OBJECTIVES: Lyme borreliosis is a tick-borne disease of increasing incidence and public concern. Our cross-sectional study was aimed at evaluating seroprevalence of Borrelia burgdorferi in a group of respondents from Eastern Slovakia. METHODS: In total, 515 blood samples collected in 2013-2016 were analysed with NovaLisaTM, NovaTec - Borrelia IgG/IgM kit (Immunodiagnostica, Dietzenbach, Germany). Positive and equivocal IgG-antibody results were further examined with immunoblotting (LYMECHECK® OPTIMA IgG and IgM kits, BIOSYNEX, France). Data detected by serological methods were matched with those obtained from a questionnaire. Differences between groups by residence/seropositivity were tested by χ2 test. The effect of socio-demographic and risk factors on seropositivity of IgG antibodies was assessed using binary logistic regression. RESULTS: IgG antibodies against Borrelia burgdorferi were detected in 67 cases (13.01%) and IgM antibodies in 40 cases (7.8%). Previous tick bite had been noted in 67.2% of these seropositive individuals. Higher seropositivity was observed in men and persons aged over 61 years. Rural residents had higher seropositivity (39%) than those living in urban (29%) areas. Very few of these seropositive persons reported prior symptoms. CONCLUSION: The study reveals that IgG-seropositivity for Borrelia burgdorferi in Eastern Slovakia is predominant in men and occurs mainly in rural areas. The findings also suggest that exposure to Borrelia burgdorferi (with subsequent antibody response in serum) does occur, mostly without giving rise to clinical Lyme borreliosis.

Department of Public Health and Hygiene Faculty of Medicine Pavol Jozef Safarik University in Kosice Kosice Slovak Republic

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Curcio SR, Tria LP, Gucwa AL. Seroprevalence of Babesia microti in individuals with Lyme Disease. Vector Borne Zoonotic Dis. 2016;16(12):737-43.

Barreiro-Hurlé L, Melón-García S, Seco-Bernal C, Muñoz-Turrillas C, Rodríguez-Pérez M. Seroprevalence of Lyme disease in southwest Asturias. Enferm Infecc Microbiol Clin. 2020;38(4):155-8. PubMed

Obiegala A, Król N, Oltersdorf C, Nader J, Pfeffer M. The enzootic life-cycle of Borrelia burgdorferi (sensu lato) and tick-borne rickettsiae: an epidemiological study on wild-living small mammals and their ticks from Saxony, Germany. Parasites Vectors. 2017;10:115. doi: 10.1186/s13071-017-2053-4. PubMed DOI

Schwartz AM, Hinckley AF, Mead PS, Hook SA, Kugeler KJ. Surveillance for Lyme Disease - United States, 2008-2015. MMWR Surveill Summ. 2017;66(22):1-12.

Mead PS. Epidemiology of Lyme disease. Infect Dis Clin North Am. 2015;29(2):187-210. PubMed

Petrulionienė A, Radzišauskienė D, Ambrozaitis A, Čaplinskas S, Paulauskas A, Venalis A. Epidemiology of Lyme disease in a highly endemic European zone. Medicina (Kaunas). 2020;56(3):115. doi: 10.3390/medicina56030115. PubMed DOI

Stone BL, Tourand Y, Brissette CA. Brave new worlds: the expanding universe of Lyme disease. Vector Borne Zoonotic Dis. 2017;17(9):619-29.

Vandekerckhove O, De Buck E, Van Wijngaerden E. Lyme disease in Western Europe: an emerging problem? A systematic review. Acta Clin Belg. 2021;76(3):244-52. PubMed

Public Health Authority of the Slovak Republic. Analysis of the epidemiological situation and activities of epidemiology departments in the Slovak Republic [Internet]. Banská Bystrica: Public Health Authority of the Slovak Republic; 2019 [cited 2020 Dec 15]. Available from: https://www.epis.sk/InformacnaCast/Publikacie/VyrocneSpravy/Files/VS_SR_2019.aspx. (In Slovak.)

Smith RP, Elias SP, Cavanaugh CE, Lubelczyk CB, Lacombe EH, Brancato J, et al. Seroprevalence of Borrelia burgdorferi, B. miyamotoi, and Powassan virus in residents bitten by Ixodes Ticks, Maine, USA. Emerg Infect Dis. 2019;25(4):804-7.

Munro H, Mavin S, Duffy K, Evans R, Jarvis LM. Seroprevalence of Lyme borreliosis in Scottish blood donors. Transf Med. 2015;25(4):284-6.

