Didier R, Philippe P, Frédéric P. Monitoring human tick-borne disease risk and tick bite exposure in Europe: Available tools and promising future methods. Ticks Tick Borne Dis. 2014; 5(6): 607–619.
7. Wójcik-Fatla A, Zając V, Cisak E, Sroka J, Sawczyn A, Dutkiewicz J. Leptospirosis as a tick-borne disease? Detection of Leptospira spp. in Ixodes ricinus ticks in eastern Poland. Ann Agric Environ Med. 2012; 19: 656–659.
8. Cisak E, Chmielewska-Badora J, Zwoliński J, Wójcik-Fatla A, Jolanta P, Dutkiewicz J. Risk of tick-borne bacterial disease among workers of Roztocze National Park (south-eastern Poland). Ann Agric Environ Med. 2005; 12: 127–132.
9. Socolovschi C, Reynaud P, Kernif T, Raoult D, Parola P. Rickettsiae of spotted fever group, Borrelia valaisiana, and Coxiella burnetii in ticks on passerine birds and mammals from the Camargue in the south of France. Ticks Tick Borne Dis. 2012; 3: 355–360.
10. Subramanian G, Sekeyova Z, Raoult D, Mediannikov O. Multiple tick-associated bacteria in Ixodes ricinus from Slovakia. Ticks Tick Borne Dis. 2012; 3: 406–410.
11. Wallménius K, Pettersson JHO, Jaenson TGT, Nilsson K. Prevalence of Rickettsia spp., Anaplasma phagocytophilum, and Coxiella burnetii in adult Ixodes ricinus ticks from 29 study areas in central and southern Sweden. Ticks Tick Borne Dis. 2012; 3: 100–106.
12. Sroka J, Szymańska J, Wójcik-Fatla A. The occurrence of Toxoplasma gondii and Borrelia burgdorferi sensu lato in Ixodes ricinus ticks from eastern Poland with the use od PCR. Ann Agric Environ Med. 2009; 16: 313–319.
13. Dietrich F, Schmidgen T, Maggi RG, Richter D, Matuschka FR, Vonthein R, Breitschwerdt EB, Kempf V a J. Prevalence of Bartonella henselae and Borrelia burgdorferi sensu lato DNA in Ixodes ricinus ticks in Europe. Appl Environ Microbiol. 2010; 76: 1395–1398.
14. Chmielewski T, Brydak-Godowska J, Fiecek B, Rorot U, Sędrowicz E, Werenowska M, Kopacz D, Hevelke A, Michniewicz M, Kęcik D, Tylewska-Wierzbanowska S. Bacterial tick-borne diseases caused by Bartonella spp., Borrelia burgdorferi sensu lato, Coxiella burnetii, and Rickettsia spp. among patients with cataract surgery. Med Sci Monit. 2014; 20: 927–931.
15. Bacon RM, Kugeler KJ, Mead PS. Surveillance for Lyme disease- United States, 1992–2006. Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C.: 2002) 2008; 57: 1–9.
16. Gray JS, Dautel H, Estrada-Peña A, Kahl O, Lindgren E. Effects of climate change on ticks and tick-borne diseases in Europe. Interdiscip Perspect Infect Dis. 2009 Jan; 2009: 593232.
17. PZH-NIZP. Meldunki epidemiologiczne. 2014. http://wwwold.pzh.gov.pl/oldpage/epimeld/index_p.html#01.
18. Wilking H, Stark K. Trends in surveillance data of human Lyme borreliosis from six federal states in eastern Germany, 2009–2012. Ticks Tick Borne Dis. 2014; 5: 219–224.
19. Kriz B, Beneš Č. Lymeská borrelióza – epidemiologická data do roku 2013. 2014. http://www.szu.cz/uploads/Epidemiologie/Lymeska_borrelioza/Lymeska_borrelioza_za_rok_2013.pdf.
20. Bochnicková M, Szilágyiová M, Gardlík R. Lyme borreliosis-epidemiological analysis of incidence in the northern region of Slovakia. Epidemiologie, Mikrobiologie, Imunologie: Casopis Spolecnosti Pro Epidemiologii A Mikrobiologii Ceské Lékarské Spolecnosti J.E. Purkyne. 2012; 61: 3–8.
21. Tarageľová VR, Mahríková L, Selyemová D, Václav R, Derdáková M. Natural foci of Borrelia lusitaniae in a mountain region of Central Europe. Ticks Tick Borne Dis. 2015 Dec [In press; cited 2015 Dec 31];.
22. Tappe J, Jordan D, Janecek E, Fingerle V, Strube C. Revisited: Borrelia burgdorferi sensu lato infections in hard ticks (Ixodes ricinus) in the city of Hanover (Germany). Parasit Vectors. 2014; 7: 441.
23. James MC, Gilbert L, Bowman AS, Forbes KJ. The Heterogeneity, Distribution, and Environmental Associations of Borrelia burgdorferi Sensu Lato, the Agent of Lyme Borreliosis, in Scotland. Front Public Health. 2014; 2: 129.
24. Kiewra D, Stańczak J, Richter M. Ixodes ricinus ticks (Acari, Ixodidae) as a vector of Borrelia burgdorferi sensu lato and Borrelia miyamotoi in Lower Silesia, Poland – preliminary study.Ticks Tick Borne Dis. 2014; 5: 892–897.
