Lyme disease is a vector-borne infection, primarily transmitted by Ixodes ticks, and caused by Borrelia burgdorferi. It has a wide distribution in the northern hemisphere. In Korea, however, only one human case has been reported, although B. burgdorferi was isolated from the vector tick I. persulcatus in the region. A 60-year-old male and a 45-year-old female developed the clinical sign of erythema migrans. Each patients were bitten by a tick four weeks and five weeks, respectively, before entering the hospital. On serologic examination, significantly increased IgM and IgG antibody titers to B. burgdorferi were observed in consecutive tests performed at an interval of two weeks. They responded well to treatment with tetracycline.
Case Report ; Erythema Chronicum Migrans/pathology* ; Erythema Chronicum Migrans/immunology ; Erythema Chronicum Migrans/drug therapy ; Female ; Human ; Korea ; Lyme Disease/pathology* ; Lyme Disease/immunology ; Lyme Disease/drug therapy ; Male ; Middle Age

OBJECTIVETo understand the clinical characteristics of Lyme disease in children.

METHODSCase records of 30 children with Lyme disease who were admitted to the pediatric department of Forest Hospital, Inner Mongolia from May 1995 to Oct. 2000, were reviewed. Twenty-one cases were male and 9 were female. Their age ranged from 2 to 14 years. The possible factors associated with the onset, incubation period, clinical manifestations of the organ systems and response to treatment were analyzed.

RESULTSEach of the 30 cases had a history of tick bite for one time or more. The incubation period was 1 to 14 days. All of them were hospitalized for typical erythema migrans. Among the 30 cases, 21 (70%) showed symptoms of acute upper respiratory tract infection; 4 (13%) showed circulatory system symptom and manifestations of myocardial lesion; 3 (10%) had joint pain; 1 case (3%) had eye symptom and another case (3%) had nervous system symptoms, such as headache, vomiting, drowsiness, neck stiffness and so on. EEG and spinal fluid test showed some abnormal results. All the 30 cases were positive for IgG antibody to Lyme spirochetes with titers higher than 1:128. Penicillin or cefazolin was effective in treatment of the patients.

CONCLUSIONThe incubation period of the disease observed among this series of patients was 1-14 d. Lyme disease in this group of patients involved multiple organ systems while erythema migrans and arthralgia were the most frequently seen manifestations. Most of the patients had a favorable outcome with no sequelae.

Adolescent ; Animals ; Bites and Stings ; complications ; Child ; Child, Preschool ; Female ; Humans ; Immunoglobulin G ; blood ; Lyme Disease ; diagnosis ; etiology ; immunology ; Male ; Ticks

OBJECTIVETo recombine OspC gene from Borrelia burgdorferi PD91 of China and expressed it in E. coli for early diagnosis of Lyme disease.

METHODSThe OspC gene was amplified from the genome of Borrelia burgdorferi PD91 strain by polymerase chain reaction and recombined with plasmid PET-11D. The recombinant plasmid PET-11D-OspC was identified with PCR, restriction endonuclease analysis and sequencing. The antigenicity was verified with Western Blot.

RESULTSOspC gene was cloned correctly into vector PET-11D. The resultant sequence was definitely different from the published sequence. The recombinant OspC seemed to have had strong antigenicity.

CONCLUSIONThe findings laid basis for the studies on early diagnosis of Lyme disease.

Antigens, Bacterial ; Bacterial Outer Membrane Proteins ; genetics ; immunology ; Blotting, Western ; Borrelia burgdorferi Group ; immunology ; Escherichia coli ; genetics ; Humans ; Lyme Disease ; diagnosis ; Polymerase Chain Reaction ; Recombinant Proteins ; analysis ; immunology

OBJECTIVEWestern blotting (WB; immunoblotting) is a widely used tool for the serodiagnosis of Lyme borreliosis (LB), but so far, no generally accepted criteria for its performance and interpretation have been established in China. The present study was designed to determine the criteria for standardized Western blot for the predominant species of Borrelia burgdorferi sensu lato in China, in which WB was produced with strain PD₉₁ as the representative strain attributed to predominant genospecies Borrelia garinii of Borrelia burgdorferi sensu lato.

