title: Evidence for Lyme disease in urban park workers: a potential new health hazard for city inhabitants.
abstract: In the UK, cases of Lyme disease have only been reported from rural areas. Recently, however, Ixodes ticks infected with Borrelia burgdorferi have been found in London parks. To determine whether this constituted a health hazard, we questioned 44 workers from Richmond and Bushey parks to assess their exposure to tick bites and whether they had a clinical history of Lyme disease. Their serum was subsequently investigated for antibodies to two different preparations of Borrelia burgdorferi (whole cell sonicate and flagellin) and the specificity of these antibodies determined by immunoblotting. Comparison was made to zoo keepers (n = 27) from a wildlife park outside London. Tick bites were reported in 23% of park workers and of these, three described symptoms compatible with Lyme disease. Raised antibody levels were found in 10 (24%) of the park workers compared with one (4%) of the zoo keepers using ELISA with whole cell sonicate as antigen (P = 0.02) and 6 (14%) of park workers and none of the zoo keepers using purified flagellin as antigen (P < 0.05). Analysis of the immunoblots revealed more bands were detected in park workers (mean 1.8, range 0-6) than in the zoo keeper controls (mean 0.8, range 0-4); P < 0.001 and 14 (32%) of the park workers had reactivity with three or more protein bands, whilst only one of the zoo keepers showed this level of antigen binding (P < 0.005). These data suggest previous infection with B. burgdorferi in London park workers which has important health implications for these individuals, other park workers and possibly park visitors.
authors.affiliation: Division of Immunology, St George's Hospital Medical School, University of London.
authors.forename: D H
authors.initials: DH
authors.lastname: Rees
authors.forename: J S
authors.initials: JS
authors.lastname: Axford
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000032:analysis / Q000276:immunology; D015748:Borrelia burgdorferi Group / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D015151:Immunoblotting; D015994:Incidence; D008131:London / Q000453:epidemiology; D008193:Lyme Disease / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D016272:Occupational Health; D012217:Rheumatoid Factor / Q000032:analysis / Q000276:immunology; D014208:Treponema / Q000276:immunology; D014504:Urban Health; D014505:Urban Population
chemical_list: D000907:Antibodies, Bacterial; D012217:Rheumatoid Factor