Int J Food Microbiol. 1991 Dec; 14(3-4): 247-60.

Borrelia burgdorferi: another cause of foodborne illness?

Farrell GM, Marth EH.

Department of Food Science, University of Wisconsin-Madison 53706.

Borrelia burgdorferi was identified as the etiological agent of Lyme disease in 1982. This Gram-negative spirochete is classified in the order Spirochaetales and the family Spirochaetaceae. The pathogen is fastidious, microaerophilic, mesophilic and metabolises glucose through the Embden-Meyerhof pathway. A generation time of 11 to 12 h at 37 degrees C in Barbour-Stoenner-Kelly medium has been reported. Lyme disease, named after Lyme in Connecticut, is distributed globally. It is the most commonly reported vector-borne disease in the United States, where the incidence is highest in the eastern and midwestern states. Since establishment of national surveillance in 1982, there has been a nine-fold increase in the number of cases reported to the U.S. Centers for Disease Control. The deer tick of the genus Ixodes is the primary vector of Lyme borreliosis. The tick may become infected with B. burgdorferi, by feeding on an infected host, at any point in its 2-year life cycle which involves larval, nymphal and adult stages. The infection rate in deer ticks may be as high as 40% in endemic areas. The primary vertebrate reservoirs for Ixodes are the white-footed mouse (Peromyscus leucopus) and the white-tailed deer (Odocopileus virginianus). Dairy cattle and other food animals can be infected with B. burgdorferi and hence some raw foods of animal origin might be contaminated with the pathogen. Recent findings indicate that the pathogen may be transmitted orally to laboratory animals, without an arthropod vector. Thus, the possibility exists that Lyme disease can be a food infection. In humans, the symptoms of Lyme disease, which manifest themselves days to years after the onset of infection, may involve the skin, cardiac, nervous and/or muscular systems, and so misdiagnosis can occur.

Detection of Borrelia burgdorferi DNA by polymerase chain reaction in the urine and breast milk of patients with Lyme borreliosis.

Diagnostic Microbiology and Infectious Disease, March 1995

Diagn Microbiol Infect Dis. 1995 Mar; 21(3): 121-8.

Detection of Borrelia burgdorferi DNA by polymerase chain reaction in the urine and breast milk of patients with Lyme borreliosis.

Schmidt BL, Aberer E, Stockenhuber C, Klade H, Breier F, Luger A.

Ludwig Boltzmann Institute for Dermato-Venerological Serodiagnosis, University of Vienna, Austria.

Current laboratory diagnosis of Lyme borreliosis relies on tests for the detection of antibodies to Borrelia burgdorferi with known limitations. By using a simple extraction procedure for urine samples, B. burgdorferi DNA was amplified by a nested PCR with primers that target the specific part of the flagellin gene. To control possible inhibition of the enzyme (polymerase), a special assay using the same primers was developed. We examined 403 urine samples from 185 patients with skin manifestations of Lyme borreliosis. Before treatment, B. burgdorferi DNA was detected in 88 of 97 patients with Lyme borreliosis. After treatment, all but seven patients became nonreactive. Six of these seven persons suffered from intermittent migratory arthralgias or myalgias, and one from acrodermatitis chronica atrophicans. Two of 49 control patients with various dermatologic disorders and none out of 22 presumably healthy persons were reactive in the PCR. In addition to urine, breast milk from two lactating women with erythema migrans was tested and also found reactive. Borrelia burgdorferi DNA can be detected with high sensitivity (91%) by a nested PCR in urine of patients with Lyme borreliosis. In addition, this test can be a reliable marker for the efficacy of treatment.

Lyme disease--another transfusion risk?

Transfusion, September 1989

Transfusion. 1989 Sep; 29(7): 646-5.

Lyme disease--another transfusion risk?

Aoki SK, Holland PV.

Sacramento Medical Foundation Blood Center, California.

Lyme disease (or Lyme borreliosis) is caused by a spirochetal bacteria, Borrelia burgdorferi. Increased recognition of the disease and increased exposure to the vector (ticks) capable of spreading B. burgdorferi from animal hosts have resulted in a rise in the number of cases of Lyme borreliosis reported in the United States. There are three stages of the clinical course of Lyme borreliosis; however, not all those infected will have typical manifestations of each stage, such as the arthritis of the third stage. Routine blood cultures will rarely document bacteremia and serologic testing is not yet reliable. Early treatment can prevent later stages of Lyme borreliosis. There is evidence that transmission of B. burgdorferi by blood transfusion is possible, but, to date, there has been no documentation of transfusion-associated Lyme borreliosis. Thus, no new recommendations for screening donors to identify possible carriers of B. burgdorferi are suggested at this time.

Borrelia burgdorferi: survival in experimentally infected human blood processed for transfusion.

Journal of Infectious Diseases, August 1990

J Infect Dis. 1990 Aug; 162(2): 557-9.