25. Strzelczyk JK, Gaździcka J, Cuber P, Asman M, Trapp G, Gołąbek K, Zalewska-Ziob M, Nowak-Chmura M, Siuda K, Wiczkowski A, Solarz K. Prevalence of Borrelia burgdorferi sensu lato in Ixodes ricinus ticks collected from southern Poland. Acta Parasitol. / Witold Stefański Institute of Parasitology, Warszawa, Poland. 2015; 60: 666–674.
26. Rudenko N, Golovchenko M, Grubhoffer L, Oliver JH. Updates on Borrelia burgdorferi sensu lato complex with respect to public health.Ticks Tick Borne Dis. 2011; 2: 123–128.
27. Wang G, van Dam a P, Schwartz I, Dankert J. Molecular typing of Borrelia burgdorferi sensu lato: taxonomic, epidemiological, and clinical implications. Clin Microbiol Rev. 1999; 12: 633–653.
28. Cisak E, Wójcik-Fatla A, Stojek NM, 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.
29. Bonczek O, Žákovská A, Vargová L, Šerý O. Identification of Borrelia burgdorferi genospecies isolated from Ixodes ricinus ticks in the South Moravian region of the Czech Republic. Ann Agric Environ Med. 2015; 22: 637–641.
30. Ornstein K, Berglund J, Bergström S, Norrby R, Barbour AG. Three major Lyme Borrelia genospecies (Borrelia burgdorferi sensu stricto, B. afzelii and B. garinii) identified by PCR in cerebrospinal fluid from patients with neuroborreliosis in Sweden. Scand J Infect Dis. 2002; 34: 341–346.
31. Bazowska S, Durovska J, Derdakova M, Taragelova V, Pancak J, Zaborska M. The genospecies B. burgdorferi s.l., isolated from ticks and from neurological patients with suspected Lyme borreliosis. Neuro Endocrinol Lett. 2011; 32: 491–495.
32. Picken RN, Strle F, Picken MM, Ruzic-Sabljic E, Maraspin V, Lotric-Furlan S, Cimperman J. Identification of three species of Borrelia burgdorferi sensu lato (B. burgdorferi sensu stricto, B. garinii, and B. afzelii) Among isolates from acrodermatitis chronica atrophicans lesions. J Invest Dermatol. 1998; 110: 211–214.
33. Burgdorfer W. Vector / host relationships of the Lyme disease spirochete, Borrelia. Rheum Dis Clin North Am. 1989; 15: 775–787.
34. Hovius JWR, van Dam AP, Fikrig E. Tick-host-pathogen interactions in Lyme borreliosis. Trends Parasitol. 2007; 23: 434–438.
35. Pal U, Fikrig E. Adaptation of Borrelia burgdorferi in the vector and vertebrate host. Microbes Infect. 2003; 5: 659–666.
36. Zhang L, Zhang Y, Adusumilli S, Liu L, Narasimhan S, Dai J, Zhao YO, Fikrig E. Molecular interactions that enable movement of the lyme disease agent from the tick gut into the hemolymph. PLoS Pathog. 2011; 7.
37. Cook MJ. Lyme borreliosis: a review of data on transmission time after tick attachment. Int J Gen Med. 2015; 8: 1–8.
38. Briciu VT, Meyer F, Sebah D, Ţǎţulescu DF, Coroiu G, Lupşe M, Carstina D, Mihalca AD, Hizo-Teufel C, Klier C, Huber I, Fingerle V. Real-time PCR-based identification of Borrelia burgdorferi sensu lato species in ticks collected from humans in Romania. Ticks Tick Borne Dis. 2014; 5: 575–581.
39. Faulde MK, Rutenfranz M, Hepke J, Rogge M, Görner A, Keth A. Human tick infestation pattern, tick-bite rate, and associated Borrelia burgdorferi s.l. infection risk during occupational tick exposure at the Seedorf military training area, northwestern Germany. Ticks Tick Borne Dis. 2014; 5: 594–599.
40. Huegli D, Moret J, Rais O, Moosmann Y, Erard P, Malinverni R, Gern L. Prospective study on the incidence of infection by borrelia burgdorferi sensu lato after a tick bite in a highly endemic area of Switzerland. Ticks Tick Borne Dis. 2011; 2: 129–136.
41. Tijsse-Klasen E, Jacobs JJ, Swart A, Fonville M, Reimerink JH, Brandenburg AH, van der Giessen JWB, Hofhuis A, Sprong H. Small risk of developing symptomatic tick-borne diseases following a tick bite in The Netherlands. Parasit Vectors. 2011; 4: 17.
42. Maiwald M, Oehme R, March O, Petney TN, Kimmig P, Naser K, Zappe H a, Hassler D, von Knebel Doeberitz M. Transmission risk of Borrelia burgdorferi sensu lato from Ixodes ricinus ticks to humans in southwest Germany. Epidemiol Infect. 1998; 121: 103–108.
43. Otranto D, Dantas-Torres F, Giannelli A, Latrofa MS, Cascio A, Cazzin S, Ravagnan S, Montarsi F, Zanzani SA, Manfredi MT, Capelli G. Ticks infesting humans in Italy and associated pathogens. Parasit Vectors. 2014; 7: 328.