TABLE 2.
Region | Study population characteristics | Reference | No. tested | Method of determinationa
|
No. (%) with:
|
|||||
---|---|---|---|---|---|---|---|---|---|---|
LD | Babesia | HA | LD + babesiosis | LD + HA | HA + babesiosis | Triple coinfection | ||||
North America | LD patients | |||||||||
California | LD patients screened for Babesia strain WA-1 | Stricker et al. (199) | 255 | S | 60 (24) | |||||
Connecticut | LD-seropositive persons | Krause et al. (105) | 735 | S | S | —f (9.5) | ||||
Connecticut | LD-seropositive patients with EM rash | Magnarelli et al. (117) | 40 | S | S | S | 3 (8) | 3 (8) | ||
Connecticut, Rhode Island | Persons with positive IgM titers for B. burgdorferi | De Martino et al. (50) | 34 | S | S | 7 (21) | ||||
Connecticut, Rhode Island | Patients diagnosed with LD | Krause et al. (106) | 240 | PCR, S | PCR, S | 26 (11) | ||||
Connecticut, Rhode Island | 4-yr prospective study of patients with culture-proven EM rash | Steere et al. (194) | 93 | C | PCR, S | PCR, S | 2 (2) | 2 (2) | 0 | 0 |
Nantucket Island | LD patients according to CDC surveillance case definition | Wang et al. (217) | 171 | D, S | M, S | 37 (22) | ||||
New York | LD-seropositive persons | Aguero-Rosenfeld et al. (3) | 175 | S | S | 45 (26) | ||||
LD patients with culture-confirmed EM | 42 | C | S | 9 (21) | ||||||
New York | LD patients from areas of Babesia endemicity | Benach et al. (22) | 30 | S | S | 20 (67) | ||||
Wisconsin, Minnesota | Patients with EM and laboratory-confirmation of LD | Mitchell et al. (128) | 96 | C, S | S | S | 2 (2) | 5 (5) | 2 (2) | |
HA patients | ||||||||||
Wisconsin, Minnesota | HA patients positive by PCR | Mitchell et al. (128) | 19 | S | S | PCR | 1 (5) | 1 (5) | 1 (5) | |
Wisconsin | Patients with HA or LD | Belongia et al. (20) | 121 | S | M, PCR, S | 11 (9) | ||||
Wisconsin | HA patients identified through active surveillance | Belongia et al. (19) | 142 | S | S | M, PCR, S | 7 (5) | 7/102 (7) | ||
Other tick-borne illness | ||||||||||
Connecticut, Nantucket Island, Rhode Island | Symptomatic patients with laboratory evidence of >1 tick-borne pathogen | Krause et al. (104) | 192b | PCR, S | M, PCR, S | M, PCR, S | 61 (32) | 7 (4) | 3 (2) | 4 (2) |
Massachusetts, New York | Babesiosis patients | Benach et al. (22) | 41 | S | S | 14 (34) | ||||
Febrile patients | ||||||||||
Connecticut | Febrile patients with tick exposure and leucopenia or thrombocytopenia | Magnarelli et al. (118) | 375c | S | S | S | 22 (6) | 15 (4) | 2 (0.5) | 2 (0.5) |
Wisconsin | Patients with unexplained febrile illness during tick season | Belongia et al. (21) | 62 | S | M, S | M, PCR, S | 0 | 2 (3) | 0 | 0 |
New York | Prospective seroincidence: 1-yr study of adults with high-risk exposures | Hilton et al. (84) | 671 | S | S | S | 0 | 0 | 0 | 0 |
Europe | ||||||||||
LD patients | ||||||||||
Bulgaria | Patients with EM rash | Christova and Dumler (42) | 145 | D | S | 14 (10) | ||||
Norway | Patients with acute LD | Bakken et al. (13) | 58 | D, S | S | 6 (10) | ||||
Poland | Hospitalized LD patients | Hermanowska-Szpakowicz et al. (81) | 74 | D, PCR, S | PCR | PCR | 0 | 8 (11) | 0 | 0 |
Switzerland | LD-seropositive persons | Brouqui et al. (28) | 70 | S | S | 12 (17) | ||||
Switzerland | Patients previously diagnosed with LD | Pusterla et al. (159)d | 149 | S | S | 19 (13) | ||||
United Kingdom | LD-seropositive persons | Sumption et al. (202) | 40 | S | S | 3 (8) | ||||
Slovenia | Other tick-borne illness: febrile pediatric patients with established tick-borne infectione | Arnez et al. (10) | 28 | C, D, S | S | PCR, S | 0 | 1 (4) | 0 | 0 |
Sweden | Febrile patients: prospective study of febrile patients following tick exposure | Bjöersdorff et al. (24) | 27 | D, S | PCR, S | 3 (11) | ||||
Sweden | Community serosurvey: permanent residents of Koster Islands of Sweden; seroprevalence of HA (11%) similar to that of LD (14%) | Dumler et al. (61) | 185 | S | S | 6 (3) |
C, bacterial culture; D, diagnosed clinically; M, microscopy; PCR, DNA detection; S, serology.
A total of 310 participants enrolled with EM rash or influenza-like illness indicative of tick-borne disease; 192 (62%) of 310 had confirmed tick-borne infection. Coinfection was documented for 75 (39%) of 192 subjects.
One hundred eighty (48%) of 375 patients tested demonstrated serologic evidence in acute- or convalescent-phase sera of a tick-borne disease; 47 (26.1%) of 180 had antibodies to two or more tick-borne agents..
The highest seroprevalence of HA occurred among persons who were seropositive for central European TBE virus (40 of 205 [20%]).
Evidence of dual infection with TBE virus and B. burgdorferi sensu lato was found for 4 (14%) of 28 pediatric patients.
Specific number not reported by authors.