Dou X, Lyu Y, Jiang Y, Tian L, Li X, Lin C, et al. Seroprevalence of Lyme disease and associated risk factors in rural population of Beijing. Int J Clin Exp Med. 2015;8(5):7995-9.

Wilking H, Fingerle V, Klier C, Thamm M, Stark K. Antibodies against Borrelia burgdorferi sensu lato among adults, Germany, 2008-2011. Emerg Infect Dis. 2015;21(1):107-10.

Hristea A, Hristescu S, Ciufecu C, Vasile A. Seroprevalence of Borrelia burgdorferi in Romania. Eur J Epidemiol. 2001;17(9):891-6.

Lernout T, Kabamba-Mukadi B, Saegeman V, Tré-Hardy M, de Laveleye M, Asikainen T, et al. The value of seroprevalence data as surveillance tool for Lyme borreliosis in the general population: the experience of Belgium. BMC Public Health. 2019;19(1):597. doi: 10.1186/s12889-019-6914-y. PubMed DOI

Dehnert M, Fingerle V, Klier C, Talaska T, Schlaud M, Krause G, et al. Seropositivity of Lyme borreliosis and associated risk factors: a population-based study in children and adolescents in Germany (KiGGS). PLoS One. 2012;7(8):e41321. doi: 10.1371/journal.pone.0041321. PubMed DOI

Sajanti E, Virtanen M, Helve O, Kuusi M, Lyytikäinen O, Hytönen J, et al. Lyme borreliosis in Finland, 1995-2014. Emerg Infect Dis. 2017;23(8):1282-8.

Eliassen KE, Berild D, Reiso H, Grude N, Christophersen KS, Finckenhagen C, et al. Incidence and antibiotic treatment of erythema migrans in Norway 2005-2009. Ticks Tick Borne Dis. 2017;8(1):1-8. PubMed

Steere AC, Strle F, Wormser GP, Hu LT, Branda JA, Hovius JW, et al. Lyme borreliosis. Nat Rev Dis Primers. 2016;2:16090. doi: 10.1038/nrdp.2016.90. PubMed DOI

Tulloch JSP, Semper AE, Brooks TJG, Russell K, Halsby KD, Christley RM, et al. The demographics and geographic distribution of laboratory-confirmed Lyme disease cases in England and Wales (2013-2016): an ecological study. BMJ Open. 2019;9(7):e028064. doi: 10.1136/bmjopen-2018-028064. PubMed DOI

De Keukeleire M, Vanwambeke SO, Cochez C, Heyman P, Fretin D, Deneys V, et al. Seroprevalence of Borrelia burgdorferi, Anaplasma phagocytophilum, and Francisella tularensis infections in Belgium: results of three population-based samples. Vector Borne Zoonotic Dis. 2017;17(2):108-15.

Cora M, Kaklikkaya N, Topbaş M, Çan G, Yavuzyilmaz A, Tosun İ, et al. Determination of Seroprevalence of Borrelia burgdorferi IgG in adult population living in Trabzon. Balkan Med J. 2017;34(1):47-52. PubMed

Curran KL, Fish D. Increased risk of Lyme disease for cat owners. N Engl J Med. 1989;320(3):183.

Goossens HA, van den Bogaard AE, Nohlmans MK. Dogs as sentinels for human Lyme borreliosis in the Netherlands. J Clin Microbiol. 2001;39(3):844-8. PubMed

Cisak E, Chmielewska-Badora J, Zwoliński J, Wójcik-Fatla A, Polak J, Dutkiewicz J. Risk of tick-borne bacterial diseases among workers of Roztocze national park (southeastern Poland). Ann Agric Environ Med. 2005;12(1):127-32.

Skinner-Taylor CM, Flores MS, Salinas JA, Arevalo-Niño K, Galán-Wong LJ, Maldonado G, et al. Antibody profile to Borrelia burgdorferi in veterinarians from Nuevo León, Mexico, a non-endemic area of this zoonosis. Reumatologia. 2016;54(3):97-102. PubMed

Ekerfelt C, Forsberg P, Svenvik M, Roberg M, Bergström S, Ernerudh J. Asymptomatic Borrelia-seropositive individuals display the same incidence of Borrelia-specific interferon-gamma (IFN-gamma)-secreting cells in blood as patients with clinical Borrelia infection. Clin Exp Immunol. 1999;115(3):498-502. PubMed