Borrelia burgdorferi: survival in experimentally infected human blood processed for transfusion.

Johnson SE, Swaminathan B, Moore P, Broome CV, Parvin M.

Meningitis and Special Pathogens Branch, Centers for Disease Control, Atlanta, Georgia 30333.

The isolation of Borrelia burgdorferi from blood raises the possibility of bloodborne transmission of Lyme borreliosis through transfusions. To assess this possibility, the ability of B. burgdorferi to survive in human blood processed for transfusion was studied. Human blood was inoculated with B. burgdorferi type strain B-31 (ATCC 35210) at 0.2, 20, or 2000 viable cells/ml, processed by conventional blood banking procedures, stored at 4 degrees C, and cultured for B. burgdorferi at 12, 23, 36, and 48 days of storage. After processing, most B. burgdorferi were found in the packed cell fraction. At inoculum levels of 20 or 2000 viable cells/ml, B. burgdorferi survived in processed blood through 48 days of storage at 4 degrees C. B. burgdorferi was isolated from packed cells after 36 days of storage at 4 degrees C even when the initial inoculum level was as low as 0.2 cells/ml. The data demonstrate that B. burgdorferi can survive the blood processing procedures normally applied to transfused blood in the USA. Since hematogenous spread of the spirochete seems to occur early in the illness, primarily in symptomatic patients, the risk of transfusion-associated Lyme disease may be small. However, the possibility of survival of B. burgdorferi under blood banking conditions warrants a heightened awareness of this potential problem.

Longitudinal study of Lyme borreliosis in a high risk population in Switzerland., Parasite, December 1998

Parasite. 1998 Dec; 5(4): 383-6.

Longitudinal study of Lyme borreliosis in a high risk population in Switzerland.

Zhioua E, Gern L, Aeschlimann A, Sauvain MJ, Van der Linden S, Fahrer H.

Department of Parasitology, University of Neuchatel, Switzerland.

Orienteers from all parts of Switzerland (n = 416) were included in a longitudinal study for Lyme borreliosis. In spring 1986, the seroprevalence was 28.1%. At the beginning of the study, 84.3% of orienteers reported a history of tick bite, and 3.8% reported a past history of Lyme borreliosis. During the first (spring 1986-autumn 1986), second (autumn 1986-spring 1987) and third (spring 1987-autumn 1987) period, rates of seroconversion were 0.6%, 2.7% and 2.1% respectively. During the first and second period, clinical incidence were 1.0% and 0.25% respectively. No active Lyme borreliosis was detected during the third period. Among orienteers who seroconverted during the study (n = 16), only two developed clinical symptoms. Hence, Borrelia burgdorferi infection is often asymptomatic.

Lyme arthritis in a 12-year-old patient after a latency period of 5 years.

Infection, September 1999

Infection. 1999; 27(4-5): 286-8.

Lyme arthritis in a 12-year-old patient after a latency period of 5 years.

Albert S, Schulze J, Riegel H, Brade V.

Institute Med. Microbiology, University Hosptial Frankfurt, Frankfurt/M., Germany.

Lyme arthritis (LA) may be confused with other rheumatic diseases, particularly in the absence of a history of erythema migrans (EM). We report the case of a 12-year-old patient who developed a large effusion of the right knee joint. The titer for antinuclear antibodies was 1:80 and the test for rheumatoid factor was negative. Investigations for antibody response to Borrelia burgdorferi demonstrated remarkable elevation of IgG antibody and no specific IgM response.These results were confirmed by immunoblotting reactivity with the bands p83/100, p58, p43, p41, p39, OspA, p30, OspC, p21, and p17. We subsequently learned that the child had suffered a tick bite followed by an EM 5 years earlier and had been treated with trimethoprim/sulfamethoxazole at that time. The patient now was given intravenous ceftriaxone, 2 g daily for 14 days. In the absence of clinical improvement 3 weeks later a knee joint aspiration was performed which resulted in a positive polymerase chain reaction (PCR) test for B. burgdorferi DNA (OspA) in the synovial fluid.The patient fully recovered 2 months later without further treatment. The case indicates that the latency period between EM and onset of LA may last up to 5 years. In addition to serologic test methods, analysis of synovial fluid using PCR may be decisive for making the final diagnosis of LA.

Activation of latent Lyme borreliosis concurrent with a herpes simplex virus type 1 infection.

Scandinavian Journal of Infectious Disease, December 2002

Scand J Infect Dis. 2002; 34(12): 922-4.

Activation of latent Lyme borreliosis concurrent with a herpes simplex virus type 1 infection.

Gylfe A, Wahlgren M, Fahlen L, Bergstrom S.

Department of Molecular Biology, Umea University, Umea, Sweden

The case is reported of a 26-y-old woman with latent Lyme borreliosis that was concurrently activated with a herpes simplex virus type 1 infection. Immune suppression by stress may have caused activation of both infections.