METHODSApproximately 13 bands between 14 and 100 kD were differentiated for strain PD₉₁ by using Gel-Pro analysis software. In a study with 631 serum samples (taken from 127 patients with Lyme borreliosis and 504 controls), all observed bands were documented. To establish criteria for a positive WB result for strain PD₉₁, receiver operating characteristic (ROC) curves were used.

RESULTSThe following interpretation criteria were recommended: for IgG, at least one band of P83/100, P58, P39, P30, OspC, P17, P66, and OspA; for IgM, at least one band of P83/100, P58, OspA, P30, OspC, P17 or P41. In addition, syphilis, leptospirosis and other related diseases should be excluded when the positive band is P41 in IgM. For IgG criteria, the sensitivity is 73.2%, the specificity is 99.4% and Youden index is 0.726; for IgM criteria, the sensitivity is 50.6%, the specificity is 93.1% and Youden index is 0.437.

CONCLUSIONStandardization of WB assays is necessary for comparison of results from different laboratories. Moreover, the criteria of other genospecies of Borrelia burgdorferi sensu lato should be determined in the future to complete the criteria of WB for the diagnosis of the Lyme disease in China.

Antibodies, Bacterial ; blood ; Blotting, Western ; standards ; Borrelia burgdorferi ; immunology ; China ; Humans ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Lyme Disease ; blood ; diagnosis ; Reproducibility of Results ; Sensitivity and Specificity

OBJECTIVETo evaluate the Anaplasma phagocytophilum (A. phagocytophilum), Ehrlichia canis (E. canis), Dirofilaria immitis (D. immitis) (canine heartworm), Borrelia burgdorferi (B. burgdorferi) infections in countryside dogs from Yunnan, Hainan and Anhui provinces.

METHODSSerum samples were collected from 26 dogs in Yunnan, Hainan and Anhui provinces. The samples were tested using a commercial ELISA rapid diagnostic assay kit (SNAP(®) 4Dx(®); IDEXX Laboratories, Inc. U.S.A.). Meanwhile, indirect immunofluorescence assay (IFA) recommended by WHO was conducted to detect IgG to A. phagocytophilum. Two methods were analyzed and compared.

RESULTSThe number of serologically positive dogs for IgG to A. phagocytophilum was only 2 which was from Hainan province and none of the 26 dogs responded positive for E. canis, D. immitis (canine heartworm), and B. burgdorferi by ELISA rapid diagnostic method. The number of serologically positive dogs for IgG to A. phagocytophilum was 13 (50%) by IFA method. Data of the two methods were analyzed by statistical software and the difference was statistically significant (P=0.002).

CONCLUSIONSIt can be concluded that IFA method was more sensitive than ELISA rapid diagnostic method. However, we need conduct further and intensive epidemiology survey on tick-born diseases pathogens including A. phagocytophilum, E. canis, D. immitis (canine heartworm), and B. burgdorferi which have public health significance.

Anaplasma phagocytophilum ; immunology ; Animals ; Borrelia burgdorferi ; immunology ; China ; epidemiology ; Dirofilaria immitis ; immunology ; Dirofilariasis ; blood ; epidemiology ; immunology ; Disease Vectors ; Dog Diseases ; epidemiology ; Dogs ; Ehrlichia canis ; immunology ; Ehrlichiosis ; blood ; epidemiology ; immunology ; Enzyme-Linked Immunosorbent Assay ; methods ; Fluorescent Antibody Technique, Indirect ; methods ; Immunoglobulin G ; blood ; Lyme Disease ; blood ; epidemiology ; immunology ; Tick-Borne Diseases ; epidemiology